10A NCAC 09 .0803 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 2/27/2025 Number Present: 20 Completed Date: 2/27/2025 Age: From 0 To 3 Total Minutes: 305 Time In: 09:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Deborah Cornelius, Enrollment Coordinator, assisted me with today’s visit. I conducted your last annual compliance visit on April 22, 2024. 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. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, The Enola Group, LLC. that owns your facility. On February 27, 2025, the corporation that owns your facility, The Enola Group, LLC, was listed as current-active in the NC Secretary of State. Your program’s compliance history was 93% as of January 27, 2025, and was reviewed with you today. Your program currently operates with a five-star license, issued on August 6, 2024, earning 7 points in staff education, 7 points in program standards, and 1 quality point for having an infrastructure of parent involvement. Your program operates with the following permit restrictions: 1st shift Daytime care, meets enhanced space, meets enhanced ratios, and reduce staff/child ratios by one per group. All required postings were prominently displayed at the entrance to the facility. Your last sanitation inspection was dated December 4, 2024, with a “superior” classification. I verified that you initiated the lead water testing required to be completed every three years. I verified that you have registered for the lead-based paint and asbestos testing. Your last fire inspection was dated February 25, 2025, and was sent to me on February 26, 2025. I visited each licensed indoor and outdoor space with you today. I observed students playing in activity areas, handwashing, toileting, outdoors play and eating lunch. 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. The lunch that was prepared /served included: spaghetti and meatballs, spinach, peaches, whole wheat bread, and 1% unflavored white milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including incident report logs, playground safety inspections, and emergency drills were monitored and current. A random sampling of three (3) child record files were monitored. Staff record files for four (4) staff members, which included three (3) new staff and one (1) existing staff member. Daily attendance and sign in/out records were monitored. I monitored your current EPR Plan, Operational Policies and Parent Handbook that was sent to me prior to today’s visit. There were five (5) diaper creams monitored today. You stated that your program does not provide screen time or transportation. I monitored health and safety requirements. Supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions were observed during today’s visit. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were cited during today's visit: Violation Number Comment Rule 543 Frozen human milk, stored beyond 7 days was not stored in a freezer compartment of a full-size refrigerator with a separate door to the freezer, chest, or deep freezer. Frozen human milk was stored in a freezer for more than 3 months and/or was not labeled with date received and date thawed for use. In space #1, Human milk that was stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. 15A NCAC 18A .2804(d)&(e) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. 15A NCAC 18A .2825(a) 847 Parent's medication authorization did not include required information. In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1 one topical cream had expired. The medication "Aquafor Healing Ointment" had expired as of 12/2024. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. .0803(12) 1301 Center did not maintain a record of daily attendance. In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. GS 110-91(9) TECHNICAL ASSISTANCE: • In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. This item was corrected during the visit by the Enrollment Specialist receiving verbal permission from the child’s parent to write the dates of the permission to administer standing orders. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. This item was corrected during the visit by the Enrollment Specialist updating the form by writing in the date the medication will expire. As discussed, the medication permission to administer form should include the directions for how to administer the medication is to be administered, medication expiration date, name of the child to receive the medication, amount of medication to apply, parent signature, date of signature, date the form was completed and the valid dates the medication may be administered. To maintain compliance with this child care requirement, I suggest you review all medication permission to administer forms when received from the parent and before the parent leaves the facility at the time of receiving the medication. • In space # 1 there was one (1) medication that had expired. The medication date of expiration was 12/2024. As discussed, all medication that has expired should be removed from the classroom and given to the child’s parent to discard of. I suggest that medications be monitored at least quarterly to ensure that medications have not expired. This item was corrected during the visit by the Enrollment Specialist removing the medication. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. This item was corrected during the visit by the Enrollment Specialist removing the medication. • In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. I suggest that the walkthrough of each classroom be completed by teachers daily to ensure that the classroom spaces are in good repair and when it is noticed that repairs are needed the Administrator should be notified. • In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. As discussed, children should be signed in as they arrive in the classroom daily. I suggest that as children arrive for the day a teacher is designated to sign the children in during arrival time and the other teacher or an Administrator check throughout the day to ensure that attendance documentation is current. This item was corrected during the visit by the teacher updating the attendance roster. • In space #1, there was human milk stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. As discussed, all milk/formula brought into the facility should be labeled with the child’s name and the date the milk/formula was brought in. This can be done by the parent or the teacher prior to storing the milk in the refrigerator or freezer. This item was corrected during the visit by the teacher labeling the milk with the date it was brought to the classroom. CONSULTATION: • DCDEE Resources - Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. - Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License - Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development - Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings - Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy - DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New • Child Care facility’s now have until May 31, 2025, to enroll in the lead in water testing, lead based paint testing and Asbestos testing through Clean Water for US Kids. The following link will take you to the website to enroll https://www.cleanwaterforuskids.org/en/carolina/. • ABCMS SYSTEM: The process of notifying the Division of any new child care providers working who are hired or moved into the child care facility within five business days 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 as stated in G.S. 110-90.2 & .2703(r) 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. • Fire inspections are to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. • When reviewing Staff Files, Children’s Files, and Program Records, utilize the Staff Files Checklist, Children’s File Checklist, Volunteer Files Checklist and the Program Records File Checklist to ensure that you are maintaining compliance with all of the files that are monitored by DCDEE and that all of the documents within those files are current, accurate and relevant. These forms should be updated annually with staff files, children’s records and program record documents to ensure that all information stored in your facilities files are current and accurate prior to DCDEE monitoring visits. These file checklists can be found on the DCDEE website under provider documents. • Located on the DCDEE website there is an editable form of the staff and training worksheet that you may utilize when completing the staff and training worksheet to assist you with being prepared for your upcoming monitoring visits. This document can be downloaded to your computer and completed electronically. • Per child care rule 10A NCAC 09 .0803(12), expired medications and medications with expired permission to administer forms should be returned to the parent within seventy-two hours of expiration. • 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. • 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: 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 Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements 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 March 13, 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. 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: Meria Wilder Post Office Box 9591 Statesville, NC 28677 For your convenience, your compliance letter may be sent by email to: meria.wilder@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 (980) 434-3877 or by email at meria.wilder@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

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 2/27/2025 Number Present: 20 Completed Date: 2/27/2025 Age: From 0 To 3 Total Minutes: 305 Time In: 09:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Deborah Cornelius, Enrollment Coordinator, assisted me with today’s visit. I conducted your last annual compliance visit on April 22, 2024. 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. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, The Enola Group, LLC. that owns your facility. On February 27, 2025, the corporation that owns your facility, The Enola Group, LLC, was listed as current-active in the NC Secretary of State. Your program’s compliance history was 93% as of January 27, 2025, and was reviewed with you today. Your program currently operates with a five-star license, issued on August 6, 2024, earning 7 points in staff education, 7 points in program standards, and 1 quality point for having an infrastructure of parent involvement. Your program operates with the following permit restrictions: 1st shift Daytime care, meets enhanced space, meets enhanced ratios, and reduce staff/child ratios by one per group. All required postings were prominently displayed at the entrance to the facility. Your last sanitation inspection was dated December 4, 2024, with a “superior” classification. I verified that you initiated the lead water testing required to be completed every three years. I verified that you have registered for the lead-based paint and asbestos testing. Your last fire inspection was dated February 25, 2025, and was sent to me on February 26, 2025. I visited each licensed indoor and outdoor space with you today. I observed students playing in activity areas, handwashing, toileting, outdoors play and eating lunch. 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. The lunch that was prepared /served included: spaghetti and meatballs, spinach, peaches, whole wheat bread, and 1% unflavored white milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including incident report logs, playground safety inspections, and emergency drills were monitored and current. A random sampling of three (3) child record files were monitored. Staff record files for four (4) staff members, which included three (3) new staff and one (1) existing staff member. Daily attendance and sign in/out records were monitored. I monitored your current EPR Plan, Operational Policies and Parent Handbook that was sent to me prior to today’s visit. There were five (5) diaper creams monitored today. You stated that your program does not provide screen time or transportation. I monitored health and safety requirements. Supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions were observed during today’s visit. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were cited during today's visit: Violation Number Comment Rule 543 Frozen human milk, stored beyond 7 days was not stored in a freezer compartment of a full-size refrigerator with a separate door to the freezer, chest, or deep freezer. Frozen human milk was stored in a freezer for more than 3 months and/or was not labeled with date received and date thawed for use. In space #1, Human milk that was stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. 15A NCAC 18A .2804(d)&(e) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. 15A NCAC 18A .2825(a) 847 Parent's medication authorization did not include required information. In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1 one topical cream had expired. The medication "Aquafor Healing Ointment" had expired as of 12/2024. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. .0803(12) 1301 Center did not maintain a record of daily attendance. In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. GS 110-91(9) TECHNICAL ASSISTANCE: • In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. This item was corrected during the visit by the Enrollment Specialist receiving verbal permission from the child’s parent to write the dates of the permission to administer standing orders. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. This item was corrected during the visit by the Enrollment Specialist updating the form by writing in the date the medication will expire. As discussed, the medication permission to administer form should include the directions for how to administer the medication is to be administered, medication expiration date, name of the child to receive the medication, amount of medication to apply, parent signature, date of signature, date the form was completed and the valid dates the medication may be administered. To maintain compliance with this child care requirement, I suggest you review all medication permission to administer forms when received from the parent and before the parent leaves the facility at the time of receiving the medication. • In space # 1 there was one (1) medication that had expired. The medication date of expiration was 12/2024. As discussed, all medication that has expired should be removed from the classroom and given to the child’s parent to discard of. I suggest that medications be monitored at least quarterly to ensure that medications have not expired. This item was corrected during the visit by the Enrollment Specialist removing the medication. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. This item was corrected during the visit by the Enrollment Specialist removing the medication. • In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. I suggest that the walkthrough of each classroom be completed by teachers daily to ensure that the classroom spaces are in good repair and when it is noticed that repairs are needed the Administrator should be notified. • In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. As discussed, children should be signed in as they arrive in the classroom daily. I suggest that as children arrive for the day a teacher is designated to sign the children in during arrival time and the other teacher or an Administrator check throughout the day to ensure that attendance documentation is current. This item was corrected during the visit by the teacher updating the attendance roster. • In space #1, there was human milk stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. As discussed, all milk/formula brought into the facility should be labeled with the child’s name and the date the milk/formula was brought in. This can be done by the parent or the teacher prior to storing the milk in the refrigerator or freezer. This item was corrected during the visit by the teacher labeling the milk with the date it was brought to the classroom. CONSULTATION: • DCDEE Resources - Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. - Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License - Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development - Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings - Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy - DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New • Child Care facility’s now have until May 31, 2025, to enroll in the lead in water testing, lead based paint testing and Asbestos testing through Clean Water for US Kids. The following link will take you to the website to enroll https://www.cleanwaterforuskids.org/en/carolina/. • ABCMS SYSTEM: The process of notifying the Division of any new child care providers working who are hired or moved into the child care facility within five business days 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 as stated in G.S. 110-90.2 & .2703(r) 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. • Fire inspections are to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. • When reviewing Staff Files, Children’s Files, and Program Records, utilize the Staff Files Checklist, Children’s File Checklist, Volunteer Files Checklist and the Program Records File Checklist to ensure that you are maintaining compliance with all of the files that are monitored by DCDEE and that all of the documents within those files are current, accurate and relevant. These forms should be updated annually with staff files, children’s records and program record documents to ensure that all information stored in your facilities files are current and accurate prior to DCDEE monitoring visits. These file checklists can be found on the DCDEE website under provider documents. • Located on the DCDEE website there is an editable form of the staff and training worksheet that you may utilize when completing the staff and training worksheet to assist you with being prepared for your upcoming monitoring visits. This document can be downloaded to your computer and completed electronically. • Per child care rule 10A NCAC 09 .0803(12), expired medications and medications with expired permission to administer forms should be returned to the parent within seventy-two hours of expiration. • 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. • 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: 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 Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements 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 March 13, 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. 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: Meria Wilder Post Office Box 9591 Statesville, NC 28677 For your convenience, your compliance letter may be sent by email to: meria.wilder@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 (980) 434-3877 or by email at meria.wilder@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

GS 110-91 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 2/27/2025 Number Present: 20 Completed Date: 2/27/2025 Age: From 0 To 3 Total Minutes: 305 Time In: 09:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. You, Deborah Cornelius, Enrollment Coordinator, assisted me with today’s visit. I conducted your last annual compliance visit on April 22, 2024. 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. I reviewed the facility’s permit with you today. You stated there has been no change with the corporation, The Enola Group, LLC. that owns your facility. On February 27, 2025, the corporation that owns your facility, The Enola Group, LLC, was listed as current-active in the NC Secretary of State. Your program’s compliance history was 93% as of January 27, 2025, and was reviewed with you today. Your program currently operates with a five-star license, issued on August 6, 2024, earning 7 points in staff education, 7 points in program standards, and 1 quality point for having an infrastructure of parent involvement. Your program operates with the following permit restrictions: 1st shift Daytime care, meets enhanced space, meets enhanced ratios, and reduce staff/child ratios by one per group. All required postings were prominently displayed at the entrance to the facility. Your last sanitation inspection was dated December 4, 2024, with a “superior” classification. I verified that you initiated the lead water testing required to be completed every three years. I verified that you have registered for the lead-based paint and asbestos testing. Your last fire inspection was dated February 25, 2025, and was sent to me on February 26, 2025. I visited each licensed indoor and outdoor space with you today. I observed students playing in activity areas, handwashing, toileting, outdoors play and eating lunch. 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. The lunch that was prepared /served included: spaghetti and meatballs, spinach, peaches, whole wheat bread, and 1% unflavored white milk. I monitored hazardous product storage, medication storage, medication administration, general safety, and discipline practices. I monitored program records including incident report logs, playground safety inspections, and emergency drills were monitored and current. A random sampling of three (3) child record files were monitored. Staff record files for four (4) staff members, which included three (3) new staff and one (1) existing staff member. Daily attendance and sign in/out records were monitored. I monitored your current EPR Plan, Operational Policies and Parent Handbook that was sent to me prior to today’s visit. There were five (5) diaper creams monitored today. You stated that your program does not provide screen time or transportation. I monitored health and safety requirements. Supervision of children, staff-child ratios and group sizes, approved space use, space capacities, and permit restrictions were observed during today’s visit. I completed the “Annual Compliance Monitoring Checklist for Child Care Centers” during today’s visit. The following violations were cited during today's visit: Violation Number Comment Rule 543 Frozen human milk, stored beyond 7 days was not stored in a freezer compartment of a full-size refrigerator with a separate door to the freezer, chest, or deep freezer. Frozen human milk was stored in a freezer for more than 3 months and/or was not labeled with date received and date thawed for use. In space #1, Human milk that was stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. 15A NCAC 18A .2804(d)&(e) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. 15A NCAC 18A .2825(a) 847 Parent's medication authorization did not include required information. In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. 10A NCAC 09 .0803(4)(6-9) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #1 one topical cream had expired. The medication "Aquafor Healing Ointment" had expired as of 12/2024. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. .0803(12) 1301 Center did not maintain a record of daily attendance. In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. GS 110-91(9) TECHNICAL ASSISTANCE: • In space #1, there was one (1) medication permission to administer form for Desitin Maximum Strength diaper cream was not completed and was left blank. This item was corrected during the visit by the Enrollment Specialist receiving verbal permission from the child’s parent to write the dates of the permission to administer standing orders. In space #1 there was one topical cream that had a medication permission to administer form that did not list the medication expiration date. This item was corrected during the visit by the Enrollment Specialist updating the form by writing in the date the medication will expire. As discussed, the medication permission to administer form should include the directions for how to administer the medication is to be administered, medication expiration date, name of the child to receive the medication, amount of medication to apply, parent signature, date of signature, date the form was completed and the valid dates the medication may be administered. To maintain compliance with this child care requirement, I suggest you review all medication permission to administer forms when received from the parent and before the parent leaves the facility at the time of receiving the medication. • In space # 1 there was one (1) medication that had expired. The medication date of expiration was 12/2024. As discussed, all medication that has expired should be removed from the classroom and given to the child’s parent to discard of. I suggest that medications be monitored at least quarterly to ensure that medications have not expired. This item was corrected during the visit by the Enrollment Specialist removing the medication. In space #1 there was one (1) medication permission to administer form for Aquafor Healing Ointment that had expired. The dates listed on the medication permission to administer form for this topical cream was from 9/9/2024 to 12/31/2024. This item was corrected during the visit by the Enrollment Specialist removing the medication. • In space #1, there was one wall that had peeling paint. As discussed, walls should be kept in good repair and be free of peeling paint. I suggest that the walkthrough of each classroom be completed by teachers daily to ensure that the classroom spaces are in good repair and when it is noticed that repairs are needed the Administrator should be notified. • In space #3 the attendance roster was not up to date and current. There were two (2) children that were present today that were not identified as present on the attendance roster. As discussed, children should be signed in as they arrive in the classroom daily. I suggest that as children arrive for the day a teacher is designated to sign the children in during arrival time and the other teacher or an Administrator check throughout the day to ensure that attendance documentation is current. This item was corrected during the visit by the teacher updating the attendance roster. • In space #1, there was human milk stored in the freezer in a container labeled with the child’s name that was not labeled with the date the milk was brought to school by the parent. As discussed, all milk/formula brought into the facility should be labeled with the child’s name and the date the milk/formula was brought in. This can be done by the parent or the teacher prior to storing the milk in the refrigerator or freezer. This item was corrected during the visit by the teacher labeling the milk with the date it was brought to the classroom. CONSULTATION: • DCDEE Resources - Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. - Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License - Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development - Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings - Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy - DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New • Child Care facility’s now have until May 31, 2025, to enroll in the lead in water testing, lead based paint testing and Asbestos testing through Clean Water for US Kids. The following link will take you to the website to enroll https://www.cleanwaterforuskids.org/en/carolina/. • ABCMS SYSTEM: The process of notifying the Division of any new child care providers working who are hired or moved into the child care facility within five business days 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 as stated in G.S. 110-90.2 & .2703(r) 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. • Fire inspections are to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. • When reviewing Staff Files, Children’s Files, and Program Records, utilize the Staff Files Checklist, Children’s File Checklist, Volunteer Files Checklist and the Program Records File Checklist to ensure that you are maintaining compliance with all of the files that are monitored by DCDEE and that all of the documents within those files are current, accurate and relevant. These forms should be updated annually with staff files, children’s records and program record documents to ensure that all information stored in your facilities files are current and accurate prior to DCDEE monitoring visits. These file checklists can be found on the DCDEE website under provider documents. • Located on the DCDEE website there is an editable form of the staff and training worksheet that you may utilize when completing the staff and training worksheet to assist you with being prepared for your upcoming monitoring visits. This document can be downloaded to your computer and completed electronically. • Per child care rule 10A NCAC 09 .0803(12), expired medications and medications with expired permission to administer forms should be returned to the parent within seventy-two hours of expiration. • 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. • 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: 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 Supporting documentation including the following: Please send supporting documentation such as training certificates, CBC letters, acknowledgement statements 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 March 13, 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. 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: Meria Wilder Post Office Box 9591 Statesville, NC 28677 For your convenience, your compliance letter may be sent by email to: meria.wilder@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 (980) 434-3877 or by email at meria.wilder@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

10A NCAC 09 .0803 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 4/22/2024 Number Present: 14 Completed Date: 4/22/2024 Age: From 0 To 3 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child are requirements during an annual compliance monitoring visit. You, Angela Revell, Director, assisted me with today’s visit. Your program operates with a five-star license that was issued on January 15, 2019. Your program received 7 points in staff education, 7 points in program standards and 1 quality point and operates with the following restrictions: daytime care, meets enhanced space, meets enhanced ratios, and meets enhanced ratios minus 1. The following was prominently posted in each classroom entrance: NC Summary of Child Care Law, First Aid information sheet, emergency phone numbers, safe arrival and departure procedures, tobacco free signage, emergency medical care plan, daily schedule, activity plan and sanitation inspection. The following inspections were current: playground inspection, fire, sanitation lockdown emergency drill, and fire drills. Your facilities compliance history score was 94% prior to today’s visit. You stated that your program does not provide transportation. All indoor and outdoor spaces were monitored today for health and safety requirements. Incident log was monitored, and incident reports were logged with children’s records. Your EPR plan was printed and current. Today’s menu was posted, and current with the meal served to children consisting of macaroni and cheese, ham, baked beans, peaches, whole wheat bread and 1% unflavored white milk. There were 6 diaper creams and no emergency medications to monitor today. Children were cared for in a nurturing way. Daily sign in/out sheets and daily attendance records were monitored. In the classroom the following was posted: allergy list, daily schedule, and an activity plan. Indoor furnishings were clean and in good repair. Toys were of sufficient quantity, developmentally appropriate and in good repair. Adequate supervision, adequate/approved space, staff/child ratios, appropriate group sizes and appropriate discipline was observed. Children were participating in teacher directed activities, whole group story time, music and movement, outside time, meal time, toileting, and handwashing routines. You stated that your program does not offer screen time. A random sampling of 2 children’s records was monitored. There was 1 new staff file monitored, and 2 existing staff files monitored during today’s visit. All health and safety requirements were monitored. During today's visit the following violations were cited: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. G.S. 110-91(6); .0601(b) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In space 2, 1 unopened package of Destin was not labeled with the child’s name. 10A NCAC 09 .0803(4) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 1, 1 medication permission to administer form for Destin did not name a sizable amount to administer. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance: All violations cited during today’s visit must be corrected immediately. • In space 1, 1 medication permission to administer form for Desitin did not name a sizable amount to administer. As discussed, be sure all medication permission to administer forms that are completed have been completed entirely and are specific. I recommend that all medication permission to administer forms be monitored at least quarterly to ensure that all medication permission to administer forms are completed according to specifications in child care rules. This item was corrected during the visit. • In space 2, 1 unopened package of Desitin was not labeled with the child’s name. As discussed, be sure that all medications including diaper creams are labeled with the child’s name to ensure the right child receives the right medication. I recommend prior to storing medications brought in, that the child’s name is immediately placed on the packaging. This item was corrected during the visit. • The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. As discussed, all items with chipped paint should not be accessible to children. I recommend when completing playground inspections all materials that have chipped paint, are worn, broken and not in good repair be removed from the playground. This item was corrected during the visit. • The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. As discussed, when receiving forms be sure that all forms and documents are completed entirely, and no blank spaces are left. Where an item does not apply put “NA” to identify that the item is not applicable. I recommend that all children’s records be reviewed regularly to ensure that all forms are completed entirely with no blank spaces left prior to storing those forms in the child’s record. This item was corrected during the visit. Consultation: • One staff member with a hire date of 3/12/2024, will need to complete the 1st 6 weeks of new hire orientation by 4/23/2024. • As discussed, please use the Staff File Checklist and Children’s Records Checklist to ensure that files contain all required documents, and that training and documentation is completed within the specified timeframe to ensure compliance with child care rules. • Although not an issue today, remember fire inspection reports are required to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. Child care facilities must comply with all state laws, federal laws and local ordinances that pertain to child health, safety, and welfare of children (GS110-91 – Mandatory standards for a license). Failure to comply may lead to an administrative action (General statue 110-102-2- Administrative penalties). 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. All violations cited must be corrected immediately. Due to all violations that were cited today being corrected during the visit there is no compliance letter required to be sent to me. A copy of today’s visit summary was reviewed, printed and left with you today for you to save for your records. Thank you for your time today. If I can be of assistance in the future, please feel free to contact me at (980) 434-3877 or email meria.wilder@dhhs.nc.gov or Erin Pickard, Supervisor, 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

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-91 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 4/22/2024 Number Present: 14 Completed Date: 4/22/2024 Age: From 0 To 3 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child are requirements during an annual compliance monitoring visit. You, Angela Revell, Director, assisted me with today’s visit. Your program operates with a five-star license that was issued on January 15, 2019. Your program received 7 points in staff education, 7 points in program standards and 1 quality point and operates with the following restrictions: daytime care, meets enhanced space, meets enhanced ratios, and meets enhanced ratios minus 1. The following was prominently posted in each classroom entrance: NC Summary of Child Care Law, First Aid information sheet, emergency phone numbers, safe arrival and departure procedures, tobacco free signage, emergency medical care plan, daily schedule, activity plan and sanitation inspection. The following inspections were current: playground inspection, fire, sanitation lockdown emergency drill, and fire drills. Your facilities compliance history score was 94% prior to today’s visit. You stated that your program does not provide transportation. All indoor and outdoor spaces were monitored today for health and safety requirements. Incident log was monitored, and incident reports were logged with children’s records. Your EPR plan was printed and current. Today’s menu was posted, and current with the meal served to children consisting of macaroni and cheese, ham, baked beans, peaches, whole wheat bread and 1% unflavored white milk. There were 6 diaper creams and no emergency medications to monitor today. Children were cared for in a nurturing way. Daily sign in/out sheets and daily attendance records were monitored. In the classroom the following was posted: allergy list, daily schedule, and an activity plan. Indoor furnishings were clean and in good repair. Toys were of sufficient quantity, developmentally appropriate and in good repair. Adequate supervision, adequate/approved space, staff/child ratios, appropriate group sizes and appropriate discipline was observed. Children were participating in teacher directed activities, whole group story time, music and movement, outside time, meal time, toileting, and handwashing routines. You stated that your program does not offer screen time. A random sampling of 2 children’s records was monitored. There was 1 new staff file monitored, and 2 existing staff files monitored during today’s visit. All health and safety requirements were monitored. During today's visit the following violations were cited: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. G.S. 110-91(6); .0601(b) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In space 2, 1 unopened package of Destin was not labeled with the child’s name. 10A NCAC 09 .0803(4) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 1, 1 medication permission to administer form for Destin did not name a sizable amount to administer. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance: All violations cited during today’s visit must be corrected immediately. • In space 1, 1 medication permission to administer form for Desitin did not name a sizable amount to administer. As discussed, be sure all medication permission to administer forms that are completed have been completed entirely and are specific. I recommend that all medication permission to administer forms be monitored at least quarterly to ensure that all medication permission to administer forms are completed according to specifications in child care rules. This item was corrected during the visit. • In space 2, 1 unopened package of Desitin was not labeled with the child’s name. As discussed, be sure that all medications including diaper creams are labeled with the child’s name to ensure the right child receives the right medication. I recommend prior to storing medications brought in, that the child’s name is immediately placed on the packaging. This item was corrected during the visit. • The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. As discussed, all items with chipped paint should not be accessible to children. I recommend when completing playground inspections all materials that have chipped paint, are worn, broken and not in good repair be removed from the playground. This item was corrected during the visit. • The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. As discussed, when receiving forms be sure that all forms and documents are completed entirely, and no blank spaces are left. Where an item does not apply put “NA” to identify that the item is not applicable. I recommend that all children’s records be reviewed regularly to ensure that all forms are completed entirely with no blank spaces left prior to storing those forms in the child’s record. This item was corrected during the visit. Consultation: • One staff member with a hire date of 3/12/2024, will need to complete the 1st 6 weeks of new hire orientation by 4/23/2024. • As discussed, please use the Staff File Checklist and Children’s Records Checklist to ensure that files contain all required documents, and that training and documentation is completed within the specified timeframe to ensure compliance with child care rules. • Although not an issue today, remember fire inspection reports are required to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. Child care facilities must comply with all state laws, federal laws and local ordinances that pertain to child health, safety, and welfare of children (GS110-91 – Mandatory standards for a license). Failure to comply may lead to an administrative action (General statue 110-102-2- Administrative penalties). 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. All violations cited must be corrected immediately. Due to all violations that were cited today being corrected during the visit there is no compliance letter required to be sent to me. A copy of today’s visit summary was reviewed, printed and left with you today for you to save for your records. Thank you for your time today. If I can be of assistance in the future, please feel free to contact me at (980) 434-3877 or email meria.wilder@dhhs.nc.gov or Erin Pickard, Supervisor, 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

GS110-91 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 4/22/2024 Number Present: 14 Completed Date: 4/22/2024 Age: From 0 To 3 Total Minutes: 210 Time In: 10:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child are requirements during an annual compliance monitoring visit. You, Angela Revell, Director, assisted me with today’s visit. Your program operates with a five-star license that was issued on January 15, 2019. Your program received 7 points in staff education, 7 points in program standards and 1 quality point and operates with the following restrictions: daytime care, meets enhanced space, meets enhanced ratios, and meets enhanced ratios minus 1. The following was prominently posted in each classroom entrance: NC Summary of Child Care Law, First Aid information sheet, emergency phone numbers, safe arrival and departure procedures, tobacco free signage, emergency medical care plan, daily schedule, activity plan and sanitation inspection. The following inspections were current: playground inspection, fire, sanitation lockdown emergency drill, and fire drills. Your facilities compliance history score was 94% prior to today’s visit. You stated that your program does not provide transportation. All indoor and outdoor spaces were monitored today for health and safety requirements. Incident log was monitored, and incident reports were logged with children’s records. Your EPR plan was printed and current. Today’s menu was posted, and current with the meal served to children consisting of macaroni and cheese, ham, baked beans, peaches, whole wheat bread and 1% unflavored white milk. There were 6 diaper creams and no emergency medications to monitor today. Children were cared for in a nurturing way. Daily sign in/out sheets and daily attendance records were monitored. In the classroom the following was posted: allergy list, daily schedule, and an activity plan. Indoor furnishings were clean and in good repair. Toys were of sufficient quantity, developmentally appropriate and in good repair. Adequate supervision, adequate/approved space, staff/child ratios, appropriate group sizes and appropriate discipline was observed. Children were participating in teacher directed activities, whole group story time, music and movement, outside time, meal time, toileting, and handwashing routines. You stated that your program does not offer screen time. A random sampling of 2 children’s records was monitored. There was 1 new staff file monitored, and 2 existing staff files monitored during today’s visit. All health and safety requirements were monitored. During today's visit the following violations were cited: Violation Number Comment Rule 721 All equipment and furnishings were not in good repair. The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. G.S. 110-91(6); .0601(b) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In space 2, 1 unopened package of Destin was not labeled with the child’s name. 10A NCAC 09 .0803(4) 1325 Parent’s statement includes the child’s name and date of enrollment and the date the parent signed the statement. The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. .1804(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space 1, 1 medication permission to administer form for Destin did not name a sizable amount to administer. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical Assistance: All violations cited during today’s visit must be corrected immediately. • In space 1, 1 medication permission to administer form for Desitin did not name a sizable amount to administer. As discussed, be sure all medication permission to administer forms that are completed have been completed entirely and are specific. I recommend that all medication permission to administer forms be monitored at least quarterly to ensure that all medication permission to administer forms are completed according to specifications in child care rules. This item was corrected during the visit. • In space 2, 1 unopened package of Desitin was not labeled with the child’s name. As discussed, be sure that all medications including diaper creams are labeled with the child’s name to ensure the right child receives the right medication. I recommend prior to storing medications brought in, that the child’s name is immediately placed on the packaging. This item was corrected during the visit. • The outside space in the front of the center, had 1 round chalkboard lined stool that was worn with chipped paint. As discussed, all items with chipped paint should not be accessible to children. I recommend when completing playground inspections all materials that have chipped paint, are worn, broken and not in good repair be removed from the playground. This item was corrected during the visit. • The discipline policy for a child with a birthdate of 3/15/2024, did not list the date of enrollment on the acknowledgement statement. As discussed, when receiving forms be sure that all forms and documents are completed entirely, and no blank spaces are left. Where an item does not apply put “NA” to identify that the item is not applicable. I recommend that all children’s records be reviewed regularly to ensure that all forms are completed entirely with no blank spaces left prior to storing those forms in the child’s record. This item was corrected during the visit. Consultation: • One staff member with a hire date of 3/12/2024, will need to complete the 1st 6 weeks of new hire orientation by 4/23/2024. • As discussed, please use the Staff File Checklist and Children’s Records Checklist to ensure that files contain all required documents, and that training and documentation is completed within the specified timeframe to ensure compliance with child care rules. • Although not an issue today, remember fire inspection reports are required to be sent to the consultant within 7 business days of the inspection being completed. If the fire inspection report is not sent to the consultant within 7 business days a violation will be cited at the next monitoring visit. Child care facilities must comply with all state laws, federal laws and local ordinances that pertain to child health, safety, and welfare of children (GS110-91 – Mandatory standards for a license). Failure to comply may lead to an administrative action (General statue 110-102-2- Administrative penalties). 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. All violations cited must be corrected immediately. Due to all violations that were cited today being corrected during the visit there is no compliance letter required to be sent to me. A copy of today’s visit summary was reviewed, printed and left with you today for you to save for your records. Thank you for your time today. If I can be of assistance in the future, please feel free to contact me at (980) 434-3877 or email meria.wilder@dhhs.nc.gov or Erin Pickard, Supervisor, 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

G.S. 110-90 · Violation

Name of Operation: ALEXANDER EARLY HEAD START Facility ID: 02000104 Consultant: MERIA WILDER Operation Type: Center Case Number: Visit Date: 2/9/2024 Number Present: 14 Completed Date: 2/9/2024 Age: From 0 To 3 Total Minutes: 215 Time In: 10:00 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable childcare requirements during a routine unannounced visit. You, Angela Revell, Director, assisted me, Meria Wilder, Child Care Consultant, with today’s visit. Your last annual compliance visit was conducted May 30, 2023. Your program earned 7 points in staff education, 7 points in program standards and 1 quality point for a total of 15 points earned. Your program operates with a five-star license that was issued on January 15, 2019. Your program currently meets staff child ratios for multi-age groups. The staff child ratios for groups with children infant through 3 years of age is 1 staff to 4 children. The following required postings were prominently posted: license, NC Summary of Child Care Law, Sanitation placard, Emergency Medical Care Plan, emergency phone numbers, Allergy posting, First Aid poster, safe arrival and departure procedures. I monitored daily attendance records and sign/out rosters for each classroom. I observed today’s menu to be posted and current. I observed the meal served to be chicken alfredo, vegetables, and mixed fruit and 1% unflavored white milk. I observed a variety of toys and material available. I observed toys and furnishings to be ae appropriate, clean and in good repair. I observed adequate supervision, approved space, approved group sizes and adequate staff child ratios. I observed children being cared for in a nurturing way. I monitored 6 diaper creams, and 2 emergency medications for a total of 8 medications monitored and permissions to administer forms for each medication. I monitored the most recent fire inspection was conducted on 5/17/23, the most recent sanitation inspection was conducted on 10/6/23, your most recent shelter-in-place emergency drill to be conducted on 12/11/23, and your most recent playground inspection to be conducted on 1/11/24. I monitored your incident log and found incident reports to be stored with children’s records. I monitored your most recent EPR Plan that was dated 8/31/23. I monitored your indoor and outdoor spaces. No children’s records were monitored during today’s visit. I monitored 2 new staff files and all existing staff files for criminal background qualifying letters, First Aid, CPR, Recognizing and Responding to Suspicions of Child Maltreatment, IT’S SIDS, and special trainings. The following violations were cited during today’s visit. Violation Number Comment Rule 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. One staff member with a hire date of 3/26/19 had not completed the IT’S SIDS training prior to the expiration of the training certificate on file with an expiration date of 7/13/2023. .1102(f) Technical Assistance: • One staff member with a hire date of 3/26/19 had not completed the IT’S SIDS training prior to the expiration of the training certificate on file with an expiration date of 7/13/2023. As discussed, staff files must be gone through in detail to ensure that all required paperwork is on file, accurate, and complete according to the File Checklist for Staff Files form. It is important that the staff and training worksheet is complete and accurate at all times. Create a system for reviewing and following-up on missing paperwork in children’s files. All violations cited must be corrected immediately and a compliance letter for violations cited during today’s visit must be sent to me by February 23, 2024. Email information to: Meria Wilder, Child Care Consultant P.O. Box 6591 Statesville, NC 28677 Email: meria.wilder@dhhs.nc.gov When sending your compliance letter through your email address registered with the DCDEE (this serves as your signature) and the following information must be included: Your Name, Your position, Facility name, Facility ID number Violation Item number Date of violation correction How the violation was corrected How the violation will be prevented in the future Any observed violations cited during visits will negatively affect the center’s Compliance History Score. Your program must maintain a compliance score of at least 75% as required by G.S. 110-90 (4)(c) in order to be eligible for a star rated license. Consultation: • Your program is in Cohort 1 for Rated License reassessment. Your reassessment planning year begins July 1, 2023, and goes through June 30, 2024. Be prepared to begin the timeline for reassessment up to 6 months prior to the expiration month of the current star rated license. • You stated that you have been in contact with the Partnership and have been working with them in order to be prepared for Environment Rating Scale assessment and that you are requesting to have the Environment Rating Scale assessment completed prior to your Cohort year. I have advised you to have all of your staff send their education in to WORKS to be updated and verified. I have provided you with the Initial Application for Assessment for a Two Component Star Rated License, Rated License Assessment Request Review Form and the Quality Point Form and requested that these forms be sent back to me by February 23, 2024. At that time I will send your application to NCRLAP and they will then schedule your assessment. • As of September 2023, the NC Summary of Child Care Law has been updated, be sure that parents receive, sign and acknowledgement of receipt as well as post the updated information with other required postings in your facility. • Stay updated with changes and new rule updates by visiting DCDEE new website at http://ncchildcare.nc.gov/general/home.asp. You may contact me by phone at (980) 434-3877 or by email at meria.wilder@dhhs.nc.gov or Erin Pickard by email at erin.pickard@dhhs.nc.gov, if you have questions. Thank you for your time and assistance 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

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.