Cloverleaf Prime Time FOR Kids

10A NCAC 09 .0604 · Violation

Name of Operation: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 12/12/2025 Number Present: 18 Completed Date: 12/12/2025 Age: From 5 To 12 Total Minutes: 180 Time In: 02:00 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Amy Stevenson, Site Coordinator, assisted me with today’s visit. I conducted your last annual compliance visit on January 08, 2025. I reviewed with you today the facility information found in our system. You stated there have been no changes to your phone number, email address, mailing address, or corporate contact for the facility, Iredell-Statesville School System . I reviewed the facility’s permit with you today. I reviewed with you today the restrictions on your license, capacity, and age range on your permit and observed these being maintained. Your program’s compliance history was 94% as of December 11, 2025, and was reviewed with you today. Your program currently operates with a five-star license, issued on May 18, 2016, earning seven points in staff education, seven points in program standards, and one quality point. During today’s visit, we discussed the three QRIS Pathways to the Stars effective July 1, 2025. We covered enhanced ratios and space expectations, staff education including ensuring all staff have WORKS accounts, understanding the 50% requirement for lead teachers and for other educators, and how work experience may count, the Family and Community Engagement Foundational Practices, Continuous Quality Improvement (CQI) Plan for the Facility and Individuals, Self-Study and Coaching/Mentoring or Training. Today during my visit it was decided that Cloverleaf Prime Time for Kids will be choosing Pathway 1. I visited each licensed indoor and outdoor space with you today. I observed students playing in activity areas, small activity groups, outside play, and eating snacks. A current menu was posted, documented appropriate nutritious snacks and meals, showed a variety of foods, and complied with Meal Patterns for Children in Child Care Programs. Snack was prepared in the kitchen and served in the cafeteria. Today’s snack included Ham & Cheese sandwiches, carrots, fruit cups, and milk. Cold food and milk were stored in a commercial refrigerator in the kitchen at a temperature of 36 degrees Fahrenheit. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. You stated you have no children attending with emergency medications or medical action plans. In space 708 one plug did not have a cover over the outlet. The outlet was covered with a plug cover during the visit. It was observed that in spaces 705, 708, and 709 the walls in all classrooms need to be painted. Each classroom has chipped and peeling paint on the wall. I monitored that your last fire drill was dated November 19, 2025. I observed that your last emergency drill was dated November 14, 2025, and it was a Shelter-in-Place drill. I monitored program records, child record files, staff record files. I monitored health and safety requirements. I monitored supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The walls in space 705, 708, and 709 paint is chipping of the wall and spots where paint is missing on the wall. 15A NCAC 18A .2825(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One outlet in space 708 was not covered with a plug cover. 10A NCAC 09 .0604(c) Technical Assistance: 1. It was discussed that each Group Leader is to check his or her classroom at the end of the day to ensure that all electrical outlets are properly covered before closing the classroom. 2.It was discussed that when facility repairs are needed, staff must notify upper management so that maintenance can be contacted to complete the necessary work. CONSULTATION: 1 Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. 2 Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. COMPLIANCE PLAN: No compliance documentation is needed for those violations corrected during today’s visit. In the visit summary, I documented the corrective actions taken today to correct those violations. All violations cited and not corrected today must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your compliance letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature 2)Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements, and photographs for me to use to verify compliance. Please DO NOT send staff or child medical documents or documentation for verification as this is a violation of HIPPA protocol. If needed I will verify these documents at the next monitoring visit. I must receive your compliance letter no later than December 23, 2025. Please be aware any information submitted by you is legal documentation. If you state in your compliance letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past eighteen (18) months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your compliance letter may be sent by email to: toni.washington@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included in the body of the email: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 1/8/2025 Number Present: 28 Completed Date: 1/8/2025 Age: From 5 To 12 Total Minutes: 195 Time In: 01:45 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an Annual Compliance Visit. You, Verity Hager , Site Coordinator assisted me with the visit. Your program currently operates with a 5-star license effective March 22, 2019. Your last ACV was on January 18, 2024. I observed your Five-Star License, NC Child Care Summary of the Law, current menu, Sanitation placard, Emergency Medical Care Plan, daily schedule, activity plans posted as required. The Emergency Medical Care Plan needs to be updated to reflect current staff. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratio maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed permit restrictions maintained during today’s visit. I observed children engaged in transition from school to Prime-Time care, supper, gross motor activities, routine toileting practices and washing hands, children in activity areas, and snack. I observed a menu posted for of the month January 2025. Today’s snack consisted of pizza, corn, strawberry cups, and milk. I observed activity areas including books, blocks, manipulatives, dramatic play, art, and science. I observed toys and equipment to be of sufficient quantity for the use of children. I observed that all materials are developmentally appropriate in all the spaces and materials are in good repair. I observed no hazardous materials or equipment to be accessible to the children during today’s visit. I observed two medications today and the medical action plans. I observed that the teacher did not have a copy of the medical actions plans or the medications administer forms with the medication. Your sanitation inspection was conducted on September 13, 2024, with a Superior classification and five (5) demerits. Your current Fire Inspection was conducted on October 4, 2024. I observed monthly Outdoor Inspections documented. I observed your last outdoor inspection was dated January 2, 2025. I observed your monthly Fire Drill Log, a drill was conducted on December 18, 2024. I observed your Emergency Drill Log and a Lock-down drill was conducted on November 18, 2024. I observed your Incident Log to be current and up to date. I observed that your EPR plan was updated in August 2024. I monitored staff files and children files today. The following violation(s) were observed and cited during my visit today: Violation Number Comment Rule 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. In classroom for the older school-agers the classroom staff/child ratio chart was not complete. It did not have the Number of children allowed, Center's Ratio staff to child, and Age of youngest child in the classroom complete. .0713(a)(10), (c) & (f)(3); .2818(e) 1319 Medical authorizations were not accessible to staff. Staff did not have not have medical authorization forms with the medication. Staff did not have medical action plan with medication so staff would know when to administer medication and how to administer. .0802(d) Technical Assistance: 1. Staff/Child Ratio chart shall be completed and posted in each classroom that children are using in the facility. It was discussed with Site Coordinator to check and make sure all required charts that need to be posted are posted and complete. 2. Make sure current Sanitation and Fire Inspections are sent to consultant within 7 days of being conducted at facility. 3. Make sure that medical actions plans are with the medication so that staff will have all information needed if an emergency happens with child. Consultation: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your letter may be sent by email to: toni.washington@dhhs.nc.gov I must receive your compliance letter no later than January 22, 2025 Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date, you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Please continue to visit DCDEE’s website to get the latest information for child care settings and child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for having your Staff & Training Worksheet complete and available for review prior to today’s visit. The most up to date Staff & Training Worksheet form is available on the DCDEE website under the Provider tab and “Provider Documents and Forms”. Thank you for your time today. We appreciate all you are doing to serve the children and families of NC. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 8/14/2024 Number Present: 24 Completed Date: 8/14/2024 Age: From 5 To 12 Total Minutes: 150 Time In: 01:30 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Verity Hager, Site Coordinator, assisted me with the visit. Your program currently operates with a 5-star license. Your last ACV was on January 18, 2024. I observed your Five-Star License, NC Child Care Summary of the Law, current menu, Sanitation placard, Emergency Medical Care Plan (was posted but was not current. The new Site Coordinator updated the form to reflect current staff on file), daily schedule, activity plans posted as required. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratio maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed permit restrictions maintained during today’s visit. I observed children engaged in transition from school to Prime-Time care, supper, gross motor activities, routine toileting practices and washing hands, homework time, and outdoor play. I observed a menu posted for August 2024. Today’s supper consisted of Cheese burgers, Fries, mandarin orange cups, and milk. I observed activity area including books, blocks, manipulatives, dramatic play, art, and science. I observed toys and equipment to be of sufficient quantity for the use of children. I observed that all materials are developmentally appropriate in all the spaces and materials are in good repair. I observed no hazardous materials or equipment to be accessible to the children during today’s visit. You stated that there is currently one student with Emergency medication on site. Your sanitation inspection was conducted on February 15, 2024, with a Superior classification and 4 demerits. Your Fire inspection was conducted on October 03, 2023. I observed monthly Outdoor Inspections documented. I observed you last outdoor inspection was dated July 8, 2024. I observed your monthly Fire Drill Log, a drill was conducted on July 19, 2024. Fire Drills are to be conducted every month. I observed your Emergency Drill Log, and a Lockdown drill was conducted on May 17, 2024. I observed staff Criminal Background Qualifying Letters, and they were checked today in the ABCMS system. One staff member hire date 08/05/24 did not have a copy of the qualifying letter on file. This was corrected during the visit today. CPR & First Aid trainings, BSAC trainings, and Recognizing & Responding to Suspicious of Child Maltreatment training to be current as required. The following violations were observed and cited during the visit 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. Current Fire inspection was not on file. Fire inspection was obtained from the Program Coordinator. 10A NCAC 09 .0304(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The EMC was not current with current Site Coordinator information. .0802(a)(1)(A-B); 1757 A valid qualification letter was not on file and available to review at the facility. New hire with the hire date of 08/05/24 did not have a qualification letter on file at facility. The staff printed out letter and Qualifying letter was checked in ABCMS by consultant. G.S. 110-90.2(b) & (d) & .2703(e) Today, the following Technical Assistance (TA) was provided: 1. Make sure a current Fire Inspection are sent to the consultant after each inspection. 2. Make sure your Emergency Medical Care Implementation information posted is current. When new staff is hired make sure that the Site Coordinator updates the new information. Make sure you check this and other forms quarterly. 3. Make sure when new staff is hire that each staff has a copy of the NC Qualifying letter on file in the staff’s folder. Make sure any time a staff member renews the Qualifying letter the new letter is put on file. Have staff check files quarterly to make sure information is updated. 4. New staff hired 08/05/24 needs to complete First Aid and CPR by 11/5/24, Recognizing & Responding to Suspicious of Child Maltreatment training by 11/05/24, and BSAC by 11/5/24. All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your letter may be sent by email to: toni.washington@dhhs.nc.gov I must receive your compliance letter no later than August 28, 2024. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered a falsification of information. If you cannot meet the requirements by this date, you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before October 5, 2022, 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 considered 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 may be completed. Mail or email the information to: Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Please continue to visit DCDEE’s website to get the latest information for child care settings and child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time today. We appreciate all you are doing to serve the children and families of NC. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. or at (704)594-0153. 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: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 8/14/2024 Number Present: 24 Completed Date: 8/14/2024 Age: From 5 To 12 Total Minutes: 150 Time In: 01:30 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Verity Hager, Site Coordinator, assisted me with the visit. Your program currently operates with a 5-star license. Your last ACV was on January 18, 2024. I observed your Five-Star License, NC Child Care Summary of the Law, current menu, Sanitation placard, Emergency Medical Care Plan (was posted but was not current. The new Site Coordinator updated the form to reflect current staff on file), daily schedule, activity plans posted as required. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratio maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed permit restrictions maintained during today’s visit. I observed children engaged in transition from school to Prime-Time care, supper, gross motor activities, routine toileting practices and washing hands, homework time, and outdoor play. I observed a menu posted for August 2024. Today’s supper consisted of Cheese burgers, Fries, mandarin orange cups, and milk. I observed activity area including books, blocks, manipulatives, dramatic play, art, and science. I observed toys and equipment to be of sufficient quantity for the use of children. I observed that all materials are developmentally appropriate in all the spaces and materials are in good repair. I observed no hazardous materials or equipment to be accessible to the children during today’s visit. You stated that there is currently one student with Emergency medication on site. Your sanitation inspection was conducted on February 15, 2024, with a Superior classification and 4 demerits. Your Fire inspection was conducted on October 03, 2023. I observed monthly Outdoor Inspections documented. I observed you last outdoor inspection was dated July 8, 2024. I observed your monthly Fire Drill Log, a drill was conducted on July 19, 2024. Fire Drills are to be conducted every month. I observed your Emergency Drill Log, and a Lockdown drill was conducted on May 17, 2024. I observed staff Criminal Background Qualifying Letters, and they were checked today in the ABCMS system. One staff member hire date 08/05/24 did not have a copy of the qualifying letter on file. This was corrected during the visit today. CPR & First Aid trainings, BSAC trainings, and Recognizing & Responding to Suspicious of Child Maltreatment training to be current as required. The following violations were observed and cited during the visit 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. Current Fire inspection was not on file. Fire inspection was obtained from the Program Coordinator. 10A NCAC 09 .0304(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The EMC was not current with current Site Coordinator information. .0802(a)(1)(A-B); 1757 A valid qualification letter was not on file and available to review at the facility. New hire with the hire date of 08/05/24 did not have a qualification letter on file at facility. The staff printed out letter and Qualifying letter was checked in ABCMS by consultant. G.S. 110-90.2(b) & (d) & .2703(e) Today, the following Technical Assistance (TA) was provided: 1. Make sure a current Fire Inspection are sent to the consultant after each inspection. 2. Make sure your Emergency Medical Care Implementation information posted is current. When new staff is hired make sure that the Site Coordinator updates the new information. Make sure you check this and other forms quarterly. 3. Make sure when new staff is hire that each staff has a copy of the NC Qualifying letter on file in the staff’s folder. Make sure any time a staff member renews the Qualifying letter the new letter is put on file. Have staff check files quarterly to make sure information is updated. 4. New staff hired 08/05/24 needs to complete First Aid and CPR by 11/5/24, Recognizing & Responding to Suspicious of Child Maltreatment training by 11/05/24, and BSAC by 11/5/24. All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your letter may be sent by email to: toni.washington@dhhs.nc.gov I must receive your compliance letter no later than August 28, 2024. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered a falsification of information. If you cannot meet the requirements by this date, you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before October 5, 2022, 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 considered 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 may be completed. Mail or email the information to: Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Please continue to visit DCDEE’s website to get the latest information for child care settings and child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time today. We appreciate all you are doing to serve the children and families of NC. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. or at (704)594-0153. 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: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 8/14/2024 Number Present: 24 Completed Date: 8/14/2024 Age: From 5 To 12 Total Minutes: 150 Time In: 01:30 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Verity Hager, Site Coordinator, assisted me with the visit. Your program currently operates with a 5-star license. Your last ACV was on January 18, 2024. I observed your Five-Star License, NC Child Care Summary of the Law, current menu, Sanitation placard, Emergency Medical Care Plan (was posted but was not current. The new Site Coordinator updated the form to reflect current staff on file), daily schedule, activity plans posted as required. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratio maintained during today’s visit. I observed adequate approved space used during today’s visit. I observed permit restrictions maintained during today’s visit. I observed children engaged in transition from school to Prime-Time care, supper, gross motor activities, routine toileting practices and washing hands, homework time, and outdoor play. I observed a menu posted for August 2024. Today’s supper consisted of Cheese burgers, Fries, mandarin orange cups, and milk. I observed activity area including books, blocks, manipulatives, dramatic play, art, and science. I observed toys and equipment to be of sufficient quantity for the use of children. I observed that all materials are developmentally appropriate in all the spaces and materials are in good repair. I observed no hazardous materials or equipment to be accessible to the children during today’s visit. You stated that there is currently one student with Emergency medication on site. Your sanitation inspection was conducted on February 15, 2024, with a Superior classification and 4 demerits. Your Fire inspection was conducted on October 03, 2023. I observed monthly Outdoor Inspections documented. I observed you last outdoor inspection was dated July 8, 2024. I observed your monthly Fire Drill Log, a drill was conducted on July 19, 2024. Fire Drills are to be conducted every month. I observed your Emergency Drill Log, and a Lockdown drill was conducted on May 17, 2024. I observed staff Criminal Background Qualifying Letters, and they were checked today in the ABCMS system. One staff member hire date 08/05/24 did not have a copy of the qualifying letter on file. This was corrected during the visit today. CPR & First Aid trainings, BSAC trainings, and Recognizing & Responding to Suspicious of Child Maltreatment training to be current as required. The following violations were observed and cited during the visit 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. Current Fire inspection was not on file. Fire inspection was obtained from the Program Coordinator. 10A NCAC 09 .0304(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The EMC was not current with current Site Coordinator information. .0802(a)(1)(A-B); 1757 A valid qualification letter was not on file and available to review at the facility. New hire with the hire date of 08/05/24 did not have a qualification letter on file at facility. The staff printed out letter and Qualifying letter was checked in ABCMS by consultant. G.S. 110-90.2(b) & (d) & .2703(e) Today, the following Technical Assistance (TA) was provided: 1. Make sure a current Fire Inspection are sent to the consultant after each inspection. 2. Make sure your Emergency Medical Care Implementation information posted is current. When new staff is hired make sure that the Site Coordinator updates the new information. Make sure you check this and other forms quarterly. 3. Make sure when new staff is hire that each staff has a copy of the NC Qualifying letter on file in the staff’s folder. Make sure any time a staff member renews the Qualifying letter the new letter is put on file. Have staff check files quarterly to make sure information is updated. 4. New staff hired 08/05/24 needs to complete First Aid and CPR by 11/5/24, Recognizing & Responding to Suspicious of Child Maltreatment training by 11/05/24, and BSAC by 11/5/24. All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your letter may be sent by email to: toni.washington@dhhs.nc.gov I must receive your compliance letter no later than August 28, 2024. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered a falsification of information. If you cannot meet the requirements by this date, you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before October 5, 2022, 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 considered 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 may be completed. Mail or email the information to: Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Please continue to visit DCDEE’s website to get the latest information for child care settings and child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for your time today. We appreciate all you are doing to serve the children and families of NC. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. or at (704)594-0153. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: CLOVERLEAF PRIME TIME FOR KIDS Facility ID: 49000441 Consultant: TONI WASHINGTON Operation Type: Center Case Number: Visit Date: 1/18/2024 Number Present: 28 Completed Date: 1/18/2024 Age: From 5 To 12 Total Minutes: 210 Time In: 01:30 PM Time Out: 05:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Angela Gillion, Site Coordinator assisted me with the visit today. Your last annual compliance visit was conducted on February 07, 2023. Your program currently operates with a five-star license, issued on March 23, 2019, earning 7 points in staff education, 7 points in program standards, and 1 quality points. Your program’s compliance history was 98% as of January 17, 2024, and was reviewed with you today. I observed your sanitation inspection was dated October 03, 2023, with a superior classification and 4 demerits. I observed your last fire inspection was dated April 11, 2023. I visited each license indoor space and each outdoor space with you today. I observed children adequately supervised during today’s visit. I observed enhanced staff-child ratio maintained during today’s visit. I observed adequate approved enhanced space use maintained during today’s visit. I observed children engaged in free play activities indoor and outdoor. I observed toys, materials, and equipment to be child-sized, developmentally appropriate, and in good repair. I observed materials accessible to the children and of sufficient quantity. I reviewed children’s records today and observed no violations. I reviewed staff records today. I observed and monitored no medications, and you stated you do not have any medical action plans on file. You stated there are no children on medications. I observed the outdoor play environment. I observed the equipment and materials to be in good repair. I observed the fence to be of adequate height and in good repair in all areas. I observed your monthly fire drill log documented for the past twelve (12) months. I observed your last fire drill was January 04, 2024. I observed your quarterly shelter-in-place and lock-down drill log. I observed your last dill was a Lock-down drill, and it was dated December 20, 2023. I observed your Emergency Preparedness Response (EPR) Plan was last updated on August 22, 2023. I observed menus posted and current. I observed today’s dinner consisted of chicken fillet sandwich, dill pickle, chilled peaches, and milk. I observed your Incident Log to be current for the school year. I reviewed your completed Staff and Training worksheet. The visit summary packet was discussed at the end of you visit. The following violations were observed and cited during today's visit. Violation Number Comment Rule 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The last fire drill was done on November 30.2024. .0604(t); .0302(d)(5) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Two outlets in the classroom were not covered with safety plugs. 10A NCAC 09 .0604(c) 853 Incident logs were not completed and maintained as required. Incident log was not current. .0802(g)(1-6) Technical Assistance 1. Make sure current Sanitation and Fire Inspections are sent to the Consultant within 7 days of being conducted at the facility. 2. Fire drills need to be conducted monthly. When talking to the site coordinator it was suggested that the fire drills are done the same time every month. Suggestion the drills be done the first Monday or Tuesday of the month. 3. Classrooms need to be checked daily to make sure plugs are covered at all times. All violations cited must be corrected immediately. Please submit a written, signed, and dated statement to me at the email/address below detailing the steps taken to correct each violation. 4. Incident Logs are to completed at the time of the incident. The incident log must be current. Your letter must include the following: 1. The name of your center 2. The center’s ID number 3. The date you write the letter 4. Address each violation stating how you corrected the violation and are now in compliance. 5. Address your plan to ensure that you will not have that violation again. 6. Your signature I advise you to be prepared to provide supporting documentation in the form of photos, documents, certificates, etc. should I request them in order to clarify or verify compliance. Your letter may be mailed to me at: Toni Washington Post Office Box 5347 Mooresville, NC 28117 For your convenience, your letter may be sent by email to: toni.washington@dhhs.nc.gov I must receive your compliance letter no later than February 01, 2024. Please Note: If you state in your letter that corrections have been made when they have not, it will be considered falsification of information. If you cannot meet the requirements by this date, you shall contact me with a timeline of the corrections. In some cases, this timeline may be extended. 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 or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development and Early Education 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. Compliance History: You are required to maintain compliance with all applicable child care rules and regulations at all times. North Carolina General Statute 110-90(4)(d) requires all child care facilities to maintain a compliance history of at least seventy-five percent (75%) for the past 18 months or during the length of time the facility has operated, whichever is less. Failure to do so may result in the issuance of a provisional license or other administrative action against the facility's license. Any violations cited during a visit may affect your score. Please continue to visit DCDEE’s website to get the latest information for child care settings and child care updates at https://ncchildcare.ncdhhs.gov/. Thank you for having your Staff & Training Worksheet complete and available for review prior to today’s visit. The most up to date Staff & Training Worksheet form is available on the DCDEE website under the Provider tab and “Provider Documents and Forms”. Thank you for your time today. We appreciate all you are doing to serve the children and families of NC. If you have any questions, feel free to contact me by phone at (704) 437-2549 or by email at toni.washington@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov.or at (704)594-0153. 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