10A NCAC 09 .0604 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/5/2025 Number Present: 43 Completed Date: 6/5/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site (and/or electronically emailed upon request) with you. When I arrived, I was greeted by Ms. Annika, floater in charge. She called Louse Renfro, owner/operator who lives nearby and was visiting with family. Rachael Byles, administrator, arrives at 11:00 am each day. Today, Ms. Renfro accompanied me during my walkthrough. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percent as of 6/4/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability, Jack and Jill Children Center, LLC, is current/active as of 6/4/25. Permit type – Three Star License, issued on 10/3/23. Special Services/Restrictions – Daytime care only and meets enhanced ratios. The last annual compliance visit was conducted on 6/18/25. The last fire drill was practiced on 5/30/25. The last lock down drill was practiced on 4/28/25. The last playground inspection was documented on 5/50/25. The last fire inspection was approved on 5/19/25. The last sanitation inspection was conducted on 1/8/25 with four (4) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Lead water testing was completed on 3/30/25 without hazards. Lead paint and asbestos testing is being reviewed by RTI at this time. During today’s visit I observed six (6) classrooms in two (2) separate buildings during today’s visit. In space #1, I observed children playing on the floor, being rocked by their teacher, one was napping in their crib. I also observed children being fed a bottle and eating table food. In space #2 children were playing throughout the classroom with a variety of materials. I also observed the children singing songs in group with their teacher as well as rest time. In space #3, I observed children exploring their classroom materials during morning playtime as well as rest time. The top building consists of infants, toddlers, and two-year-old children. During rest time, the top building had plenty of natural light coming through the windows so that all children were easily visible. In the lower building, which consists of children two-years old up to school age. In space #4 I observed children playing in centers. They were coloring with crayons, playing with cars and a large wooden playhouse. In space #5 I observed children exploring in center play with magna-tiles, magnet tubes, plastic bugs and Play-Doh. In space #6, the school-age children were making hats, and they informed me they were learning about the Wild West. I also went back through and observed everyone at rest time to make sure they were properly spaced and easily visible. All teachers were up moving around the classrooms checking on children, asking if they wanted their backs rubbed and helping meet their needs. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. This inspection was 4 months past due. 10A NCAC 09 .0304(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Menu was available but not posted for parents to see. 10A NCAC 09 .0901(b) 811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. .0604(a) 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. Outlet in space #6 was uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. .2820(b) 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. Provider has been logging incidents but not filling out an incident report. .0802 (e) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. Staff P.S. did not have a current health questionnaire. .0701(a) 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. Staff P.S. did not have a current emergency information form filled out. .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff P.S., R.F., and A.R. have not completed the required number of training hours. .1103(a) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. Provider has not taken the ABCMS training to develop a roster G.S. 110-90.2 & .2703(r) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. .0605(k)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff K.R. was rehired and her above training was over 5 years old. .1102(g) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Staff P.S. has not renewed the health and safety training within the 5-year timeline. .1103(b) Technical assistance was provided as follows: Item #106 The operator did not schedule and obtained a fire inspection within 12 months of the previous inspection. *This inspection was 4 months past due. *Ms. Byles stated that they contacted the fire marshal several times to come out to complete this inspection. Item #1867 The depth of the loose surfacing was not based on critical height of the equipment. *The climber closest to the fence on the bottom playground did not have adequate depth of surfacing. The circular swing on the top playground did not have adequate depth of surfacing. *We discussed the recent rain and how mulch needs to frequently be raked back to the areas where children need cushioning. Item #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. *Outlet in space #6 was uncovered. *This was corrected during the visit. Item 1805 A child care operator did not notify the Division of any new child care providers who were hired or moved into the home within five business days. *Provider has not taken the ABCMS training to develop a roster. *Ms. Byles stated that she thought this was optional and not a requirement. Item #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. *Provider has been logging incidents but not filling out an incident report. *We went over the incident form and how to fill it out. Item #811 Potentially hazardous items including but not limited to power tools, nails, chemicals, propane stoves, lawn mowers, gasoline, or kerosene were not stored in locked areas, removed from the premises, or made inaccessible to children. *A storage shed door was ajar and unlocked. The shed contained a pressure washer, W-D40 and other hazardous materials. *Ms. Byles stated that she thought that it was locked. She will talk to Ms. Renfro about getting it locked. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. *Aerosol Lysol spray was unlocked in space #4. Hand sanitizer was lower than 5 feet, which is determined out of reach of children in space #4, 6 and at the entrance. Wet wipes that stated “keep out of reach of children” were in space #2. *All of these were corrected during the visit. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. *Staff K.R. was rehired and her above training was over 5 years old. *I discussed this requirement with Ms. Byles. Item #1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. *Staff P.S. has not renewed the health and safety training within the 5-year timeline. *I discussed this with Ms. Byles and told her that when renewing these training courses, the do count as training hours. Item #1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. *Staff P.S., R.F., and A.R. have not completed the required number of training hours. *We discussed whether staff could use the online training offered by Southwester CDC. Since there is a fee for these training courses, a group membership could be purchased allowing all staff to access training to be completed during rest time or paid planning time. Item #1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. *Staff P.S. did not have a current health questionnaire. *We discussed that this is required to be updated annually. Item #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. *Staff P.S. did not have a current emergency information form filled out. *We discussed that this is required to be updated annually. Item #526 Menus for meals and snacks were not current or posted where easily seen by parents. *Menu was available but not posted for parents to see. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. 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. 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 (Automated Background Check Management System) 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) 814-6401 and someone will assist you. 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 June 18, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall P.O. Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today we discussed: • Infant bottles need covers on them. If parent has lost covers, use a cup, foil or anything that will keep them sanitary. • Make sure the infant feeing plan are easily accessible for parents to update and dietary changes occur. • Make sure everyone has been trained in NC-FELD and is linking the goals to the activity plans. • Make sure all staff are training on how to fill out an activity plan. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1102 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/24/2025 Number Present: 30 Completed Date: 2/24/2025 Age: From 0 To 6 Total Minutes: 245 Time In: 10:15 AM Time Out: 02:20 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. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Ms. Louise Renfro, owner, and I explained the reason for my visit. Ms. Renfro accompanied me during my walkthrough of the facility. In the upper building, in space #1, there were two (2) infants were napping and one being fed a bottle. In space #2, the toddlers were all sitting together playing in the floor with their teacher. In space #3, the children were playing throughout the room with a variety of materials. The teacher was assisting some children that were thirsty to get water to drink. In the lower building, in space #4, the group of children were outside playing on the playground. Children were interacting with each other in pretend play, climbing, sliding other gross motor activities. In space #5, this group of children were also outside in the same space that group #4 was in. They were all playing and interacting together. Space #6, is for school age children so this classroom was not in use at the time of my visit. Space # 7 is used for a teacher resource/break room and cot storage. Lunch today consisted of fish sticks, mashed potatoes, applesauce and milk. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-six (76%) percentage as of 2/21/25. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, Inc, is current/active as of 2/21/25. There were one (1) new teacher at this facility today. This one (1) file was monitored today. There are seventy five (75) children enrolled and thirty (30) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/18/24. During Tropical Storm Helene, this facility was closed from September 27th to October 28th, 2024. They sustained very little damage, however the closing was primarily due to no power. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three-star license, effective 10/3/23 Permit Restrictions- Daytime care only, meets enhanced ratios. The last fire drill was practiced on 1/17/25. An emergency drill was conducted on 1/17/25. The last playground inspections was on 1/17/25. The last fire inspection was 1/9/24. They have been in contact with the fire marshal, however he told them he would get to them as soon as he could. Due to the current flexibilities due to Tropical Storm Helene, this will not be a violation during today’s visit. The last sanitation inspection was completed on 1/8/25 with four (4) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, the activity plan was not dated. GS 110-91(12); .0508(a) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, non of the bottles were dated. 15A NCAC 18A .2804(d) 541 The written feeding plan did not include the child's name, parent signature, and/or was not dated when received by the center. In space #1, a child's feeding plan was not signed by the parent. All feeding plans need to be updated. .0902(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep charts have not been maintained. .0606(g) 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 staff (RF) has an expired first aid certification. .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 staff (RF) has an expired CPR certification. .1102(d) Technical assistance: • One staff (RF) needs to renew the first aid and CPR certifications. • Sleep charts are not being maintained. We discussed using her phone to set a timer to remind her to check on the child and document that she did it. There are several forms on our website to choose from. • One feeding plan was not signed by the parent and several needed to be updated. • Bottle were labeled with the child’s names, but none were dated. • Activity plans need to have the current dates on them. We discussed the activity plan form on our website and how it is geared towards each child and what they are working on and these should be updated monthly. 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 March 10, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. • We discussed activity plans for infants and toddlers and how they are individualized and monthly. This will help teachers be able to work on specific items depending on the child’s needs. 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. Criminal Background Check System (ABCMS)- All child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 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. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-106 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/1/2024 Number Present: 49 Completed Date: 7/1/2024 Age: From 0 To 1 Total Minutes: 340 Time In: 10:50 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today's visit was to follow-up on a violation written during your annual compliance visit conducted on 6/18/24. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. A signed copy of today’s visit was left on site today. An electronic copy of the visit summary is available electronically upon request. Upon my arrival I explained to Ms. Byles and Ms. Renfro (owner/operator) the reason for my visit today. During today's visit, children were observed playing outside on the playground with gross motor activities. Children were observed being held, fed and rocked, as well as free play in the classrooms. There were children in small groups in centers. The children played with peers and asked for teacher assistance when needed. All caregiver interactions were positive. Materials were sufficient. Lunch today consisted of macaroni and cheese, green beans, fruit cocktail, bread and milk. The following violations of child care requirements were observed today: Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. 15A NCAC 18A .2804(d) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. The teacher in space #3 is seventeen years old. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff A.J. did not have enough annual training hours. .1103(a) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #1, there was a Monster energy drink can sitting out. .0901(i) Technical Assistance: Item # 1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. (b) On or before the first day of work, the operator shall verify the age of substitute providers and volunteers and documentation of the substitute provider or volunteer's date of birth shall be maintained in the individual's personnel file in the center. Age shall be verified with any official document that provides a date of birth, such as a driver's license or birth certificate. Note: The teacher in space #3 is seventeen years old. Item 1792 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) Staff shall role model appropriate eating behaviors by consuming only food or beverages that meet the nutritional requirements specified in Paragraph (a) of this Rule in the presence of children in care. Note: In space #1, there was a Monster energy drink can sitting out. If staff drink beverages other than water, it needs to be in an opaque container. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles of formula/milk in the refrigerator were not dated and one was not labeled with a name. Item #1052 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. Note: Staff A.J. did not have enough annual training 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 may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by July 15, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Item #303, 10A NCAC 09- .1801 Supervision in child care centers, was a violation that was cited during the last visit on 6/18/24 which required a follow up visit to check for compliance. During today’s visit, I discussed with the teacher in space #1 as well as Ms. Renfro, the severity of this violation. We discussed that the teacher will let the other teachers know when she has to step into the kitchen so that they can assist in supervision while she prepares a bottle. o If it is possible to prepare bottles ahead of time (make sure they are labeled and dated), when an extra person can assist. This violation was marked corrected during the consultant visit today. • During today’s visit, I saw that the staff bathroom where diaper bags are stored, is now locked with a lock and key method. This will prevent violations for the diaper creams and over the counter medications that parents have in the diaper bags. o Items #840, 841 and 849 These violations were marked corrected during the consultant visit today. • We discussed that it might be best to tell parents that you do not allow blankets at all. A parent had put a blanket in a child’s crib, however not children had napped during my observation. • I discussed with the teacher in space #2, that a child in her care that likes to walk around with a bottle hanging in the mouth, can’t do that. If a child is eating or drinking a bottle, they must be held, sitting at the table or in a high chair. o Caring for Our Children Resource regarding sitting while eating for safety https://nrckids.org/CFOC/Database/4.5.0.3 o Sanitation rule regarding completion of feeding: 15A NCAC 18A .2804 FOOD SUPPLIES (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration. Nothing in these Rules shall prohibit human milk from being sent home at the end of the day with the child whose name is on the label for the human milk instead of being discarded when the child's parent or guardian has given the child care center written permission to send the human milk home. • We discussed the need for a standing diaper change in the classroom for three-year-old children. You can find that poster at this website: https://healthychildcare.unc.edu/resources/posters/ Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0605 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2024 Number Present: 45 Completed Date: 6/18/2024 Age: From 0 To 11 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 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. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachael Byles, administrator, during the visit. An electronic signed copy of the visit summary was left on-site and can be electronically emailed to you upon request. Ms. Byles was present and available to my answer questions during the visit today, however she was also having to prepare lunch for the children. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-four (74%) percentage as of 6/17/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation for Jack and Jill Children Center, LLC, is current/active as of 06/17/24. There are ninety-three (93) children enrolled. Ten (10) children’s files were monitored today. The staff and training worksheet was not complete, therefore I was unable to check the staff files during today’s visit. A return visit will be made to check the staff files. Permit type – Three-star license, issued 10/3/2023. Special Services/Restrictions – Daytime care only, meets enhanced ratios. The last annual compliance visit was conducted on 7/12/23. The last fire drill was practiced on 5/30/24. The last lock down drill was practiced on 4/17/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 2/2/24 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. When I arrived, I saw that children were out on both the upper and lower playgrounds. As I entered the classrooms, the children had started coming inside. I started in space #4, where children were playing in centers. The children were very friendly and talkative to me. In space #5, the children were cooling off from being outside. They were also playing in centers with a variety of materials. In space #6 children were busy building with Legos in two small groups, while another group were drawing with art materials. In space #1, children were all hungry and tired. There were 2 in low high chairs, one on the floor, and two in bouncy seats. One child was being fed baby food. During my observation, other children were fed baby food and/or a bottle. In space #2, children were building with blocks, climbing on the table and gate. Children were redirected to not climb on the table or gate. In space #3, the children were tired and hungry. Some children were playing with a variety of materials, while others were seeking comfort from their teacher. Lunch today consisted of turkey sandwich on whole wheat bread, carrots, pears and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 303 Children were not adequately supervised at all times. Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. .1801(a)(1-5) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. 15A NCAC 18A .2804(d) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. 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. Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. .0803(12) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. .0606(g) 1043 All staff records, except financial records, were not made available for review. The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. G.S. 110-91( 9) 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. .0605(k)(1-4) Technical assistance was provided as follows: Item # 1043 § 110-91. Mandatory standards for a license All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (9) Records. – Each child care facility shall keep accurate records on each child receiving care in the child care facility and on each staff member or other person delegated responsibility for the care of children in accordance with a form furnished or approved by the Commission, and shall submit records as required by the Department. All records of any child care facility, except financial records, shall be available for review by the Secretary or by duly authorized representatives of the Department or a cooperating agency who shall be designated by the Secretary and shall be submitted as required by the Department. Note: The staff and training worksheet was not complete so that staff files could be monitored. Administrator stated that they were short staffed and that she has been cooking and giving breaks for weeks. Item #849 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. Note: Diaper creams found in two (2) diaper bags must be sent home or a permission slip filled out. This is a REPEAT violation. Items #840 and #841 15A NCAC 18A .2820 STORAGE b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: Zep disinfecting wipes that state “keep out of reach of children” were in Space #4 on a low shelf. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: A bottle of over the counter Afrin noes spray was found in a diaper bag and not locked up. This is a REPEAT violation. Items #824 and #1867 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: A section of the lower playground near the trike path (including the gate) was lower than the minimum four feet. (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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: Mulch at green slide, caterpillar climber, red slide and spring rocker on the lower playground as well as the red slide and circle swing did not measure at least six (6) inches deep. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: Bottles and sippy cups that were in the refrigerator in space #1, was not dated. This is a REPEAT violation. Item #303 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. Note: Children in space #1, was left alone while the teacher made a bottle. The door to the kitchen was open a small amount, but teacher could not see the children. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: Sleep checks were being documented on a pad of paper, however it did not state the position of the child and was not consistent in fifteen-minute (15) checks. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 2, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • Today we discussed informing parents that the center isn’t allowed to use blankets for infants (under thirteen [13] months). They are stored in a file bin above the crib and I saw that two had feel down into the crib. There wasn’t a child in the crib when the blanket was there, however they are at risk of falling down into the crib while a child is in the crib. • We discussed putting a lock on the bathroom door where children’s diaper bags are stored. Or inform parents that diaper bags are not to be brought to child care. • We discussed the possibility of cutting the kitchen door in half for staff to have easier access since the lock/key is so difficult. • The summary of the law that is posted need to be updated to the most current version. • I recommend that the new teachers take the NC Foundations for Early Learning Training so that they can connect the goals to their activity plans. The infant and toddler activity plans need to be individualized. See the form on our website. • When changes occur to the menu, make sure that you make those changes by writing it in. • There was a full bag and part of a second bag of trash out on the lower playground. • The children in space #2 was climbing on the table and on the gate. This is a climbing age, so having something inside to climb one would be helpful. • Make sure that children do not walk around with a bottle. We discussed today that the bottle is the same as food and should be done at the table. • The upper playground had recently been mowed and weed-eated. There was grass all over the toys. I suggest that the teacher take something out to wipe the grass off of the toys. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Your facility has been placed in cohort 2. Your prep year will be 7/1/24-6/30/25. Your reassessment year will be 7/1/25- 6/30/26. Please visit ncrlap.org to learn more about ways to prepare for the Environment Rating Scale assessments. We discussed the importance of ensuring all staff have their education evaluated by WORKS. 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 lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs. 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 . 0508 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0511 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-106 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 2/22/2024 Number Present: 41 Completed Date: 2/22/2024 Age: From 0 To 5 Total Minutes: 330 Time In: 10:00 AM Time Out: 03:30 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. Child care requirements monitored today included staff/child ratios, group sizes, supervision, general safety, emergency care plan, attendance records and sign-in/out forms, medication or other hazardous substances and emergency drills (fire, lockdown and shelter in place). The visit summary was reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Louise Renfro, owner/operator. The computerized generated report of today’s visit was completed on site and electronically emailed to Rachael Byles., administrator. Upon my arrival I greeted Louise Renfro, the owner, who was covering a classroom due to being short staffed. Rachael Byles, arrived later, but she also had to be in a classroom so that Ms. Renfro could prepare lunch. I explained to Mrs. Renfro the reason for my visit today as well as Ms. Byles when she arrived. In the lower building the children were observed during free play and table activities. Some children were building with Legos and others were exploring with plastic bugs and insects. I transitioned to the upper building and observed the younger children during free play in their classrooms. They did not go outside during my visit today. I returned to the lower building and proceeded to monitor the playground where all three classrooms in this building was outside riding on trikes, climbing, and exploring with acorns and pinecones. Lunch today consisted of turkey and cheese sandwich on whole wheat bread, diced pears, sliced carrots and milk. There were two new teachers at this facility today, and those staff files were monitored today. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Jack and Jill Children Center, LLC, is current/active as of 2/22/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Three (3) star license issued October 3, 2023. Permit Restrictions- Daytime care only, meeting enhanced ratios. The playground inspection was completed on 1/26/24. The last fire drill was practiced on 1/26/24. An emergency drill was conducted on 1/31/24. The last fire inspection was 1/9/24. The last sanitation inspection was completed on 2/2/24 with five (5) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #1, a current activity plan was not posted. GS 110-91(12); .0508(a) 491 Caregiver did not respond at the earliest opportunity to an infant or toddler’s physical and emotional needs. Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. .0511(b)(1) 498 For children under 2 years of age, a minimum of 30 minutes of outdoor time throughout the day either as part of a small group, whole group, or individual activity was not provided. During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. 10A NCAC 09 . 0508(c) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. In space #1, bottles were not dated. 15A NCAC 18A .2804(d) 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. In space #6, an outlet was left uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. .2820(b) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. In space #1, over the counter medications were found in diaper bags with no permission slips 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. Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. .0803(12) 1016 Someone less than 18 years old had responsibility for, or was left in charge of a group of children. A seventeen-year-old (17) was substituting in a classroom alone. GS 110-91(8); GS 110-106(e); 10A NCAC 09 .0703(a) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. New staff KM did not have a health questionnaire on file. .0701(a) 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. New staff KM did not have an emergency information form on file. .0701(a) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. .0605(k)(1-4) 1873 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with existing staff who care for children ages 0-5 within 30 days of adopting the policy. One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. .0608 (d) Technical assistance: Item #491 10A NCAC 09 .0511 DAILY ROUTINES FOR CHILDREN UNDER TWO YEARS OF AGE (b) The caregivers shall interact in a positive manner with each child every day, as follows: (1) caregivers shall respond at the earliest opportunity to an infant or toddler's physical and emotional needs, especially when indicated by crying, through actions such as feeding, diapering, holding, positive touching, smiling, talking, and eye contact; Note: Teacher is space #1, was holding an infant that was content, while other children were crying. I didn't observe her trying to see if the child was hungry, sleepy or wet to sooth and comfort the child. Items #840, 841 15A NCAC 18A .2820 STORAGE which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: In space #2, a diaper cream and hand sanitizer were stored below five (5) feet. (d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. Note: In space #1, over the counter medications were found in diaper bags with no permission slips and not locked. Item #1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. Note: The mulch on both upper and lower playgrounds did not measure six (6) inches deep. In some places it was down to the dirt. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: In space #6, an outlet was left uncovered. Item # 849 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. Note: Orajel was found in a diaper bag that staff didn’t know who it belonged to. Medicines found in diaper bags that do not have a parent authorization, should be sent home or discarded. Items #428 and 498 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. Note: In space #1, a current activity plan was not posted. (c) When children are in care and weather conditions permit, there shall be outdoor time, either as part of a small group, a whole group, or individual activity, for no less than the following durations: All Programs Under 2 years 30 Minutes Less than 5 hours 0-12 years 30 Minutes 5 hours or more 2-12 years 60 minutes Note: During my visit, none of the children in the top building went outside. This was infants, toddlers and two year old children. Item #1873 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. Note: One new staff KM, did not have the Shaken Baby and Abusive Head Trauma policy signed prior to caring for children. Items #1034 and 1035 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Emergency Information Form, including the name, address, and telephone number of the person to be contacted in case of an emergency, and the responsible party's choice of health care professional. On or before the first day of work. The emergency information shall be updated as changes occur and at least annually. Health Questionnaire A statement signed by the staff member that indicates that the person is emotionally and physically fit to care for children. Annually following the initial medical statement. Note: New staff KM did not have an emergency information form or health questionnaire on file. Item #533 15A NCAC 18A .2804 FOOD SUPPLIES (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day. Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Note: In space #1, bottles were not dated. Item #1016 10A NCAC 09 .0703 GENERAL STATUTORY REQUIREMENTS (a) Child care providers, substitute providers, and uncompensated providers counted toward meeting the staff/child ratio requirements set forth in Rule .0713 of this Section shall meet the requirements of G.S. 110-91(8). No one under 18 years of age shall have responsibility for or be left in charge of a group of children. Note: A seventeen year old (17) was substituting in a classroom alone. 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 March 7, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • In space #6, the Lego table needs to be cleaned. • In some classrooms, area rugs are curled on the corners which can cause a tripping hazard. If you sit something heavy on it after hours with a few ice cubes, it will help relax it back down. • It is extremely important that all children go outside daily. This will help reduce sickness as well as keep children happier. • There was a lot of tears in the upper building. It is important to seek to find out why the child is crying. Taking the children outside give them a change of scenery as well which can help reduce tears. • You may want to consider asking parents not to bring diaper bags to the center. Whatever they need at daycare can be left in their cubby. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0605 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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 .2204 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 8/28/2023 Number Present: 32 Completed Date: 8/28/2023 Age: From 0 To 4 Total Minutes: 255 Time In: 10:30 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Unannounced Visit Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced follow up visit was to follow up on violations that occurred during the last annual compliance visit follow up Louise Renfro, Owner, was on-site and available to assist with questions. Rachel Stafford, Administrator arrived at the same time as I did (10:30) and was available to assist with questions. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. During today’s visit, I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. I completed a walkthrough of each classroom. The following violations documented during the 7/12/2023 visit was monitored for compliance during this visit: The following repeat violation was documented today: Item 824- Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. The following repeat violation was documented today: Item 871 and 887- Center staff did not comply with the safe sleep policy. In space #1, a child was asleep in crib when I arrived to the classroom. During my entire walkthrough of three (3) classrooms, the teacher sat in the rocking chair holding a child while two (2) children were in highchairs in front of her. One was eating from a Bento box and the other had a bottle. There is a climbing area in the center of the room that is blocked off. A child was inside the climbing area. The asleep child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide clothes detergent was stored in an unlocked closet in the resource room. There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Violations requiring additional time for correction, must be addressed immediately to ensure a safe environment for the children in your care. This may require you to stop using part of a space/block it off, and/or make other modifications while waiting on repairs (mulch, fence) to be completed. Continued noncompliance may result in an administrative action per Child Care Rule 10A NCAC 09 .2204(6). The following violation was documented during today’s visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. .2820(b) 871 Center staff did not comply with the safe sleep policy. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. 10A NCAC 09 .0606(a) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. .0605(k)(1-4) Technical assistance was provided as follows: The following repeat violation was documented today: Item 824- 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Note: Outdoor play area was not enclosed by fence with a minimum height of 4 feet. I remeasured the both playground fence heights. Both had short areas where the fence was below 4 feet, but Ms. Renfro dug it out during my visit, and I remeasured it. There was a heavy rain the night before and Ms. Renfro stated that she always has issues with the mulch washing down the hill causing the fence to become shorter. This violation was corrected during today’s visit. However, we discussed that more rain is expected and there needs to be a long-term plan. Ms. Renfro stated that she did not want to add lattice or plastic tubing to the top due to it looking tacky. Item 871 and 887- 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: (1) specifies that caregivers shall place infants aged 12 months or younger on their backs for sleeping, unless: (A) for an infant aged six months or less, the center receives a written waiver of this requirement from a health care professional; or (B) for an infant older than six months, the center receives a written waiver of this requirement from a health care professional, or a parent or a legal guardian; (2) specifies no pillows, wedges or other positioners, pillow-like toys, blankets, toys, bumper pads, quilts, sheepskins, loose bedding, towels and washcloths, or other objects may be placed with a sleeping infant aged 12 months or younger; (3) specifies that children shall not be swaddled; (4) specifies that nothing shall be placed over the head or face of an infant aged 12 months or younger when the infant is laid down to sleep; (5) specifies that the temperature in the room where infants aged 12 months or younger are sleeping does not exceed 75° F; (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; (8) specifies that pacifiers that attach to infant clothing shall not be used with sleeping infants; (9) specifies that infants aged 12 months or younger sleep alone in a crib, bassinet, play pen, mat, or cot; (10) specifies that infants aged 12 months or younger are prohibited from sleeping in sitting devices, including car safety seats, strollers, swings, and infant carriers. Infants that fall asleep in sitting devices shall be moved to a crib, bassinet, play pen, mat, or cot; and (11) specifies any other steps the center shall take to provide a safe sleep environment for infants aged 12 months or younger. AND (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: a child was asleep in crib when I arrived in the classroom. During my entire walkthrough of three (3) classrooms, the sleeping child was on their side and a fifteen (15) minute visual check was not documented that it was conducted. During the visit, the sleep charts were not found to be in compliance. The teacher is a substitute in the classroom this week. No sleep charts could be found. These must be maintained for one month. The following repeat violation was documented today: Item #840 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Note: There was a lock on the door that looks similar to a gun or bicycle lock. I lifted it right off without the key. I showed Rachael the approved locks that need to be added to this area. Item 1867 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; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. ALSO: loose surfacing material, including wood mulch, double shredded bark mulch, uniform wood chips, fine sand, coarse sand, and pea gravel, except that pea gravel shall not be used if the area will be used by children under three years of age. Loose surfacing material shall not be installed over concrete; Note: On the lower playground, 6 inches of mulch or other approved surfacing should be added under climbers and in fall zones around slides. 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 September 11, 2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation is provided as follows: Today, we discussed the following: •We discussed the LLC on the Secretary of State website. Ms. Renfro updated the application today during my visit. •As of 8/28/23 the center’s compliance history is 76%. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-200-9952, 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 .0102 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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 .0302 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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 .0514 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: JACK AND JILL DAY CARE CENTER Facility ID: 61000050 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/12/2023 Number Present: 54 Completed Date: 7/12/2023 Age: From 0 To 10 Total Minutes: 322 Time In: 09:50 AM Time Out: 02:17 PM Time In: 04:05 PM Time Out: 05:00 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant, Dawn McCrary, Child Care Consultant, and also signed by Rachel Stafford, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Lousie Renfro, Owner and Rachel Stafford, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-five percentage (75%) as of 7/7/2023. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Jack and Jill Children Center, LLC, is current/active as of 7/7/23. Permit type – Three (3) Star Rated License, issued 1/4/2019 Special Services/Restrictions – First Shift (daytime care), meets enhanced ratios. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/27/2023. The last lockdown drill was practiced on 3/15/23. The last playground inspection was documented on 6/27/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/23/2023 with zero (0) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, we introduced ourselves to the school age teacher Haley Langlois. She stated that the Administrator does not arrive till 10:00a and the owner was at her home office. I asked that she call the owner to let her know that we are here. The owner arrived at 9:53a. We introduced ourselves and stated the reason for our visit. The administrator arrived at the facility at 10:15a. In space #6, the group of six- to ten-year-olds were engaged in free choice center play with dress up, scale and weights, cars, Lincoln logs, legos, and coloring. In space #5, the group of four- to five-year-old children were engaged in outdoor gross motor play with the trikes, little tikes climbers, metal boat, and metal fire truck. After gross motor play, the group transitioned indoors to wash hands and transition to free choice center play. In space #4, the group of two- to three -year-old children were engaged in outdoor gross motor play, the children engaged in play with the Little Tikes climbers, balls, slide, yellow bus, and red fire truck. In space #1, the group of infant and one year old children were going for a walk in the bye bye buggy. The group transitioned indoors for free choice play on the floor. In space #2, the group of two- year-old children were engaged in gross motor play engaged in play with the swings, running, climbing. In space #3, the group of one- to two-year-old children were engaged in gross motor play outdoors with the coupe cars, and swing. All caregiving interactions were positive and nurturing. The lunch today was turkey and cheese sandwich, carrots, pears, and milk. The staff and training worksheet was not completed and received prior to todays visit. The administrator stated that she had to work on it. I stated that I would need to receive the staff and training worksheet by 7/14/2023. Upon receipt and monitoring of the staff and training worksheet additional violations maybe documented. Today, we monitored and completed the staff and training worksheet for one (1) new staff file and three (3) existing staff files. There are eighty-three (83) children enrolled and eight (8) children’s files were monitored and the children’s record worksheet was completed 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 were documented during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. G.S. 110-91(14) 475 Sand and water play activities were not available weekly to each group. Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. .0510(c)(3) 705 Equipment and furnishings were not sturdy, stable and free of hazards. There are exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). .0601(c) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. GS 110-91(6); .0605((i) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Tide laundry detergent was stored in an unlocked closet in the resource room. .2820(b) 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 bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. .0604(q) 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. Staff member HL hired 2/23/23 medical report was not on file prior to employment. 10A NCAC 09 .0701(a) 1041 Prior to employment a Criminal Background Check was not completed. One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. G.S. 110-90.2(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Of the staff files monitored, zero (0) staff files contained an annual staff evaluation or staff development plan. 10A NCAC 09 .0514(f) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. Of the children's records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. .0802(c) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The last shelter-in-place or lockdown drill was practiced 3/15/23 .0604(u);.0302(d)(8) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. .1102(a) Technical assistance was provided as follows: Item # 108 The operator made an effort to falsify information. (14) Any effort to falsify information provided to the Department shall be considered by the Secretary to be evidence of violation of this Article on the part of the operator or sponsor of the child care facility and shall constitute a cause for revoking or denying a license to such child care facility. Item #824 was cited during a Routine Unannounced visit conducted by Karla Terry, Child Care Consultant on 1/5/23. An extension was requested and approved until 1/20/23. A letter of compliance, from the facility administrator, was received for the violation #824 on 1/20/23. During today's visit, the facility received a repeat violation for item #824. The administrator stated that the work needed to bring item #824 into compliance was actually not finished on 1/20/23 as stated in the letter, due to weather and an injury of the person doing the maintenance. Item # 475 Sand and water play activities were not available weekly to each group. 10A NCAC 09 .0510 ACTIVITY AREAS (c) Each center shall provide materials and opportunities for each group of children at least weekly, indoors or outdoors, for the following: (1) music and rhythm; (2) science and nature; and (3) sand and water play Sand and water play is not indicated on activity plans. The teachers stated that they do not usually have sand and water play. Item #705 Equipment and furnishings were not sturdy, stable and free of hazards. 10A NCAC 09 .0601 SAFE ENVIRONMENT (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. There were exposed footings and concrete on the playground space #3. This is a violation of a requirement in .0601(c). Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (i) The outdoor play area shall be protected by a fence. The height shall be a minimum of four feet and the top of the fence shall be free of protrusions. The requirement disallowing protrusions on the tops of fences shall not apply to fences six feet high or above. The fencing shall exclude fixed bodies of water such as ditches, quarries, canals, excavations, and fish ponds. Gates to the fenced outdoor play area shall remain closed while children occupy the area. Areas of the fence on outdoor spaces #1, #2 and #3 measure between 3ft 7inches to 3ft 10inches. This is a repeat violation. Item #840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. 15A NCAC 18A .2820 STORAGE (b) All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its 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, electronic or magnetic device, key, or equivalent locking device. These 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 product not listed above, which is labeled "keep out of reach of children" without any other warnings, shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. The 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. Tide clothes detergent was stored in an unlocked closet in the resource room. Item #858 bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. 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. Plastic bags were accessible to children in between spaces #1 and #2 and also in space #4. The bags were placed above 5 feet during the visit. Item #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. 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. Staff member HL hired 2/23/23 medical report was not on file prior to employment. Item #1041 Prior to employment a Criminal Background Check was not completed. "§ 110-90.2. Mandatory child care providers' criminal history checks. (b) Effective January 1, 1996, the Department shall ensure that, prior to employment and every three years thereafter, the criminal history of all child care providers is checked and a determination is made of the child care provider's fitness to have responsibility for the safety and well-being of children based on the criminal history. The Department shall ensure that all child care providers are checked for county, State, and federal criminal histories. (b1) The Department may prevent an individual from being a child care provider if the Department determines that the individual is a habitually excessive user of alcohol, illegally uses narcotic or other impairing drugs, or is mentally or emotionally impaired to an extent that may be injurious to children." One staff H.L., hired 2/23/23 did not complete a DCDEE Criminal Background Check prior to employment. This staff member was removed from the facility during the visit. Item #1232 Each employee’s personnel file did not contain an annual staff evaluation and a staff development plan. 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. Of the staff files monitored, zero (0) staff files had an annual staff evaluation or staff development plan on file. Item #1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. 10A NCAC 09 .0802 EMERGENCY MEDICAL CARE (c) Emergency medical care information shall be on file for each child. That information shall include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually. Of the children’s records monitored, the children S.LP; T.B.; R.B.; C.C. and A.E. have not had emergency medical care information updated at least annually. Item # 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (u) A "shelter in place drill" or "lockdown drill" as defined in 10A NCAC 09 .0102 shall be conducted at least every three months and records shall be maintained as required by 10A NCAC 09 .0302(d)(8). The last shelter-in-place or lockdown drill was practiced 3/15/23. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Staff member HL hired 2/23/23 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. Item #1898 Staff did not complete the health and safety training within one year of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (a) Child care administrators and staff members shall complete health and safety training within one year of employment, unless the staff member has completed the training within the year prior to beginning employment. Health and safety training shall be in addition to the new staff orientation requirements set forth in Rule .1101 of this Section. Staff A.R., hired 5/9/22 and A.P, hired 3/10/22 have not completed Health and Safety training. 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 7/26/2023. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@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: Today, we discussed the following: - Resuming Rated License- The facility is in cohort 2 with a year of preparation beginning 7/1/2024 and ending 6/30/2025. Then a year for the assessments to be conducted beginning 7/1/2025 and ending 6/30/2026. - We discussed how the compliance history is calculated. Ms. Renfro is concerned that this is an unfair system and would like to file a complaint to the Commission. We provider her with the contact information to file her complaint. - Criminal Background Check process- was discussed that new staff members must be completed prior to employment and the qualifying letter must be on file on or before the staff members first day of employment. - Medication Administration- the parents must be very specific the amount that needs to be applied to the child during each dose that is administer. If you have any questions or concerns regarding the Stabilization and Expansion Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. 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. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. 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 karla.terry@dhhs.nc.gov or 828-200-9952, 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