10A NCAC 09 .0304 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 110-102 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/18/2025 Number Present: 6 Completed Date: 6/18/2025 Age: From 6 To 10 Total Minutes: 240 Time In: 10:30 AM Time Out: 02:30 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. Due to connectivity issues, a typed version 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. A computer generated version will be email to you within 24 hours. Ms. Pam Shuford, program coordinator/group leader, was available to answer/ask questions throughout 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. Staff and training worksheet was checked at the sister center on 6/5/25. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-nine (89%) percent as of 6/16/25. 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 6/16/25. Permit type – Five star license issued on October 3, 2023. Special Services/Restrictions – Day time care only, no cooking allowed in building, school age children only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/3/24. The last fire drill was practiced on 5/30/25. The last shelter-in-place drill was practiced on 4/1/25. The last playground inspection was documented on 6/5/25. The last fire inspection was approved on 5/19/25, which was four months past due. The last sanitation inspection was conducted on 1/8/25 with zero (0) 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 was completed and is being reviewed by RTI. During today’s visit, I greeted Ms. Shuford and explained the purpose of today’s visit. This is the second annual compliance visit this year due to the fiscal year and the due date. When I arrived, the children were playing in centers. Ms. Shuford stated that they go outside early before it gets too hot since two of their shade trees fell during tropical storm Helene and there isn’t a lot of shade now. Lunch is brought over by the owner or administrator from the sister center. While I was inspecting the playground, lunch arrived ad children were eating when I came back inside. Lunch today consisted of hot dogs on bread, baked beans, tomatoes, cucumbers, cantaloupe and milk. After lunch and cleaning up, the group walked down the hall to the bathroom. When returning to the classroom, they began transitioning to rest time. 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) 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. GS 110-102 608 Children did not wash their hands upon arrival at the center, after each visit to the toilet, before eating, before and after water activity play, after outside play, and after handling animals or animal cages. When observing the children during a bathroom break, more than one child came out without washing their hands. 15A NCAC 18A .2803(c) 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. .0605(j) 717 Surfacing did not extend six (6) feet beyond the external limits of the equipment or 3 feet for equipment used only by children less than 2 years of age. The fall-zone for the monkey bars needs to be extended and more surfacing added. .0605(l)(1-2) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The black tubing is meant to be on top of the fence to make the fench height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. GS 110-91(6); .0605((i) 901 A written copy of the discipline policy was not provided and/or explained to each child’s parent, at the time of enrollment by the person who conducted the enrollment conference. Notice of the discipline policy was not in one of the children’s files monitored today. .1804(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. Notice of smoking/tobacco restriction was not in the two children’s files monitored today. .0604(j) 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. I recommended that she add this to her calendar or a reminder in her phone to contact them a couple of months ahead of schedule. Item #608 Handwashing- When observing the children during a bathroom break, more than one child came out without washing their hands. Item #824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The black tubing is meant to be on top of the fence to make the fence height taller. Even after I moved the plastic tubing up, the lower corner only measured 3 feet 10 inches tall. The lower corner area may need to be dug out to make the fence the correct height. Item #716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There was one to two inches of rubber mulch on top of shredded bark mulch. When changing the type of mulch from bark mulch to rubber mulch, all of bark mulch must be removed first. Additionally, there was dirt and grass combined with the mulch located within the fall zones. Item #717 Surfacing did not extend six (6) feet beyond the external limits of the equipment. For stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The fall-zone for the monkey bars needs to be extended and more surfacing added. Item #1851 Notice of smoking/tobacco restriction was not in the two children’s files monitored today. Item #901 Notice of the discipline policy was not in one of the children’s files monitored today. Item #114 Notice of the summary of the NC Child Care Law was not in one of the children’s files that was monitored today. 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. 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 July 2, 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: • When children sit at the picnic tables on the playground, I would suggest having some towels for them to sit on since the material is black it gets very hot. • Check the boards where a possible sandbox may have once been for broken or splintered boards. Or create another sandbox. Children love to play in sand. It is very calming and there isn’t a right or wrong way to play with it, • Depending on the time of day, I don’t think the one tree gives enough shade, so you may need to add a sun sail or canopy tent. • Try looking up some interesting ways to use the leftover stumps from where the trees were. 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 .0102 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 7/3/2024 Number Present: 9 Completed Date: 7/3/2024 Age: From 6 To 12 Total Minutes: 300 Time In: 10:30 AM Time Out: 03:30 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 Abigayle Crowe, group leader, during the visit. A signed copy of the visit summary was left on-site and is available to be electronically emailed to you upon request. During today’s visit, Louise Renfro, owner/operator, came to the center to assist me. 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 eighty-nine percentage (89%) as of 207/02/24. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Cooperation, Jack and Jill Children Center, LLC, is current/active as of 07/02/24. This is a school age program with a permit type of- Five Star License issued on 10/03/23. Special Services/Restrictions – Daytime care only, no cooking allowed, school age only, meeting enhanced space and enhanced ratios. The last annual compliance visit was conducted on 07/17/23. The last fire drill was practiced 5/30/24. This is past due, so the building manager was called. She said she was out sick last week and plans to do a fire drill this afternoon. The last shelter-in-place drill was practiced 1/17/24. Since Ms. Crowe is new to this position, we conducted a shelter in place and a lock down drill today 7/3/24. The last playground inspection was documented on 3/28/24. This is three (3) months past due. The last fire inspection was approved on 1/9/24. The last sanitation inspection was conducted on 08/03/23 with five (5) demerits for superior classification. The Emergency Medical Care plan was posted and current. Upon my arrival, the children were outside on the playground. I started my visit by introducing myself to Ms. Crowe and explaining the reason for today’s visit. I monitored the playground while the group was outside explaining the process. Ms. Renfro, owner/operator, arrived as I was finishing outside. We went inside and I observed a group activity. This week they are studying ocean animals. The children were telling me about a painting activity that they did earlier this morning. Ms. Renfro and I assisted in a shelter in place drill and a lock down drill. Children went to the bathroom down the hall to wash hands and lunch was transported over from Jack and Jill Daycare Center by the director, Rachael Byles. Lunch today consisted of spaghetti with red sauce and parmesan cheese, mixed vegetables, banana, whole wheat bread and milk. After lunch, children assisted in cleaning up and washing the tables. They settled down with blankets and pillows on the rug to watch the movie “A Turtles Tale; Sammy’s Escape to Paradise”, to go along with their ocean theme. Children are free to find a spot in the classroom to talk, play games and a couple of children actually do fall asleep. 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 805 Fire drills were not practiced monthly and/or the drill record was incomplete. A fire drill was not conducted in June 2024. .0604(t); .0302(d)(5) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was last conducted in March 2024. This is three (3) months past due. .0605(q) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. An emergency drill has not been conducted since January 2024. .0604(u);.0302(d)(8) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Two prescribed medications had permission slips that had exceeded the six months and should be updated. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance was provided as follows: Items # 805 and 1811 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (5) records of monthly fire drills documenting the date and time of each drill, the length of time taken to evacuate the building, and the signature of the person who conducted the drill as required by NC Fire Code 405.5; A copy of the form may be found on the Division's website. Note: A fire drill was not conducted in June 2024. (8) records of lockdown or shelter-in-place drills as defined in 10A NCAC 09 .0102, giving the date each drill was held, the time of day, the length of time taken to get into designated locations and the signature of the person who conducted the drill. A copy of the form may be found on the Division's website. Note: An emergency drill has not been conducted since January 2024. This was corrected during the visit by conducting a lock down drill and a shelter in place drill. Item #859 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (q) Following completion of playground safety training as required by Rule .1102(e) of this Chapter, a monthly playground inspection shall be conducted by an individual trained in playground safety requirements. A trained administrator or staff person shall make a record of each inspection using a playground inspection checklist provided by the Division. The checklist shall be signed by the person who conducts the inspection and shall be maintained for 12 months in the center's files for review by a representative of the Division. The playground inspection checklist may be found online at https://ncchildcare.ncdhhs.gov/providers/credent.asp. The playground inspection includes a checklist of items related to safety, surfacing, and equipment quality. Note: A playground inspection was last conducted in March 2024. This is three (3) months past due. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions, such as asthma, and for allergic reactions. The authorization shall be in writing and shall contain: (a) the child's name; (b) the subject medical conditions or allergic reactions; (c) the names of the authorized over-the-counter medications; (d) the criteria for the administration of the medication; (e) the amount and frequency of the dosages; (f) the manner in which the medication shall be administered; (g) the signature of the parent; (h) the date the authorization was signed by the parent; and (i) the length of time the authorization is valid, if less than six months. Note: Two prescribed medications had permission slips that had exceeded the six months and should be updated. 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 July 17, 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 what plants are poisonous. • We discussed the fence in the bottom left corner that collects the mulch when it washes down, which in turn causes the fence to become too short. Ms. Renfro, dug out the mulch from the corner today. • We discussed that the mulch needs to be fluffed so that it isn’t compacted and hard and measured a minimum of six inches deep. • We discussed how to update the Emergency Preparedness and Response Plan (due 7/17/24). • We discussed the best place to take the children for a lock down and shelter in place, may be the office since there are no windows. • We discussed that the playground inspections need to be conducted by someone who has had the Playground Safety Training. • We discussed that even though I checked Abigayle’s file at Jack and Jill Daycare Center during my visit earlier this week, her file needs to be on site at this facility where she is working. • It might be a good idea to designate a helper (the oldest child) to show them Ms. Abigayle’s emergency information and how to call 911 if something happens. • Since there is only one adult at this facility, I told Abigayle to ask for a bathroom break when someone comes over to bring lunch and give medicine. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any 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@d 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236 or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0605 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 .2703 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/7/2024 Number Present: 5 Completed Date: 3/7/2024 Age: From 10 To 12 Total Minutes: 120 Time In: 02:30 PM Time Out: 04:30 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. Jack & Jill School Age Program, operates with a Five (5) Star Rated License issued to the owner, on 10/3/23. Nikki Trivette, Lead Teacher/Program Coordinator, was available to assist with questions during todays visit. The program’s annual compliance visit was conducted on 7/17/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During today’s visit, I observed children arriving to the facility by bus and by car. The snack today was “the white basket” which has a variety of snacks for children to choose from. Today’s choices were animal crackers, cheese-its or fig bars. Children also had a banana and water. There has been no new staff hired since the last annual compliance visit. Fire drill was monitored during today’s visit on 2/29/24. The last emergency drill, shelter in place drill, was practiced on 1/17/24. The last fire inspection was approved on 1/9/24. The program’s most recent sanitation inspection was completed on 8/3/23, with five (5) demerits. The Emergency Preparedness and Response plan is current as of 7/17/23. The last playground inspection was completed on 2/29/24. The Emergency Medical Care Plan is posted and current. The following violations of child care requirements were observed today: 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. A fire inspection was completed on 12/15/22 and again on 1/9/24. This is longer than twelve (12) months. The inspection was received by the child care consultant during a routine unannounced visit on 3/7/24. Therefore, the operator did not submit the fire inspection within one week. 10A NCAC 09 .0304(a) 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. There are places where the fence surrounding the playground does not measure at least four (4) feet high. GS 110-91(6); .0605((i) 1041 Prior to employment a Criminal Background Check was not completed. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) 1757 A valid qualification letter was not on file and available to review at the facility. A therapist who pulled a child out of the classroom for services, does not have a qualification letter on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance for Correction Plan: Item #0824 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: There are places where the fence surrounding the playground does not measure at least four (4) feet high. Item #1041 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. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Item #1757 10A NCAC 09 .2703 CRIMINAL HISTORY RECORD CHECK REQUIREMENTS FOR CHILD CARE PROVIDERS (e) Child care providers shall have a valid qualification letter prior to employment or living in the family child care home, and the qualification letter shall be kept on file at the facility for review by representatives of the Division. Note: Therapist, Jon Brett, who pulled a child out of the classroom for services, does not have a qualification letter on file. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 12/28/2022. 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: Today, we discussed the following: • Today, Ms. Trivette and I walked the perimeter of the playground and discussed the piled-up leave and such that is the partial cause of the fence to measure low. However, I dug out the leaves in the corner and it is still measuring too low. We looked at one section where the fence was broken causing it to measure lower. • We discussed that anyone left along with children (including therapists), must go through our criminal background check process. The therapist left his name, number and email address so you can let him know what his next steps should be. • We discussed the fire inspection and how that must be mailed to me within one week. In this case, it could be easy for the director to send one and not for both sites. • There is an updated version of the summary of the law that can be found on our website. • The much was deep enough but very compacted due to the weather so it should be fluffed. 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. 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 Jaime Kinner, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. 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 .0302 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 .0304 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 .0607 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 .1104 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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 & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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

GS110-91 · Violation

Name of Operation: JACK & JILL SCHOOL AGE PROGRAM Facility ID: 61000059 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 7/17/2023 Number Present: 6 Completed Date: 7/17/2023 Age: From 6 To 11 Total Minutes: 180 Time In: 09:35 AM Time Out: 12:35 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 Karla Terry, Child Care Consultant, and also signed by Nikki Trivette, Lead Teacher/Program Coordinator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. Nikki Trivette, Lead Teacher/Program Coordinator was on-site and available during the visit. Louise Renfro, Owner brought over the staff file from the other site. 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 eighty-eight percentage (88%) 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 – Five (5) Star Rated License, issued 7/2/2018. Special Services/Restrictions – First Shift (daytime care), no cooking allowed, school age only, meets enhanced ratios, meets enhanced space. The last annual compliance visit was conducted on 7/20/2022. The last fire drill was practiced on 6/29/2023. The last lockdown place drill was practiced on 4/6/2023. The last playground inspection was documented on 6/14/2023. The last fire inspection was approved on 12/15/2022. The last sanitation inspection was conducted on 6/1/2022 with four (4) demerits for a superior classification. The facility has attempted to contact the inspector, but a current inspection has not been conducted. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan is was not on-site and current. The plan on site is dated 7/11/2022. Upon arrival, I introduced myself to the Lead Teacher and Program Coordinator. I observed the group of six- to eleven-year-old children were engaged in building with legos, racing cars in the block center, and making bracelets. During free choice centers, the group lined up to transitioned to the restroom and return back to the classroom to continue free choice center play. After free choice center play, the group transitioned outdoors for gross motor play. Staff actively supervised the children while engaging in conversations. All staff interactions were positive and nurturing. The lunch today was mac and cheese, green beans, tropical fruit, bread, 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 following violations were documented during today’s visit: Violation Number Comment Rule 104 Center has not passed required sanitation inspection and received an approved or superior rating. The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 10A NCAC 09 .0304(b) 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. GS 110-91(6); .0605((i) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. 10A NCAC 09 .0302(d)(2) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. .0607(e) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. .0607(f) 1902 The professional development plan was not reviewed annually. Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. .1104 Technical assistance was provided as follows: Item # 104 Center has not passed required sanitation inspection and received an approved or superior rating. 10A NCAC 09 .0304 ON-GOING REQUIREMENTS FOR A LICENSE (b) Each center shall be inspected annually by an Environmental Health Specialist and receive an approved or superior rating in accordance with applicable sanitation requirements adopted by the Commission for Public Health as described in 15A NCAC 18A .2800. -The sanitation inspection was not conducted annually by an Environmental Health Specialist. The previous inspection on file is dated 6/1/2022. A current sanitation inspection was due by 6/30/2023. 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. -The fence height to the right of the outdoor play space measured three (3) foot nine (9) inches to three (3) foot ten (10) inches. The bottom left corner measured three (3) foot seven (7) inches. This is a repeat violation. 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. - Staff member NT hired 8/9/2012 did not have a current annual staff evaluation on file for review. 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. -Child SS enrolled 9/10/2019 application for enrollment was not updated annually. The application on file was last updated on 10/29/2020. Item 1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 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. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. -Child SS enrolled 9/10/2019 health assessment was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care; - Child SS enrolled 9/10/2019 immunizations was not completed within twelve (12) months prior to enrollment or thirty (30) days after enrollment. The health assessment on file was dated 9/11/2017. Item 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. -Emergency Preparedness Response Plan (EPR) was not reviewed annually. The EPR plan on file is dated 7/11/2022. Item 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (f) All staff shall review the center's Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. -Staff NT hired 8/9/2012 did not have documentation of the annual review of the center’s Emergency Preparedness and Response plan on file for review. Item 1902 The professional development plan was not reviewed annually. 10A NCAC 09 .1104 PROFESSIONAL DEVELOPMENT PLAN All center administrators and staff members shall complete a professional development plan within one year of employment and review the plan annually. The plan shall: (1) document the individual's professional development goals; (2) be appropriate for the ages of children in their care; (3) include the continuing education, coursework, or training needed to meet the individual’s planned goals; (4) be completed by the administrator and staff member in a collaborative manner; and (5) be maintained in their personnel file. -Staff member NT hired 8/9/2012 did not have a current professional development plan on file for review. 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 7/31/2023. 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 1 with a year of preparation beginning 7/1/2023 and ending 6/30/2024. Then a year for the assessments to be conducted beginning 7/1/2024 and ending 6/30/2025. - Health assessments and immunizations must be submitted within thirty (30) days of enrollment. The health assessment and immunizations must be current and completed within twelve months of the date of enrollment or thirty (30) days after admission. - The staff members working on site should have a current and up to date file on site and available at this location for review. - Professional Development plans and staff evaluations are due yearly and should be on file for review. 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