Lilly'S Network

10A NCAC 09 .0601 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/19/2026 Number Present: 28 Completed Date: 5/19/2026 Age: From 1 To 5 Total Minutes: 230 Time In: 10:10 AM Time Out: 02:00 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Sims, Director. Your program currently operates with a 4-Star license effective 6/23/2025. Restrictions include 1st shift care, meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility; and diapering using standing procedures only in Space 3. The program’s compliance history was 85% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, participating in general routines, and playing outdoors during the visit. Four new staff members were reported at this program. The files for these staff members were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Recognizing and Responding to Suspicions of Child Abuse and Maltreatment, Special Trainings, and Criminal Background Checks No medications were observed or reported. Storage of hazardous items was monitored today and found to be in compliance. The most recent playground inspection was recorded 5/06/2026. A fire drill was recorded on 5/06/2026. The most recent lockdown drill for the facility was recorded on 4/07/2026. The most recent fire inspection was on 12/01/2025. I observed a sanitation inspection was last conducted on 4/21/2026 earning a Superior classification. The program does not participate in off-premise or aquatic activities at this time. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. 10A NCAC 09 .0601(a) 823 Toxic plants were accessible to children. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. .0604(l) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. .0604(q) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed to be completed and signed by one new staff member with a start date of 5/06/2026. .0608(d)(1-4) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/02/26. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane Unit 146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: The mulch in both fall zones located beneath the plastic slides of the stationary structure measured three (3) inches and zero (0) inches in depth, respectively. It is important for mulch beneath equipment with a critical height of more than 5 feet, but less than 7 feet, to have at least six inches of approved loose surfacing material to ensure the safety of children enrolled if a child should fall from the equipment while playing. You may consider moving extra mulch from outside the external limits of the equipment for six feet to these fall zones to ensure the six inches in depth can be met. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. It is imperative for the EPR plan to be current at all times in the event a true emergency occurs and an emergency evacuation is necessary so all emergency personnel and center staff have access to this information. You may consider setting a calendar reminder to ensure this plan is updated in the Risk Management Portal annually as required. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. It is imperative for the outdoor environment be a safe place for children to engage with and explore at all times. Ms. Springs stated she would ensure the branches of this tree were trimmed back. She also stated she would cover this cracked area on the plastic border as soon as possible, but that the resin they tried with areas of border on the playground used by preschool children was not successful. You may consider adding these items to a daily indoor and outdoor safety check to complete each day prior to children arriving for care. Consultation Provided During Visit: The following General Statute and Child Care Rules were reviewed with Ms. Sims during the visit: § 110 90.2. Mandatory child care providers' criminal history checks 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) regarding staff modeling appropriate eating behaviors 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) (2) regarding the date the center's policy was given and explained to the individual Monitor all walls for paint which may be beginning to peel. Make sure you check all packaging containing diaper wipes when these are purchased for your program or when parents bring them to your facility (especially on plastic packages of individual wipes) for warning labels which would require these packages to be inaccessible (not necessarily locked) to children at all times. Relocate the posted evacuation plan in Space 3 so it is easily visible. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you; you were given the opportunity to as questions. Contact me at (Cara McKeown-Stewart, (336) 408-4849, cara.mckeown-stewart@dhhs.nc.gov) or (Pam Hauser, Supervisor, (336) 317-5003, pamela.hauser@dhhs.nc.gov if you have questions. Thank you for your time and assistance during the visit. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0608 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/19/2026 Number Present: 28 Completed Date: 5/19/2026 Age: From 1 To 5 Total Minutes: 230 Time In: 10:10 AM Time Out: 02:00 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Sims, Director. Your program currently operates with a 4-Star license effective 6/23/2025. Restrictions include 1st shift care, meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility; and diapering using standing procedures only in Space 3. The program’s compliance history was 85% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, participating in general routines, and playing outdoors during the visit. Four new staff members were reported at this program. The files for these staff members were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Recognizing and Responding to Suspicions of Child Abuse and Maltreatment, Special Trainings, and Criminal Background Checks No medications were observed or reported. Storage of hazardous items was monitored today and found to be in compliance. The most recent playground inspection was recorded 5/06/2026. A fire drill was recorded on 5/06/2026. The most recent lockdown drill for the facility was recorded on 4/07/2026. The most recent fire inspection was on 12/01/2025. I observed a sanitation inspection was last conducted on 4/21/2026 earning a Superior classification. The program does not participate in off-premise or aquatic activities at this time. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. 10A NCAC 09 .0601(a) 823 Toxic plants were accessible to children. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. .0604(l) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. .0604(q) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed to be completed and signed by one new staff member with a start date of 5/06/2026. .0608(d)(1-4) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/02/26. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane Unit 146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: The mulch in both fall zones located beneath the plastic slides of the stationary structure measured three (3) inches and zero (0) inches in depth, respectively. It is important for mulch beneath equipment with a critical height of more than 5 feet, but less than 7 feet, to have at least six inches of approved loose surfacing material to ensure the safety of children enrolled if a child should fall from the equipment while playing. You may consider moving extra mulch from outside the external limits of the equipment for six feet to these fall zones to ensure the six inches in depth can be met. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. It is imperative for the EPR plan to be current at all times in the event a true emergency occurs and an emergency evacuation is necessary so all emergency personnel and center staff have access to this information. You may consider setting a calendar reminder to ensure this plan is updated in the Risk Management Portal annually as required. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. It is imperative for the outdoor environment be a safe place for children to engage with and explore at all times. Ms. Springs stated she would ensure the branches of this tree were trimmed back. She also stated she would cover this cracked area on the plastic border as soon as possible, but that the resin they tried with areas of border on the playground used by preschool children was not successful. You may consider adding these items to a daily indoor and outdoor safety check to complete each day prior to children arriving for care. Consultation Provided During Visit: The following General Statute and Child Care Rules were reviewed with Ms. Sims during the visit: § 110 90.2. Mandatory child care providers' criminal history checks 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) regarding staff modeling appropriate eating behaviors 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) (2) regarding the date the center's policy was given and explained to the individual Monitor all walls for paint which may be beginning to peel. Make sure you check all packaging containing diaper wipes when these are purchased for your program or when parents bring them to your facility (especially on plastic packages of individual wipes) for warning labels which would require these packages to be inaccessible (not necessarily locked) to children at all times. Relocate the posted evacuation plan in Space 3 so it is easily visible. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you; you were given the opportunity to as questions. Contact me at (Cara McKeown-Stewart, (336) 408-4849, cara.mckeown-stewart@dhhs.nc.gov) or (Pam Hauser, Supervisor, (336) 317-5003, pamela.hauser@dhhs.nc.gov if you have questions. Thank you for your time and assistance during the visit. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/19/2026 Number Present: 28 Completed Date: 5/19/2026 Age: From 1 To 5 Total Minutes: 230 Time In: 10:10 AM Time Out: 02:00 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Sims, Director. Your program currently operates with a 4-Star license effective 6/23/2025. Restrictions include 1st shift care, meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility; and diapering using standing procedures only in Space 3. The program’s compliance history was 85% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, participating in general routines, and playing outdoors during the visit. Four new staff members were reported at this program. The files for these staff members were reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Recognizing and Responding to Suspicions of Child Abuse and Maltreatment, Special Trainings, and Criminal Background Checks No medications were observed or reported. Storage of hazardous items was monitored today and found to be in compliance. The most recent playground inspection was recorded 5/06/2026. A fire drill was recorded on 5/06/2026. The most recent lockdown drill for the facility was recorded on 4/07/2026. The most recent fire inspection was on 12/01/2025. I observed a sanitation inspection was last conducted on 4/21/2026 earning a Superior classification. The program does not participate in off-premise or aquatic activities at this time. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. 10A NCAC 09 .0601(a) 823 Toxic plants were accessible to children. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. .0604(l) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. .0604(q) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed to be completed and signed by one new staff member with a start date of 5/06/2026. .0608(d)(1-4) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/02/26. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane Unit 146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: The mulch in both fall zones located beneath the plastic slides of the stationary structure measured three (3) inches and zero (0) inches in depth, respectively. It is important for mulch beneath equipment with a critical height of more than 5 feet, but less than 7 feet, to have at least six inches of approved loose surfacing material to ensure the safety of children enrolled if a child should fall from the equipment while playing. You may consider moving extra mulch from outside the external limits of the equipment for six feet to these fall zones to ensure the six inches in depth can be met. The Emergency Preparedness and Response Plan for the facility had not been updated since 12/04/2024. It is imperative for the EPR plan to be current at all times in the event a true emergency occurs and an emergency evacuation is necessary so all emergency personnel and center staff have access to this information. You may consider setting a calendar reminder to ensure this plan is updated in the Risk Management Portal annually as required. Holly berries (toxic to children) were observed to have fallen from a tree located outside the property onto the inside of the back right side of the playground (facing away from the building) used by children ages three, four, five, and School Age. Greater than two plastic grocery bags were observed on a shelf in Space 1 designated for children one and two years of age, less than five feet from the ground and accessible to children; these bags were made inaccessible to children during the visit. The fiberboard trim covering the border of the playground used by children one and two years of age was observed to be brittle and in disrepair on the left side of this playground; small pieces of this board were breaking off in pieces, creating a choking hazard. The plastic playground board located at the back of this playground was observed to be cracked and sharp to the touch in one area, as well as a pinching hazard. It is imperative for the outdoor environment be a safe place for children to engage with and explore at all times. Ms. Springs stated she would ensure the branches of this tree were trimmed back. She also stated she would cover this cracked area on the plastic border as soon as possible, but that the resin they tried with areas of border on the playground used by preschool children was not successful. You may consider adding these items to a daily indoor and outdoor safety check to complete each day prior to children arriving for care. Consultation Provided During Visit: The following General Statute and Child Care Rules were reviewed with Ms. Sims during the visit: § 110 90.2. Mandatory child care providers' criminal history checks 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (j) regarding staff modeling appropriate eating behaviors 10A NCAC 09 .0608 PREVENTION OF SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA (d) (2) regarding the date the center's policy was given and explained to the individual Monitor all walls for paint which may be beginning to peel. Make sure you check all packaging containing diaper wipes when these are purchased for your program or when parents bring them to your facility (especially on plastic packages of individual wipes) for warning labels which would require these packages to be inaccessible (not necessarily locked) to children at all times. Relocate the posted evacuation plan in Space 3 so it is easily visible. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you; you were given the opportunity to as questions. Contact me at (Cara McKeown-Stewart, (336) 408-4849, cara.mckeown-stewart@dhhs.nc.gov) or (Pam Hauser, Supervisor, (336) 317-5003, pamela.hauser@dhhs.nc.gov if you have questions. Thank you for your time and assistance during the visit. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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 .1003 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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 .3009 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 29 Completed Date: 11/18/2025 Age: From 1 To 5 Total Minutes: 505 Time In: 08:20 AM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements, including compliance with requirements located in Child Care Rule Section .3000 in Space 4 where children participating in the NC Pre-K program are cared for. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a four-star license, issued June 3, 2025. Restrictions include 1st shift care; meets enhanced ratios and enhanced space; children under 2 ½ years old in rooms with direct exits only; children in care on main floor of facility, and diapering using standing procedures only in Space 3. The license was posted, and restrictions were observed in compliance. The Secretary of State website was monitored on 11/18/2025, and Lilly’s Network, LLC was listed as Current/ Active. The sanitation inspection was completed 9/16/2025 with a “Superior” classification. The last fire inspection was conducted 9/16/24, and your facility was approved for daytime care only. The center's compliance history was reviewed with the operator. The program’s compliance history was 76% percent as of 11/18/25. All programs are required to maintain 75% compliance. Upon arrival, the license was posted. Four classrooms were observed during this visit. All indoor and outdoor areas were observed during the visit. Upon arrival staff/child ratio was observed and recorded on the attached worksheet. Supervision was adequate during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. I observed children playing in activity areas, participating in general routines, engaging in conversations and activities with their teachers, playing outdoors, eating lunch, and napping during the visit. I observed interactions between staff and children. An allergy list was posted in each classroom and in the kitchen. Storage of hazardous items was monitored and found to be in compliance. No medications were observed, nor reported. One 15-passenger 2016 Ford T-350 Transit Wagon van, License Plate # NY815, is used to transport ten children to and from school. Vehicle insurance was observed to have an effective date of 6/15/2025 and an expiration date of 12/15/2025, with automatic insurance renewal. The registrations and inspections for both vehicles were observed to be current and in compliance. All other transportation requirements were monitored for compliance. This program does participate in off-premise and aquatic activities during the summer with School Age children only. Staff and Training Worksheets were submitted prior to the visit. Staff files and children’s records were monitored per DCDEE procedures. Four new staff members were reported at the program. The files for one existing staff member and the four new staff members were monitored during the visit. The files for four children enrolled were monitored during the visit. Playground inspections, lockdown/ shelter-in-place drills and fire drill logs were monitored and observed to be in compliance for one year. A fire drill was conducted on 11/05/2025. A lockdown drill was completed on 10/15/2025. A playground inspection was completed on 11/06/2025. Ms. Springs stated the facility has had an NC Pre-K classroom since August 13, 2025. Ms. B. Davis, Lead Teacher, is reflected in the NCPK Plan. The facility follows a staff: child ratio for NCPK of 1 teacher: 10 children. Eleven children are enrolled in the classroom; however, one child is not funded by NCPK and is private pay. Your program was monitored today for compliance with implementing an approved curriculum as required for all Four- and Five- Star licensed facilities where four-year-old children are enrolled. Your facility uses Creative Curriculum and uses the Teaching Strategies Gold activity plan format. The DIAL-4 is used as a screening tool. Family services offered include parents volunteering to donate items for class celebrations and curriculum activities. Parents participate in home visits, individual parent meetings, Open House, Orientation, Curriculum Nights, and parent projects sent home throughout the year. Parents are invited to Trunk-or-Treats, Spring Flings, a Christmas Gala, Muffins for Moms, Doughnuts for Dads, etc., and to visit the classroom to share any special skills or talents they have. Parent/teacher conferences are offered once per month, and an onsite orientation with parents when children register. Regular home projects are provided for families to engage in and complete together, and the program has recently signed up for Ready Rosie. Teachers reach out to parents by the second day a child is absent to find out the reason for the absence. Teachers also send monthly newsletters and use ProCare to send pictures and messages to parents, as well as having face-to-face contact in the mornings and afternoons. The NC Pre-K requirements in section .3000 of the childcare rules were monitored for compliance. The completed NC Pre-K Program Site Monitoring Tool was reviewed today; a copy of this tool was emailed to me during the visit. Staff-child ratios and maximum group sizes required in Child Care Rule 10A NCAC 09 .3009 were verified in compliance. The current NC Pre-K staff are lead teacher, Breyonna Harris and teacher, Mahonda Stafford. A selection of files was monitored for completed health assessments and developmental screenings. DIAL-4 screenings were onsite for review during the visit and monitored. The site uses the Teaching Strategies Gold instrument to document evidence of children's ongoing progress; the next checkpoints for students enrolled will be completed in April/May. The checkpoint assessments are conducted three times per year: at the beginning, middle and end of the school year (October, January, and April/May). The first day of school was 8/13/2025. The Environment Rating Scale score received for the permit dated 6/03/2025 was 5.72. The following violations were cited during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was conducted on 9/16/24. 10A NCAC 09 .0304(a) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. Staff/ child ratios applicable to children of School Age were not posted in Space 4. .0713(a)(10), (c) & (f)(3); .2818(e) 415 A current schedule was not posted for each group of children for reference. A current schedule for children of School Age was not observed to be posted. GS 110-91(12);.0508(a) 428 A current activity plan was not posted for each group of children for reference. A lesson plan for children of School Age was not observed to be posted. GS 110-91(12); .0508(a) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. The blocks center in Space 3 was observed to have one helicopter and one toy bus for blocks accessories. .0510(d)(1) 539 When screen time was provided to school-aged children, it was not offered as a free-choice activity; not used to meet a developmental goal; was not limited to 30 minutes per day and no more than a total of two and a half hours per week, per child; and/or was not documented on a cumulative log or the activity plan that is available for review. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. .2508(e)(1-5) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. 15A NCAC 18A .2825(a) 807 A safe indoor and outdoor environment was not provided for the children. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A plastic grocery bag was observed on the counter of Space 2, less than five feet from the ground and accessible to children under three years of age. Two thin plastic wrappers (one open) containing feathers were observed accessible to children under three years of age in the art center of Space 3. .0604(q) 1043 All staff records, except financial records, were not made available for review. The file for one substitute staff member present during the visit was incomplete. G.S. 110-91( 9) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. .1003(i)(j) 1128 For routine transport of children to and from the center, staff did not use the list to document attendance as children boarded and departed the vehicle. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. 10A NCAC 09 .1003(l) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. An annual evaluation and professional development plan were not observed on file for one existing staff member. 10A NCAC 09 .0514(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. GS110-91(1) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. G.S. 110-90.2 & .2703(r) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go File in Space 1 did not contain the emergency information for one child enrolled or blank incident reports. The Ready to Go File in Space 3 did not contain the emergency information for two children enrolled. .0607(d)(10) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones of the stationary climbing/slide structure. .0605(k)(1-4) 1890 Each staff member did not have the required medical report, proof of tuberculosis test or screening and/or completed health questionnaire in a medical file, maintained separately from the staff member's individual personnel file. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. .0701(d) 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 facility's compliance history following today's visit is 79%. You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/02/2025. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 4948 Martin View Lane, Unit #146 Winston Salem, NC 27104 Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Due to the number of violations during today’s visit, an unannounced follow-up visit will be made to monitor the correction of violations cited, and an Administrative Action may be recommended. Technical Assistance Provided During Visit: The most recent fire inspection was conducted on 9/16/24. The medical reports for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. The TB tests for two new staff members, with start dates of 10/06/25 and 10/13/25, respectively, had medical reports dated 10/14/25 and 10/15/25, respectively. An annual evaluation and professional development plan were not observed on file for one existing staff member. Lesson plans for children of school age were not observed to be posted. A daily scheduled for children of school age was not observed to be posted. The record of attendance for routine transportation of children from school was observed to have a time of boarding recorded, but not a time of departure from the vehicle upon arrival back to the facility. The file for one substitute staff member who works greater than 10 days per year and who was present during the visit did not contain greater than twelve required records. The health assessment for one child enrolled on 3/03/2025 was observed to be dated 9/23/2025. The transportation authorization forms for all children being transported did not include an expected time of arrival back to the facility. The transportation authorization for one child enrolled did not include a parent signature. The transportation authorization form for one child enrolled was not observed on file for review. One school age child enrolled who was present for summer field trips was not observed to have individual off-premise activity forms completed and on file for each field trip. A screen time log for children of school age who use screen time for 30 minutes daily was not on file for review. Ms. Springs shared she did not realize these records were incomplete or not on file for review, or did not realize certain records were required. It is imperative that all records are current and onsite for review at all times to ensure the health, safety, and quality care of children enrolled. You may consider creating a routine system for reviewing staff, program, and children’s records to ensure all information is accurate and on file. You may take into consideration requesting formal technical assistance and/or coaching through myself or Smart Start of Forsyth County, Child Care Resource Center, or other local partner for support with required file organization and documentation for staff, children, and program files. The Criminal Background Check Qualification Letters for one new staff member (start date 10/06/2025) and one substitute staff member (start date 8/08/24) were not observed linked to the ABCMS Facility Profile within five days of hire. It is necessary for her to be linked to the center’s facility profile in the ABCMS system, as the process of notifying the Division of any new child care providers working who were hired or moved into the child care facility within five business days has changed to include this process. You may consider creating a calendar reminder for all new staff CBC qualification letters to be connected to the facility’s ABCMS profile within five days of hire. One area of the wall in Space 1 was observed to have peeling paint accessible to children one and two years of age; at least two other areas of this wall were also observed to have begun to peel which were located higher up, but still in reach of children enrolled. The black plastic border of the playground used by children of preschool and school age was observed to be cracked and sharp to the touch in at least three areas. A plastic bin containing large Legos and Bristle blocks in Space 3 was observed to be cracked and sharp to the touch; this bin was made inaccessible to children in care during the visit. Greater than three metal border tacks on the playground used by preschool and school age children and one metal border tack on the playground used by children less than three years of age were observed to be raised and not flush with the playground border creating an entanglement hazard. The mulch surfacing on the playground used by preschool and school age children measured between one and four inches in two of the three fall zones. It is essential for the indoor and outdoor learning environments to be safe places for children to engage at all times. You may consider adding these items to your monthly playground inspection. Ms. Springs and I also discussed she may consider reaching out to her local Environmental Health inspector to discuss options for repairing the plastic playground border which align with sanitation requirements. Consultation Provided During Visit: The following Child Care Rules were reviewed with Ms. Springs during the visit: 10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS • Please review all content in your Emergency Preparedness and Response Plan to ensure the highlighted areas and all other areas are current and up to date with current information. • Please ensure hours and dates for completed for Staff Records of Orientation are accurate for each new staff member. • Consider filing down the edges of the plastic zip ties located on the fencing of the playground used for children under two years of age. • S. Parker must complete six additional hours of ongoing training by 12/04/2025. Ms. Springs stated the children currently enrolled in Space 2, the classroom designated for children one and two years of age, is aging up to the classroom for children two and three years of age in Space 3. She shared she is considering providing care for two to three infants and adding infant care to her permit. Ms. Springs stated she discussed this consideration with a local Environmental Health inspector. She stated the EH inspector stated secured bottle warmers, an evacuation crib and ensuring food preparation space is managed effectively would be needed, before the facility begins caring for infants. I stated to Ms. Springs she can submit a written request to me to change this permit restriction on her license once she has met the requirements of Environmental Health, the classroom has an evacuation crib and is fully set up with all required materials for infant care, and staff caring for infants have completed training certification for ITS SIDS. Ms. Springs stated children enrolled participate in sand play daily outdoors, but that due to the rain, the sand tables had to be emptied at the end of last week. Ms. Springs has more sand currently stored in the lobby of the facility and stated she would be placing more sand in the sand tables on the playground within the next two days. As the Hold Harmless period has ended, and preparations for the new QRIS Modernization process are underway, I have included the link below to DCDEE’s NC Child Care Commission’s QRIS Modernization Plan (QRIS Reform) website link: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization • Consider participating in an outreach assessment: https://ncrlap.org/Resources/pages/outreachassessments/ • Visit the NCRLAP website: Get Ready for the 3s (ECERS-3, ITERS-3, FCCERS-3) https://ncrlap.org/Resources/pages/get-ready-for-3s/ Additionally, you may consider reaching out to local partners at Child Care Resource Center and/or Smart Start of Forsyth County. Their teams are working diligently to support programs with training and more detailed information on the ERS-3 at this time. Beginning in October, child care consultants will begin discussing the new rules in Section .3200; Standards for Two through Five Star Rated Licenses during licensing visits. Consultants will review the pathway options, identify facility needs, answer questions, and work with the facility operator to establish an individualized timeline for transition to a new rated license. Ms. Springs stated she is currently still considering which Pathway she will choose; she also stated the facility is currently receiving support from Smart Start of Forsyth County to prepare for completing this process. On-Going Professional Development In addition to the required Health and Safety Trainings, staff can access professional development training on the DCDEE website in Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Orientation and Regulatory. Updated training modules are being added, including a Child Care Rule Rollout with new rules effective July 1, 2025, found under the Regulatory tab. Specifically, under the Orientation tab, I would encourage all staff to complete the training for “Child Development Module.” This training module provides a basic overview about child development and is designed to help early educators support infants, toddlers, and preschool children to reach their next developmental milestone. In addition to gaining introductory knowledge about child development, early educators will learn about the many resources and professional agencies available in North Carolina to help with promoting a responsive and engaging learning environment to support all children served. Upon completion, participants will receive one (1) contact hour credit (CHC). An individual NCID username and password is needed to access the DCDEE Moodle. If you experience problems with Moodle, contact dcdee_moodle_support@dhhs.nc.gov for assistance. For other training-related questions, please contact the Training and Program Development Consultant, Amia Eaton by calling (919) 814-6365 or emailing her at Amia.Eaton@dhhs.nc.gov Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you, and you were provided the opportunity to ask questions regarding the visit. Contact me at Cara McKeown, Child Care Consultant, (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/30/2025 Number Present: 24 Completed Date: 5/30/2025 Age: From 1 To 10 Total Minutes: 190 Time In: 10:35 AM Time Out: 01:45 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Springs, Director. Your program currently operates with a 4-Star license effective 6/16/2024. Restrictions include 1st shift care, meets enhanced space, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use; and diapering using standing procedures only in Space 3. On 12/05/2024, Environmental Health conducted a visit to this facility and added Space 1 as approved space for use. A permit change will be completed following the visit to remove this restriction from the license. The program’s compliance history was 83% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, playing outdoors, and participating in general routines during the visit. No new staff members were reported at this program. No medications were observed, nor reported. Storage of hazardous items was monitored today. The most recent playground inspection was recorded 5/05/2025. A fire drill was recorded 5/09/2025. The most recent lockdown drill for the facility was recorded 4/14/25. The most recent fire inspection was on 8/16/2024. I observed a sanitation inspection was last conducted on 5/05/2025 earning a Superior classification. Ms. Springs requested information regarding being approved for transportation via phone on 5/23/25, and emailed me transportation policies for the facility on 5/28/2025 which included all Child Care Rule requirements providing transportation. Ms. Springs stated the vehicle and required transportation documentation for children enrolled were not ready to be monitored during today’s visit, but she would contact me to schedule an announced visit to monitor transportation once this was complete. The facility may not transport children until the vehicle and all required documentation are monitored. Ms. Springs stated the children of School Age will participate in aquatic activities (swimming) at Bolton Park this summer. I stated to Ms. Springs she will need to create Aquatic Policies for the facility which will include, but may not be limited to, how the facility will meet all Child Care Rule requirements for aquatic activities included in Section .1403 of Child Care Rule ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS. Once completed, send these to me, and I will review them to ensure all requirements for aquatic activities have been addressed in your policies. Children enrolled may not participate in aquatic activities until these policies have been reviewed and confirmed to contain all Child Care Rule requirements for aquatic activities included in Section .1403. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A storage closet containing aerosol sprays and other items labeled Keep Out of Reach of Children with additional warnings was observed to be unlocked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 1, greater than three plastic diaper wrappers and other plastic wrappers were observed inside an unlatched storage closet, accessible to children under three years of age. In Space 3, colored foam blocks were observed to have teeth marks and were accessible to children under the age of three years old. Also in Space 3, two plastic grocery bags were observed to contain clothing stored in children's cubbies located less than five feet from the ground. On the playground used by children less than three years of age, plastic weed block was observed emerging from a sand box; this sand box was removed from this playground during the visit. .0604(q) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. A Ready to Go file was not observed for children enrolled of School Age. .0607(d)(10) 1828 Jump ropes and rubber bands were accessible to children under five years of age without adult supervision. A jump rope was observed lying on the ground of the outdoor play area when children less than five years of age were using the playground. .0604(q) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/13/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: A Ready to Go file was not observed for children enrolled in Space 2, the classroom designated for children of School Age. Ms. Springs stated she would create this file as soon as possible. It is important for all emergency information to be current and on file at all times for the health and safety of children enrolled. You may consider creating a Ready to Go file for children of School Age who will be enrolled at facility during the summer prior to the school year ending. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and on the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. It is imperative the outdoor learning environment be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection to ensure regular monitoring of this area is occurring. Consultation Provided During Visit: The following Child Care Rules were discussed with Ms. Springs during the visit: • 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a)(b)(f)(g) regarding required content for activity plans 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) regarding jump ropes A facility profile for Criminal Background Checks has been created in ABCMS for the facility; however, one staff member has not yet been linked to the facility’s profile. If you need additional assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Ms. Springs requested to change her name on all facility documentation during the visit; she stated she would email me a request for this change following the visit. I shared with Ms. Springs I would contact her regarding next steps she would need to take to complete this process following the visit. Please ensure a current lesson plan meeting all rule requirements is posted for each classroom. Review all posted Staff/Child Ratio Worksheets to ensure information posted is accurate. Consider adding at least two additional materials to the blocks and reading centers in Space 3. Monitor the foam mat located in the blocks center in Space 3 for areas which have tears or pieces beginning to separate from the mat. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit was reviewed with and provided to you, and you were given the opportunity to ask questions. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Cara McKeown-Stewart, Child Care Consultant (336) 408-4849 cara.mckeown-stewart@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0508 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/30/2025 Number Present: 24 Completed Date: 5/30/2025 Age: From 1 To 10 Total Minutes: 190 Time In: 10:35 AM Time Out: 01:45 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Springs, Director. Your program currently operates with a 4-Star license effective 6/16/2024. Restrictions include 1st shift care, meets enhanced space, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use; and diapering using standing procedures only in Space 3. On 12/05/2024, Environmental Health conducted a visit to this facility and added Space 1 as approved space for use. A permit change will be completed following the visit to remove this restriction from the license. The program’s compliance history was 83% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, playing outdoors, and participating in general routines during the visit. No new staff members were reported at this program. No medications were observed, nor reported. Storage of hazardous items was monitored today. The most recent playground inspection was recorded 5/05/2025. A fire drill was recorded 5/09/2025. The most recent lockdown drill for the facility was recorded 4/14/25. The most recent fire inspection was on 8/16/2024. I observed a sanitation inspection was last conducted on 5/05/2025 earning a Superior classification. Ms. Springs requested information regarding being approved for transportation via phone on 5/23/25, and emailed me transportation policies for the facility on 5/28/2025 which included all Child Care Rule requirements providing transportation. Ms. Springs stated the vehicle and required transportation documentation for children enrolled were not ready to be monitored during today’s visit, but she would contact me to schedule an announced visit to monitor transportation once this was complete. The facility may not transport children until the vehicle and all required documentation are monitored. Ms. Springs stated the children of School Age will participate in aquatic activities (swimming) at Bolton Park this summer. I stated to Ms. Springs she will need to create Aquatic Policies for the facility which will include, but may not be limited to, how the facility will meet all Child Care Rule requirements for aquatic activities included in Section .1403 of Child Care Rule ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS. Once completed, send these to me, and I will review them to ensure all requirements for aquatic activities have been addressed in your policies. Children enrolled may not participate in aquatic activities until these policies have been reviewed and confirmed to contain all Child Care Rule requirements for aquatic activities included in Section .1403. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A storage closet containing aerosol sprays and other items labeled Keep Out of Reach of Children with additional warnings was observed to be unlocked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 1, greater than three plastic diaper wrappers and other plastic wrappers were observed inside an unlatched storage closet, accessible to children under three years of age. In Space 3, colored foam blocks were observed to have teeth marks and were accessible to children under the age of three years old. Also in Space 3, two plastic grocery bags were observed to contain clothing stored in children's cubbies located less than five feet from the ground. On the playground used by children less than three years of age, plastic weed block was observed emerging from a sand box; this sand box was removed from this playground during the visit. .0604(q) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. A Ready to Go file was not observed for children enrolled of School Age. .0607(d)(10) 1828 Jump ropes and rubber bands were accessible to children under five years of age without adult supervision. A jump rope was observed lying on the ground of the outdoor play area when children less than five years of age were using the playground. .0604(q) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/13/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: A Ready to Go file was not observed for children enrolled in Space 2, the classroom designated for children of School Age. Ms. Springs stated she would create this file as soon as possible. It is important for all emergency information to be current and on file at all times for the health and safety of children enrolled. You may consider creating a Ready to Go file for children of School Age who will be enrolled at facility during the summer prior to the school year ending. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and on the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. It is imperative the outdoor learning environment be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection to ensure regular monitoring of this area is occurring. Consultation Provided During Visit: The following Child Care Rules were discussed with Ms. Springs during the visit: • 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a)(b)(f)(g) regarding required content for activity plans 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) regarding jump ropes A facility profile for Criminal Background Checks has been created in ABCMS for the facility; however, one staff member has not yet been linked to the facility’s profile. If you need additional assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Ms. Springs requested to change her name on all facility documentation during the visit; she stated she would email me a request for this change following the visit. I shared with Ms. Springs I would contact her regarding next steps she would need to take to complete this process following the visit. Please ensure a current lesson plan meeting all rule requirements is posted for each classroom. Review all posted Staff/Child Ratio Worksheets to ensure information posted is accurate. Consider adding at least two additional materials to the blocks and reading centers in Space 3. Monitor the foam mat located in the blocks center in Space 3 for areas which have tears or pieces beginning to separate from the mat. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit was reviewed with and provided to you, and you were given the opportunity to ask questions. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Cara McKeown-Stewart, Child Care Consultant (336) 408-4849 cara.mckeown-stewart@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 5/30/2025 Number Present: 24 Completed Date: 5/30/2025 Age: From 1 To 10 Total Minutes: 190 Time In: 10:35 AM Time Out: 01:45 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 childcare requirements for a routine unannounced visit. This visit was conducted with Danielle Springs, Director. Your program currently operates with a 4-Star license effective 6/16/2024. Restrictions include 1st shift care, meets enhanced space, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use; and diapering using standing procedures only in Space 3. On 12/05/2024, Environmental Health conducted a visit to this facility and added Space 1 as approved space for use. A permit change will be completed following the visit to remove this restriction from the license. The program’s compliance history was 83% prior to today’s visit. All programs are required to maintain at least 75% compliance. Today, the following items were monitored: • Supervision • Staff / Child Ratio • CPR / First Aid • Special Training • CBC Qualification • ITS – SIDS • Emergency Medical Care Plan • Administration of Medication • Storage of Hazardous Products • Storage of Medication • General Safety • Discipline • Adequate / Approved Space • Program Records • License Posted • Permit Restrictions The license was observed, and the restrictions were found in compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was adequate during the visit. I observed staff/child interactions today. I observed children engaging in conversations and activities with their teachers and in centers, playing outdoors, and participating in general routines during the visit. No new staff members were reported at this program. No medications were observed, nor reported. Storage of hazardous items was monitored today. The most recent playground inspection was recorded 5/05/2025. A fire drill was recorded 5/09/2025. The most recent lockdown drill for the facility was recorded 4/14/25. The most recent fire inspection was on 8/16/2024. I observed a sanitation inspection was last conducted on 5/05/2025 earning a Superior classification. Ms. Springs requested information regarding being approved for transportation via phone on 5/23/25, and emailed me transportation policies for the facility on 5/28/2025 which included all Child Care Rule requirements providing transportation. Ms. Springs stated the vehicle and required transportation documentation for children enrolled were not ready to be monitored during today’s visit, but she would contact me to schedule an announced visit to monitor transportation once this was complete. The facility may not transport children until the vehicle and all required documentation are monitored. Ms. Springs stated the children of School Age will participate in aquatic activities (swimming) at Bolton Park this summer. I stated to Ms. Springs she will need to create Aquatic Policies for the facility which will include, but may not be limited to, how the facility will meet all Child Care Rule requirements for aquatic activities included in Section .1403 of Child Care Rule ACTIVITIES INVOLVING WATER IN CHILD CARE CENTERS. Once completed, send these to me, and I will review them to ensure all requirements for aquatic activities have been addressed in your policies. Children enrolled may not participate in aquatic activities until these policies have been reviewed and confirmed to contain all Child Care Rule requirements for aquatic activities included in Section .1403. The following violations were cited during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. 10A NCAC 09 .0601(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. A storage closet containing aerosol sprays and other items labeled Keep Out of Reach of Children with additional warnings was observed to be unlocked. .2820(b) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. In Space 1, greater than three plastic diaper wrappers and other plastic wrappers were observed inside an unlatched storage closet, accessible to children under three years of age. In Space 3, colored foam blocks were observed to have teeth marks and were accessible to children under the age of three years old. Also in Space 3, two plastic grocery bags were observed to contain clothing stored in children's cubbies located less than five feet from the ground. On the playground used by children less than three years of age, plastic weed block was observed emerging from a sand box; this sand box was removed from this playground during the visit. .0604(q) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. A Ready to Go file was not observed for children enrolled of School Age. .0607(d)(10) 1828 Jump ropes and rubber bands were accessible to children under five years of age without adult supervision. A jump rope was observed lying on the ground of the outdoor play area when children less than five years of age were using the playground. .0604(q) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 6/13/25. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. Technical Assistance Provided During the Visit: A Ready to Go file was not observed for children enrolled in Space 2, the classroom designated for children of School Age. Ms. Springs stated she would create this file as soon as possible. It is important for all emergency information to be current and on file at all times for the health and safety of children enrolled. You may consider creating a Ready to Go file for children of School Age who will be enrolled at facility during the summer prior to the school year ending. On the playground used by children of preschool and School Age, two sections of the black plastic border were observed to be cracked and sharp to the touch. On the playground used by children of preschool and School Age and on the playground used by children less than three years of age, metal border tacks (three and one, respectively) were not observed to be flush with the border. It is imperative the outdoor learning environment be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection to ensure regular monitoring of this area is occurring. Consultation Provided During Visit: The following Child Care Rules were discussed with Ms. Springs during the visit: • 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a)(b)(f)(g) regarding required content for activity plans 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) regarding jump ropes A facility profile for Criminal Background Checks has been created in ABCMS for the facility; however, one staff member has not yet been linked to the facility’s profile. If you need additional assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. Ms. Springs requested to change her name on all facility documentation during the visit; she stated she would email me a request for this change following the visit. I shared with Ms. Springs I would contact her regarding next steps she would need to take to complete this process following the visit. Please ensure a current lesson plan meeting all rule requirements is posted for each classroom. Review all posted Staff/Child Ratio Worksheets to ensure information posted is accurate. Consider adding at least two additional materials to the blocks and reading centers in Space 3. Monitor the foam mat located in the blocks center in Space 3 for areas which have tears or pieces beginning to separate from the mat. • You must notify your consultant 30 days prior to changing the ownership status of your facility. At the completion of the visit, this visit was reviewed with and provided to you, and you were given the opportunity to ask questions. Thank you for your time and assistance during the visit. If you have any questions about the visit, please contact me or my supervisor using the information below. Cara McKeown-Stewart, Child Care Consultant (336) 408-4849 cara.mckeown-stewart@dhhs.nc.gov Pamela Hauser, Supervisor pamela.hauser@dhhs.nc.gov For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0514 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. 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: Lilly's Network Facility ID: 34001416 Consultant: CARA MCKEOWN-STEWART Operation Type: Center Case Number: Visit Date: 12/4/2024 Number Present: 17 Completed Date: 12/4/2024 Age: From 1 To 4 Total Minutes: 385 Time In: 08:35 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced An unannounced annual compliance visit was conducted at this childcare center to monitor compliance with applicable childcare requirements. This visit was conducted by Cara McKeown-Stewart, Childcare Consultant with Danielle Springs, Director. Your program currently operates with a 4-Star license. Restrictions include 1st shift care, meets enhanced ratios, meets enhanced space, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility; Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was monitored on 12/04/2024, and Lilly’s Network, LLC was listed as Current/ Active. The license was observed, and the restrictions were monitored. The program’s compliance history was 94% prior to today’s visit. All programs are required to maintain at least 75% compliance. A walk-through of the facility was completed today. Indoor and outdoor areas were observed. Upon arrival, staff/child ratio and space capacity were monitored as indicated on the attached worksheet. Supervision was monitored during the visit. I observed children playing in activity centers, engaging in conversations and activities with their teachers, and eating breakfast during the visit. I observed developmentally appropriate materials and activities were available to the children in the classrooms. The last temporary time period visit was conducted on 5/13/2024. A sanitation inspection was completed 3/18/2024 with a Superior classification. The last fire inspection was conducted on 8/16/2024. Program records and required postings were monitored. A fire drill was conducted on 11/12/2024. A lockdown drill was documented on 10/28/2024. An outdoor inspection was documented on 12/02/2024. Staff files and children’s records were monitored per DCDEE procedures. Three new staff were reported at the program. The files for one existing staff member and the three new staff members were monitored during the visit. The files for two children enrolled were monitored during the visit. Storage of hazardous items was monitored today. No medications were observed, nor reported. Ms. Springs stated the program does not transport children or participate in off-premise or aquatic activities at this time. I stated to Ms. Springs she must contact me to schedule a visit to monitor transportation requirements prior to transporting children for routine transportation or field trips. The following violations were cited during today’s visit: Violation Number Comment Rule 209 Children used space that was not approved. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. GS 110-91(1)&(4-5) 428 A current activity plan was not posted for each group of children for reference. A current lesson plan was not posted in Spaces 1 and 3. GS 110-91(12); .0508(a) 807 A safe indoor and outdoor environment was not provided for the children. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. 10A NCAC 09 .0601(a) 830 A First Aid information sheet was not posted in a place for referral and/or the information sheet did not include all the required information. A First Aid poster was not observed to be posted in Space 1. .0802(h) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground. One liquid plug-in was observed in the lobby where children enter, leave and transition through. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked. .2820(b) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. 10A NCAC 09 .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. An Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional. .0701(a) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A medical exam was not observed on file for two children enrolled. GS110-91(1) 1823 The EPR Plan did not include the location of the Ready to Go File and or the required information. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. .0607(d)(10) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members. .0608(d)(1-4) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. .1102(g) 1947 An individual on a provisional criminal background check status was not supervised by a staff person who was determined to be qualified. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age. G.S. 110-90.2(b) & .2703(f) Compliance documentation: You must correct the violations found during today's visit immediately and send me documentation verifying compliance on or before 12/18/2024. The following information must be included in your compliance letter: • each violation number, • how you corrected each violation, • what plan will be implemented to prevent each violation from occurring again, • the name of your center, • facility ID number, • date, • title of the person who signs the letter If you state in your Compliance Letter that corrections or changes have been made when they have not, it will be considered falsification of information and could lead to administrative action taken by the DCDEE. You may email the letter to cara.mckeown@dhhs.nc.gov or mail two copies of the letter to: Cara McKeown 353 Jonestown Road, Unit #146 Winston Salem, NC 27104 Repeated violations, continued non-compliance, or failure to submit the compliance letter prior to the date given in this visit summary can also lead to administrative action taken by the DCDEE. Additional monitoring visits may be conducted during the year to monitor compliance with applicable childcare requirements. An unannounced follow-up visit will be conducted to monitor requirements for approved space. Technical Assistance Provided During Visit: A medical exam was not observed on file for two children enrolled. A medical report was not observed on file for one new staff member who started employment on 11/25/2024. A training certificate for Recognizing and Responding to Suspicions of Child Maltreatment training was not observed on file for one new staff member who began work on 9/03/24. Ms. Springs shared she was unaware this documentation was missing or incomplete. It is imperative that all required records are current and onsite for review at all times to ensure the health, safety, and quality of care of children enrolled. You may consider creating a routine schedule for monitoring all program, staff, and children’s files to ensure all records remain complete and current. A Health Questionnaire and Emergency Contact information was not observed on file for one new staff member who began employment on 11/25/2024; each of these forms was completed during the visit. The emergency information for one new staff member who also began employment on 11/25/2024 did not include the responsible party's choice of health care professional; a choice of health care professional was added to this form by the staff member during the visit. Documentation of receipt of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not observed on file for two new staff members; these policies were signed and placed on file for each staff member during the visit. Documentation of Operational and Personnel Policy receipt was not observed on file for one staff member during the visit; this was signed by the staff member and placed on file during the visit. A current lesson plan was not posted in Spaces 1 and 3; each teacher posted current lesson plans during the visit. A First Aid poster was not observed to be posted in Space 1; this item was posted during the visit. The Ready to Go file did not contain the applications for two children enrolled in Space 2 and two children enrolled in Space 4, and a Ready to Go file was not observed for children enrolled in Space 1. Ms. Springs added all of this information and created a Ready to Go file for this classroom during the visit. One small bottle of hand sanitizer was observed stored on top of a shelf in Space 3, less than five feet from the ground; this bottle was placed greater than five feet from the ground during the visit. One outlet was observed in Space 3 without a safety cover; a cover was placed in this outlet during the visit. One liquid plug-in was observed in the lobby where children enter, leave and transition through; this plug-in was placed into locked storage during the visit. One closet located in the same lobby containing items labeled Keep Out of Reach of Child with additional warnings was observed unlocked; this door was locked during the visit. On the playground used by children 2 ½ to 5 years of age, plastic weed block was observed emerging from the grass and dirt surfacing in greater than two areas, creating a potential choking and/or tripping hazard. On the playground used by children one and two years of age, a torn plastic liner was observed exposed in the sand table, creating a potential choking hazard. It is important for the outdoor environment to be a safe place for children to engage with and explore. You may consider adding these items to your monthly playground inspection. One new staff member, employed on 11/25/24, has a Provisional Criminal Background Check Qualification letter through 12/30/24 and was observed to be alone in Space 2 caring for children one and two years of age, instead of with another staff member who has a full qualification letter. Ms. Springs stated the other staff member had to arrive to work late today due to school delays. Another teacher was placed in the classroom with this staff member during the visit. I asked Ms. Springs to notify me when the new employee received her full qualification letter. Permit restrictions state “Space 1 Not In Use”; Space 1 was observed to be used for children one and two years of age during today’s visit. During a Temporary Time Period visit conducted on 5/13/2024 by a lead child care consultant, the consultant documented, “Currently this center operates with a Temporary License, issued on December 15, 2023. The restrictions are Daytime care only, children under 2 ½ years old in rooms with direct exits only, Space 1 not in use, children in care on main floor of facility, and diapering using standing procedures only in space 3. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate 3 classrooms”. In a visit conducted by the lead consultant on 12/05/24, the she documented “Spaces 1 and 2 cannot be opened until fully furnished and approved by Environmental Health”; Space 2 has since been approved for use. Space 1 has not been approved for use. Ms. Springs stated she thought she was able to use the space following another Environmental Health inspector’s visit conducted on 3/18/24, as she stated the inspector walked through Space 1 and tested water temperatures during the visit. She also stated she had not been instructed to contact Environmental Health prior to have approval prior to use two other spaces which had not been in use during a prior sanitation visit. Ms. Springs contacted Environmental Health during the visit, and an inspector is scheduled to monitor Space 1 tomorrow morning at 9 a.m. Until then, Ms. Springs transitioned the children in this space to another classroom for care. Consultation Provided During Visit: The following Child Care Rule was reviewed with Ms. Springs during the visit: - 10A NCAC 09 .0901 GENERAL NUTRITION REQUIREMENTS (g) Please update all posted Staff/Child Ratio worksheets to reflect Voluntary Enhanced Ratios. Please remove all children’s applications and staff contact information from the Ready to Go file who are no longer enrolled in your program. Please check all battery-operated toys to ensure they function properly. Please monitor the plastic playground border for open cracked holes which may encourage vermin and metal border ties that may begin to raise and not remain flush with the border. Monitor all fencing for developing rust. As new staff members begin, submit their education to DCDEE Works. Please ask all CPR/FA instructors to include the name of the approved organization under which they train on staff training certificates and/or cards. North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle—a video tutorial followed by a few questions. 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 on 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. Thank you for your time and assistance during this visit. At the completion of the visit, this visit summary, enrollment worksheet, and monitoring checklist were provided to you. Contact me, Cara McKeown, Child Care Consultant, at (336) 408-4849 or cara.mckeown@dhhs.nc.gov or Pamela Hauser, Licensing Supervisor, pamela.hauser@dhhs.nc.gov if you have questions. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 15 Completed Date: 4/12/2024 Age: From 1 To 5 Total Minutes: 225 Time In: 09:30 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with all applicable child care requirements during the second temporary time visit. The visit was conducted with Danielle Springs, Administrator, by Tammy Childress, Lead Child Care Consultant, and Emily Lamquaye, Child Care Consultant. Currently this center operates with a Temporary License, issued on December 15, 2023, to operate first shift. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate three classrooms within the building with an occupancy of forty. Restrictions are daytime care only, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility, Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was checked today, and the owner, Lilly’s Network LLC, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made or you decide to sale your business, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. All designated indoor and outdoor spaces for child care, all staff files, program records, documents required to be posted, and a percentage of children’s files were monitored during today’s visit. The facility does not provide transportation. There have been no changes to the playground area since the pre-licensing and first temporary time period visits. Meals are prepared at the child care facility and children eat all meals in their classroom. The playground is located behind the childcare building and is surfaced with wood mulch and grass, is enclosed by four-foot chain linked fencing. Mulch in fall zones at the stationary equipment measured 6-8 inches today. During today’s visit children present were observed to be engaged in group and free choice activities, personal care routines, outdoor play, lunch, and nap. The following violations were cited during today’s visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. Sand and water play were not offered weekly to each group of children in care. .0510(c)(3) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Two bottles stored in the kitchen refrigerator for an enrolled toddler were not labeled and dated. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Vinyl siding was cracked and broken with sharp edges outside of the preschool children's classroom door which is on the playground. .0601(c) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. fire drill for March 2024 was not conducted. .0604(t); .0302(d)(5) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were accessible to the one-year-old children in an unlocked cabinet beneath a diaper changing table. .0604(q) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Documents required for staff files were not maintained as required. .2318 (7) 9995 A violation was found for which there is no item number. A staff member's purse was on a low shelf in an unlocked cabinet in the toddler classroom, a violation of 15A NCAC 18A .2820 STORAGE (g) Purses and other personal effects belonging to child care center employees shall be kept inaccessible to children and shall be stored in accordance with this Rule, as applicable. All violations must be corrected immediately. You must submit documentation on how each violation was corrected to Ms. Childress by April 26, 2024. The documentation should be submitted by email to Ms. Childress at tammy.childress@dhhs.nc.gov using the same format we have already reviewed. Technical Assistance and/or Consultation was provided during today’s visit on the following: Your compliance history affects the star rating. It is imperative that staff maintain compliance with child care rules and requirements at all times. Violations of child care requirements affect the facility’s compliance history. You must maintain a minimum compliance history of seventy-five (75) percent. We again discussed the Rated License Assessment Process and the Environment Rating Scale Assessment. We reviewed the program and education components for a star rated license, how points are earned, and the Environment Rating Scale Assessment. The application for a Star Rated License Assessment and Request for an Environment Rating Scale Assessment was received from Ms. Springs on April 4, 2024, and the ERS assessment has been requested. Continue to prepare for the ERS Assessment by reviewing the Early Childhood Environment Rating Scale (revised edition) booklets, visiting the North Carolina Rated License Assessment Project website at www.ncrlap.org and reviewing resource guides/additional notes/ informational videos and participate in the free online training on topics such as activity areas, indoor and outdoor materials, daily schedules, sanitation, and interactions. You should also contact your local resource and referral agency for additional resources and technical assistance: Smart Start of Forsyth County 7829 North Point Boulevard #200 Winston-Salem, NC 27106 336-725-6011 https://smartstart-fc.org/ Child Care Resource Center 500 West Fourth Street, Suite 202 Winston-Salem, NC 27101 (336)245-4900 https://childcareresourcecenter.org/ Education for staff will be assessed as part of the rated license. Please ensure that all staff members have a WORKS Account and are updated with their correct educational information. The information on each staff member’s WORKS Qualification Letter and what is shown in the DCDEE WORKS system is what will be used to determine the points in education for your license. Instructions for the DCDEE WORKS system is located in the DCDEE website at https://ncchildcare.ncdhhs.gov. Currently two staff members (HO and AV) do not have WORKS Accounts and one staff member (SH) does not have a WORKS Status Letter. Once the Facility Summary Report with the individual classroom and overall assessments scores are received and all staff education is verified through WORKS ,a final visit will be conducted to determine the Star Rated License that will be issued. Lead-Based Paint and Asbestos Testing Child Care Rule 10A NCAC 09 .0601 (f) requires that Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. During pre-licensure, you obtained lead water testing. You must re-test the water every three years and provide both your sanitation inspector and your assigned child care consultant with the testing results. You must complete your enrollment for lead-based paint and asbestos testing NOW, by visiting https://www.cleanwaterforuskids.org/en/carolina/. At this time the information for your facility on the website referenced above shows the status of “enrollment started” for both the free lead-based paint and asbestos testing . To complete enrollment go back to the website to watch a video/webinar and answer questions about the building where your program operates and sign an attestation statement. RTI will determine if testing is then needed. Failure to complete enrollment could result in the issuance of an administrative action. Health and Safety Training All staff must complete Health and Safety Trainings within one year of hire and must be repeated every five years with training certificates on file for review. These trainings can be accessed on the DCDEE website at https://ncchildcare.ncdhhs.gov under the Provider tab from the home screen, select Training and Professional Development, and finally DCDEE Moodle. If you need assistance in locating the trainings, please contact me. It is important to remember that the child care administrator and all staff members must complete the specific Health and Safety Training called “Recognizing and Responding to Suspicions of Child Maltreatment”, within 90 days of employment. This training can be accessed through Moodle or directly at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. Orientation For New Staff/ New Staff Files/ CPR/FA and Trainings Health and safety training shall be in addition to the new staff orientation requirements. Orientation topics should be a review of the policies specific to your facility. All staff, including the director, must receive 16 hours of orientation. The orientation form is available on the DCDEE website www.ncchildcare.ncdhhs.gov under provider documents and forms. All documents listed on the staff file checklist must be in staff files and available for review. All CPR/FA training must be in-person by an approved training. Online only CPR/FA courses will not be accepted. On-Going Professional Development If staff complete approved college courses in child development, for every one college credit hour (CEU) completed staff will earn 16 hours of on-going training. All staff must complete the required number of on-going training hours based upon education and experience within one year of hire and annually. The required number of training hours can be determined for each staff member using the information provided in Child Care Rule 10A NCAC 09 .1103. In addition to the required Health and Safety Trainings, staff can access professional development trainings on Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Early Educator Support, Licensure, and Professional Development (EESLPD), Foundations and Regulatory. Specifically, under the Regulatory section, I would encourage all staff to complete the training for “Child Care Rule Rollout” which includes a section for the overview of new rules and rule amendments effective July 2023. Emergency Preparedness and Response Plan You must complete an EPR Plan on a template at the following website https://rmp.nc.gov/portal/portal.aspx within four (4) months of completing the EPR training. A copy of the EPR plan must be printed and on file at the facility for review. After you complete the Emergency Preparedness and Response in Child Care training, you must conduct either a shelter-in-place or a lockdown drill every three months. Use the Emergency Drill Log to document these additional drills as well as the fire drills. The form is located under the Provider Documents tab on the DCDEE website at www.ncchildcare.ncdhhs.gov. The EPR Plan will be reviewed with all staff upon hire during orientation, whenever changes to the plan occur, and at least yearly. The date of the review of the plan with staff should be documented on the Staff and Training Worksheets. In addition, the administrator must review the plan annually in the portal and make updates if required. Once reviewed, print off the first page of the plan which will reflect the date of the review. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. All children up to 15 months old must have a feeding plan. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All staff files must be maintained at all times with all required documents on file. A summary of today’s was reviewed with Ms. Springs, and she was given the opportunity to ask any questions. If you have any further questions about today’s visit, please contact Ms. Childress at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436. You may also contact the Licensing Supervisor, Pamela Hauser, at pamela.hauser@dhhs.nc.gov if you have concerns regarding today’s visit or regarding any violations documented. 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: Lilly's Network Facility ID: 34001416 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 15 Completed Date: 4/12/2024 Age: From 1 To 5 Total Minutes: 225 Time In: 09:30 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with all applicable child care requirements during the second temporary time visit. The visit was conducted with Danielle Springs, Administrator, by Tammy Childress, Lead Child Care Consultant, and Emily Lamquaye, Child Care Consultant. Currently this center operates with a Temporary License, issued on December 15, 2023, to operate first shift. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate three classrooms within the building with an occupancy of forty. Restrictions are daytime care only, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility, Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was checked today, and the owner, Lilly’s Network LLC, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made or you decide to sale your business, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. All designated indoor and outdoor spaces for child care, all staff files, program records, documents required to be posted, and a percentage of children’s files were monitored during today’s visit. The facility does not provide transportation. There have been no changes to the playground area since the pre-licensing and first temporary time period visits. Meals are prepared at the child care facility and children eat all meals in their classroom. The playground is located behind the childcare building and is surfaced with wood mulch and grass, is enclosed by four-foot chain linked fencing. Mulch in fall zones at the stationary equipment measured 6-8 inches today. During today’s visit children present were observed to be engaged in group and free choice activities, personal care routines, outdoor play, lunch, and nap. The following violations were cited during today’s visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. Sand and water play were not offered weekly to each group of children in care. .0510(c)(3) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Two bottles stored in the kitchen refrigerator for an enrolled toddler were not labeled and dated. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Vinyl siding was cracked and broken with sharp edges outside of the preschool children's classroom door which is on the playground. .0601(c) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. fire drill for March 2024 was not conducted. .0604(t); .0302(d)(5) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were accessible to the one-year-old children in an unlocked cabinet beneath a diaper changing table. .0604(q) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Documents required for staff files were not maintained as required. .2318 (7) 9995 A violation was found for which there is no item number. A staff member's purse was on a low shelf in an unlocked cabinet in the toddler classroom, a violation of 15A NCAC 18A .2820 STORAGE (g) Purses and other personal effects belonging to child care center employees shall be kept inaccessible to children and shall be stored in accordance with this Rule, as applicable. All violations must be corrected immediately. You must submit documentation on how each violation was corrected to Ms. Childress by April 26, 2024. The documentation should be submitted by email to Ms. Childress at tammy.childress@dhhs.nc.gov using the same format we have already reviewed. Technical Assistance and/or Consultation was provided during today’s visit on the following: Your compliance history affects the star rating. It is imperative that staff maintain compliance with child care rules and requirements at all times. Violations of child care requirements affect the facility’s compliance history. You must maintain a minimum compliance history of seventy-five (75) percent. We again discussed the Rated License Assessment Process and the Environment Rating Scale Assessment. We reviewed the program and education components for a star rated license, how points are earned, and the Environment Rating Scale Assessment. The application for a Star Rated License Assessment and Request for an Environment Rating Scale Assessment was received from Ms. Springs on April 4, 2024, and the ERS assessment has been requested. Continue to prepare for the ERS Assessment by reviewing the Early Childhood Environment Rating Scale (revised edition) booklets, visiting the North Carolina Rated License Assessment Project website at www.ncrlap.org and reviewing resource guides/additional notes/ informational videos and participate in the free online training on topics such as activity areas, indoor and outdoor materials, daily schedules, sanitation, and interactions. You should also contact your local resource and referral agency for additional resources and technical assistance: Smart Start of Forsyth County 7829 North Point Boulevard #200 Winston-Salem, NC 27106 336-725-6011 https://smartstart-fc.org/ Child Care Resource Center 500 West Fourth Street, Suite 202 Winston-Salem, NC 27101 (336)245-4900 https://childcareresourcecenter.org/ Education for staff will be assessed as part of the rated license. Please ensure that all staff members have a WORKS Account and are updated with their correct educational information. The information on each staff member’s WORKS Qualification Letter and what is shown in the DCDEE WORKS system is what will be used to determine the points in education for your license. Instructions for the DCDEE WORKS system is located in the DCDEE website at https://ncchildcare.ncdhhs.gov. Currently two staff members (HO and AV) do not have WORKS Accounts and one staff member (SH) does not have a WORKS Status Letter. Once the Facility Summary Report with the individual classroom and overall assessments scores are received and all staff education is verified through WORKS ,a final visit will be conducted to determine the Star Rated License that will be issued. Lead-Based Paint and Asbestos Testing Child Care Rule 10A NCAC 09 .0601 (f) requires that Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. During pre-licensure, you obtained lead water testing. You must re-test the water every three years and provide both your sanitation inspector and your assigned child care consultant with the testing results. You must complete your enrollment for lead-based paint and asbestos testing NOW, by visiting https://www.cleanwaterforuskids.org/en/carolina/. At this time the information for your facility on the website referenced above shows the status of “enrollment started” for both the free lead-based paint and asbestos testing . To complete enrollment go back to the website to watch a video/webinar and answer questions about the building where your program operates and sign an attestation statement. RTI will determine if testing is then needed. Failure to complete enrollment could result in the issuance of an administrative action. Health and Safety Training All staff must complete Health and Safety Trainings within one year of hire and must be repeated every five years with training certificates on file for review. These trainings can be accessed on the DCDEE website at https://ncchildcare.ncdhhs.gov under the Provider tab from the home screen, select Training and Professional Development, and finally DCDEE Moodle. If you need assistance in locating the trainings, please contact me. It is important to remember that the child care administrator and all staff members must complete the specific Health and Safety Training called “Recognizing and Responding to Suspicions of Child Maltreatment”, within 90 days of employment. This training can be accessed through Moodle or directly at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. Orientation For New Staff/ New Staff Files/ CPR/FA and Trainings Health and safety training shall be in addition to the new staff orientation requirements. Orientation topics should be a review of the policies specific to your facility. All staff, including the director, must receive 16 hours of orientation. The orientation form is available on the DCDEE website www.ncchildcare.ncdhhs.gov under provider documents and forms. All documents listed on the staff file checklist must be in staff files and available for review. All CPR/FA training must be in-person by an approved training. Online only CPR/FA courses will not be accepted. On-Going Professional Development If staff complete approved college courses in child development, for every one college credit hour (CEU) completed staff will earn 16 hours of on-going training. All staff must complete the required number of on-going training hours based upon education and experience within one year of hire and annually. The required number of training hours can be determined for each staff member using the information provided in Child Care Rule 10A NCAC 09 .1103. In addition to the required Health and Safety Trainings, staff can access professional development trainings on Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Early Educator Support, Licensure, and Professional Development (EESLPD), Foundations and Regulatory. Specifically, under the Regulatory section, I would encourage all staff to complete the training for “Child Care Rule Rollout” which includes a section for the overview of new rules and rule amendments effective July 2023. Emergency Preparedness and Response Plan You must complete an EPR Plan on a template at the following website https://rmp.nc.gov/portal/portal.aspx within four (4) months of completing the EPR training. A copy of the EPR plan must be printed and on file at the facility for review. After you complete the Emergency Preparedness and Response in Child Care training, you must conduct either a shelter-in-place or a lockdown drill every three months. Use the Emergency Drill Log to document these additional drills as well as the fire drills. The form is located under the Provider Documents tab on the DCDEE website at www.ncchildcare.ncdhhs.gov. The EPR Plan will be reviewed with all staff upon hire during orientation, whenever changes to the plan occur, and at least yearly. The date of the review of the plan with staff should be documented on the Staff and Training Worksheets. In addition, the administrator must review the plan annually in the portal and make updates if required. Once reviewed, print off the first page of the plan which will reflect the date of the review. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. All children up to 15 months old must have a feeding plan. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All staff files must be maintained at all times with all required documents on file. A summary of today’s was reviewed with Ms. Springs, and she was given the opportunity to ask any questions. If you have any further questions about today’s visit, please contact Ms. Childress at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436. You may also contact the Licensing Supervisor, Pamela Hauser, at pamela.hauser@dhhs.nc.gov if you have concerns regarding today’s visit or regarding any violations documented. 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 .0902 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 15 Completed Date: 4/12/2024 Age: From 1 To 5 Total Minutes: 225 Time In: 09:30 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with all applicable child care requirements during the second temporary time visit. The visit was conducted with Danielle Springs, Administrator, by Tammy Childress, Lead Child Care Consultant, and Emily Lamquaye, Child Care Consultant. Currently this center operates with a Temporary License, issued on December 15, 2023, to operate first shift. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate three classrooms within the building with an occupancy of forty. Restrictions are daytime care only, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility, Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was checked today, and the owner, Lilly’s Network LLC, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made or you decide to sale your business, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. All designated indoor and outdoor spaces for child care, all staff files, program records, documents required to be posted, and a percentage of children’s files were monitored during today’s visit. The facility does not provide transportation. There have been no changes to the playground area since the pre-licensing and first temporary time period visits. Meals are prepared at the child care facility and children eat all meals in their classroom. The playground is located behind the childcare building and is surfaced with wood mulch and grass, is enclosed by four-foot chain linked fencing. Mulch in fall zones at the stationary equipment measured 6-8 inches today. During today’s visit children present were observed to be engaged in group and free choice activities, personal care routines, outdoor play, lunch, and nap. The following violations were cited during today’s visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. Sand and water play were not offered weekly to each group of children in care. .0510(c)(3) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Two bottles stored in the kitchen refrigerator for an enrolled toddler were not labeled and dated. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Vinyl siding was cracked and broken with sharp edges outside of the preschool children's classroom door which is on the playground. .0601(c) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. fire drill for March 2024 was not conducted. .0604(t); .0302(d)(5) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were accessible to the one-year-old children in an unlocked cabinet beneath a diaper changing table. .0604(q) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Documents required for staff files were not maintained as required. .2318 (7) 9995 A violation was found for which there is no item number. A staff member's purse was on a low shelf in an unlocked cabinet in the toddler classroom, a violation of 15A NCAC 18A .2820 STORAGE (g) Purses and other personal effects belonging to child care center employees shall be kept inaccessible to children and shall be stored in accordance with this Rule, as applicable. All violations must be corrected immediately. You must submit documentation on how each violation was corrected to Ms. Childress by April 26, 2024. The documentation should be submitted by email to Ms. Childress at tammy.childress@dhhs.nc.gov using the same format we have already reviewed. Technical Assistance and/or Consultation was provided during today’s visit on the following: Your compliance history affects the star rating. It is imperative that staff maintain compliance with child care rules and requirements at all times. Violations of child care requirements affect the facility’s compliance history. You must maintain a minimum compliance history of seventy-five (75) percent. We again discussed the Rated License Assessment Process and the Environment Rating Scale Assessment. We reviewed the program and education components for a star rated license, how points are earned, and the Environment Rating Scale Assessment. The application for a Star Rated License Assessment and Request for an Environment Rating Scale Assessment was received from Ms. Springs on April 4, 2024, and the ERS assessment has been requested. Continue to prepare for the ERS Assessment by reviewing the Early Childhood Environment Rating Scale (revised edition) booklets, visiting the North Carolina Rated License Assessment Project website at www.ncrlap.org and reviewing resource guides/additional notes/ informational videos and participate in the free online training on topics such as activity areas, indoor and outdoor materials, daily schedules, sanitation, and interactions. You should also contact your local resource and referral agency for additional resources and technical assistance: Smart Start of Forsyth County 7829 North Point Boulevard #200 Winston-Salem, NC 27106 336-725-6011 https://smartstart-fc.org/ Child Care Resource Center 500 West Fourth Street, Suite 202 Winston-Salem, NC 27101 (336)245-4900 https://childcareresourcecenter.org/ Education for staff will be assessed as part of the rated license. Please ensure that all staff members have a WORKS Account and are updated with their correct educational information. The information on each staff member’s WORKS Qualification Letter and what is shown in the DCDEE WORKS system is what will be used to determine the points in education for your license. Instructions for the DCDEE WORKS system is located in the DCDEE website at https://ncchildcare.ncdhhs.gov. Currently two staff members (HO and AV) do not have WORKS Accounts and one staff member (SH) does not have a WORKS Status Letter. Once the Facility Summary Report with the individual classroom and overall assessments scores are received and all staff education is verified through WORKS ,a final visit will be conducted to determine the Star Rated License that will be issued. Lead-Based Paint and Asbestos Testing Child Care Rule 10A NCAC 09 .0601 (f) requires that Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. During pre-licensure, you obtained lead water testing. You must re-test the water every three years and provide both your sanitation inspector and your assigned child care consultant with the testing results. You must complete your enrollment for lead-based paint and asbestos testing NOW, by visiting https://www.cleanwaterforuskids.org/en/carolina/. At this time the information for your facility on the website referenced above shows the status of “enrollment started” for both the free lead-based paint and asbestos testing . To complete enrollment go back to the website to watch a video/webinar and answer questions about the building where your program operates and sign an attestation statement. RTI will determine if testing is then needed. Failure to complete enrollment could result in the issuance of an administrative action. Health and Safety Training All staff must complete Health and Safety Trainings within one year of hire and must be repeated every five years with training certificates on file for review. These trainings can be accessed on the DCDEE website at https://ncchildcare.ncdhhs.gov under the Provider tab from the home screen, select Training and Professional Development, and finally DCDEE Moodle. If you need assistance in locating the trainings, please contact me. It is important to remember that the child care administrator and all staff members must complete the specific Health and Safety Training called “Recognizing and Responding to Suspicions of Child Maltreatment”, within 90 days of employment. This training can be accessed through Moodle or directly at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. Orientation For New Staff/ New Staff Files/ CPR/FA and Trainings Health and safety training shall be in addition to the new staff orientation requirements. Orientation topics should be a review of the policies specific to your facility. All staff, including the director, must receive 16 hours of orientation. The orientation form is available on the DCDEE website www.ncchildcare.ncdhhs.gov under provider documents and forms. All documents listed on the staff file checklist must be in staff files and available for review. All CPR/FA training must be in-person by an approved training. Online only CPR/FA courses will not be accepted. On-Going Professional Development If staff complete approved college courses in child development, for every one college credit hour (CEU) completed staff will earn 16 hours of on-going training. All staff must complete the required number of on-going training hours based upon education and experience within one year of hire and annually. The required number of training hours can be determined for each staff member using the information provided in Child Care Rule 10A NCAC 09 .1103. In addition to the required Health and Safety Trainings, staff can access professional development trainings on Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Early Educator Support, Licensure, and Professional Development (EESLPD), Foundations and Regulatory. Specifically, under the Regulatory section, I would encourage all staff to complete the training for “Child Care Rule Rollout” which includes a section for the overview of new rules and rule amendments effective July 2023. Emergency Preparedness and Response Plan You must complete an EPR Plan on a template at the following website https://rmp.nc.gov/portal/portal.aspx within four (4) months of completing the EPR training. A copy of the EPR plan must be printed and on file at the facility for review. After you complete the Emergency Preparedness and Response in Child Care training, you must conduct either a shelter-in-place or a lockdown drill every three months. Use the Emergency Drill Log to document these additional drills as well as the fire drills. The form is located under the Provider Documents tab on the DCDEE website at www.ncchildcare.ncdhhs.gov. The EPR Plan will be reviewed with all staff upon hire during orientation, whenever changes to the plan occur, and at least yearly. The date of the review of the plan with staff should be documented on the Staff and Training Worksheets. In addition, the administrator must review the plan annually in the portal and make updates if required. Once reviewed, print off the first page of the plan which will reflect the date of the review. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. All children up to 15 months old must have a feeding plan. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All staff files must be maintained at all times with all required documents on file. A summary of today’s was reviewed with Ms. Springs, and she was given the opportunity to ask any questions. If you have any further questions about today’s visit, please contact Ms. Childress at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436. You may also contact the Licensing Supervisor, Pamela Hauser, at pamela.hauser@dhhs.nc.gov if you have concerns regarding today’s visit or regarding any violations documented. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1103 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: Visit Date: 4/12/2024 Number Present: 15 Completed Date: 4/12/2024 Age: From 1 To 5 Total Minutes: 225 Time In: 09:30 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with all applicable child care requirements during the second temporary time visit. The visit was conducted with Danielle Springs, Administrator, by Tammy Childress, Lead Child Care Consultant, and Emily Lamquaye, Child Care Consultant. Currently this center operates with a Temporary License, issued on December 15, 2023, to operate first shift. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate three classrooms within the building with an occupancy of forty. Restrictions are daytime care only, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility, Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was checked today, and the owner, Lilly’s Network LLC, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made or you decide to sale your business, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. All designated indoor and outdoor spaces for child care, all staff files, program records, documents required to be posted, and a percentage of children’s files were monitored during today’s visit. The facility does not provide transportation. There have been no changes to the playground area since the pre-licensing and first temporary time period visits. Meals are prepared at the child care facility and children eat all meals in their classroom. The playground is located behind the childcare building and is surfaced with wood mulch and grass, is enclosed by four-foot chain linked fencing. Mulch in fall zones at the stationary equipment measured 6-8 inches today. During today’s visit children present were observed to be engaged in group and free choice activities, personal care routines, outdoor play, lunch, and nap. The following violations were cited during today’s visit: Violation Number Comment Rule 475 Sand and water play activities were not available weekly to each group. Sand and water play were not offered weekly to each group of children in care. .0510(c)(3) 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Two bottles stored in the kitchen refrigerator for an enrolled toddler were not labeled and dated. 15A NCAC 18A .2804(d) 705 Equipment and furnishings were not sturdy, stable and free of hazards. Vinyl siding was cracked and broken with sharp edges outside of the preschool children's classroom door which is on the playground. .0601(c) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. fire drill for March 2024 was not conducted. .0604(t); .0302(d)(5) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were accessible to the one-year-old children in an unlocked cabinet beneath a diaper changing table. .0604(q) 1534 Personnel records were not maintained on file in the timeframes given by Rule .2318(7). Documents required for staff files were not maintained as required. .2318 (7) 9995 A violation was found for which there is no item number. A staff member's purse was on a low shelf in an unlocked cabinet in the toddler classroom, a violation of 15A NCAC 18A .2820 STORAGE (g) Purses and other personal effects belonging to child care center employees shall be kept inaccessible to children and shall be stored in accordance with this Rule, as applicable. All violations must be corrected immediately. You must submit documentation on how each violation was corrected to Ms. Childress by April 26, 2024. The documentation should be submitted by email to Ms. Childress at tammy.childress@dhhs.nc.gov using the same format we have already reviewed. Technical Assistance and/or Consultation was provided during today’s visit on the following: Your compliance history affects the star rating. It is imperative that staff maintain compliance with child care rules and requirements at all times. Violations of child care requirements affect the facility’s compliance history. You must maintain a minimum compliance history of seventy-five (75) percent. We again discussed the Rated License Assessment Process and the Environment Rating Scale Assessment. We reviewed the program and education components for a star rated license, how points are earned, and the Environment Rating Scale Assessment. The application for a Star Rated License Assessment and Request for an Environment Rating Scale Assessment was received from Ms. Springs on April 4, 2024, and the ERS assessment has been requested. Continue to prepare for the ERS Assessment by reviewing the Early Childhood Environment Rating Scale (revised edition) booklets, visiting the North Carolina Rated License Assessment Project website at www.ncrlap.org and reviewing resource guides/additional notes/ informational videos and participate in the free online training on topics such as activity areas, indoor and outdoor materials, daily schedules, sanitation, and interactions. You should also contact your local resource and referral agency for additional resources and technical assistance: Smart Start of Forsyth County 7829 North Point Boulevard #200 Winston-Salem, NC 27106 336-725-6011 https://smartstart-fc.org/ Child Care Resource Center 500 West Fourth Street, Suite 202 Winston-Salem, NC 27101 (336)245-4900 https://childcareresourcecenter.org/ Education for staff will be assessed as part of the rated license. Please ensure that all staff members have a WORKS Account and are updated with their correct educational information. The information on each staff member’s WORKS Qualification Letter and what is shown in the DCDEE WORKS system is what will be used to determine the points in education for your license. Instructions for the DCDEE WORKS system is located in the DCDEE website at https://ncchildcare.ncdhhs.gov. Currently two staff members (HO and AV) do not have WORKS Accounts and one staff member (SH) does not have a WORKS Status Letter. Once the Facility Summary Report with the individual classroom and overall assessments scores are received and all staff education is verified through WORKS ,a final visit will be conducted to determine the Star Rated License that will be issued. Lead-Based Paint and Asbestos Testing Child Care Rule 10A NCAC 09 .0601 (f) requires that Each child care center shall be free of lead poisoning hazards as defined in G.S. 130A-131.7(7) and asbestos hazards. During pre-licensure, you obtained lead water testing. You must re-test the water every three years and provide both your sanitation inspector and your assigned child care consultant with the testing results. You must complete your enrollment for lead-based paint and asbestos testing NOW, by visiting https://www.cleanwaterforuskids.org/en/carolina/. At this time the information for your facility on the website referenced above shows the status of “enrollment started” for both the free lead-based paint and asbestos testing . To complete enrollment go back to the website to watch a video/webinar and answer questions about the building where your program operates and sign an attestation statement. RTI will determine if testing is then needed. Failure to complete enrollment could result in the issuance of an administrative action. Health and Safety Training All staff must complete Health and Safety Trainings within one year of hire and must be repeated every five years with training certificates on file for review. These trainings can be accessed on the DCDEE website at https://ncchildcare.ncdhhs.gov under the Provider tab from the home screen, select Training and Professional Development, and finally DCDEE Moodle. If you need assistance in locating the trainings, please contact me. It is important to remember that the child care administrator and all staff members must complete the specific Health and Safety Training called “Recognizing and Responding to Suspicions of Child Maltreatment”, within 90 days of employment. This training can be accessed through Moodle or directly at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. Orientation For New Staff/ New Staff Files/ CPR/FA and Trainings Health and safety training shall be in addition to the new staff orientation requirements. Orientation topics should be a review of the policies specific to your facility. All staff, including the director, must receive 16 hours of orientation. The orientation form is available on the DCDEE website www.ncchildcare.ncdhhs.gov under provider documents and forms. All documents listed on the staff file checklist must be in staff files and available for review. All CPR/FA training must be in-person by an approved training. Online only CPR/FA courses will not be accepted. On-Going Professional Development If staff complete approved college courses in child development, for every one college credit hour (CEU) completed staff will earn 16 hours of on-going training. All staff must complete the required number of on-going training hours based upon education and experience within one year of hire and annually. The required number of training hours can be determined for each staff member using the information provided in Child Care Rule 10A NCAC 09 .1103. In addition to the required Health and Safety Trainings, staff can access professional development trainings on Moodle under Early Childhood Professional Development in the categories of Child Care and Development Fund (CCDF), Early Educator Support, Licensure, and Professional Development (EESLPD), Foundations and Regulatory. Specifically, under the Regulatory section, I would encourage all staff to complete the training for “Child Care Rule Rollout” which includes a section for the overview of new rules and rule amendments effective July 2023. Emergency Preparedness and Response Plan You must complete an EPR Plan on a template at the following website https://rmp.nc.gov/portal/portal.aspx within four (4) months of completing the EPR training. A copy of the EPR plan must be printed and on file at the facility for review. After you complete the Emergency Preparedness and Response in Child Care training, you must conduct either a shelter-in-place or a lockdown drill every three months. Use the Emergency Drill Log to document these additional drills as well as the fire drills. The form is located under the Provider Documents tab on the DCDEE website at www.ncchildcare.ncdhhs.gov. The EPR Plan will be reviewed with all staff upon hire during orientation, whenever changes to the plan occur, and at least yearly. The date of the review of the plan with staff should be documented on the Staff and Training Worksheets. In addition, the administrator must review the plan annually in the portal and make updates if required. Once reviewed, print off the first page of the plan which will reflect the date of the review. 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. All children up to 15 months old must have a feeding plan. 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All staff files must be maintained at all times with all required documents on file. A summary of today’s was reviewed with Ms. Springs, and she was given the opportunity to ask any questions. If you have any further questions about today’s visit, please contact Ms. Childress at tammy.childress@dhhs.nc.gov or by telephone at (336)317-6436. You may also contact the Licensing Supervisor, Pamela Hauser, at pamela.hauser@dhhs.nc.gov if you have concerns regarding today’s visit or regarding any violations documented. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: Lilly's Network Facility ID: 34001416 Consultant: TAMMY CHILDRESS Operation Type: Center Case Number: Visit Date: 1/29/2024 Number Present: 3 Completed Date: 1/29/2024 Age: From 2 To 3 Total Minutes: 120 Time In: 02:00 PM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor compliance with all applicable child care requirements during the first temporary time visit. The visit was conducted with Danielle Springs, Legal Designee and Director, by Tammy Childress, Lead Child Care Consultant. Currently this center operates with a Temporary License, issued on December 15, 2023, to operate first shift. The facility is licensed to provide care to children ages one to twelve-years-old and is approved to operate three classrooms within the building with an occupancy of forty. Restrictions are daytime care only, children under 2 ½ years old in rooms with direct exits only, children in care on main floor of the facility, Space 1 not in use, and diapering using standing procedures only in Space 3. The Secretary of State website was checked today, and the owner, Lilly’s Network LLC, is current on all required documents and active on the NC Business Registry. If any changes to the corporation need to be made or you decide to sale your business, then you must notify your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Children ages two to three years old were present and were sleeping and then engaged in free choice activities. Ms. Springs plans to open an approved toddler classroom soon. There is currently one classroom in operation with one staff member. Ms. Springs also provides care for children as needed and prior to closing each day. All program records, documents required to be posted, all staff and a sampling of children’s files were monitored. There have been no changes to the playground since the pre-licensing visit. Mulch at the large climbing slide structure was not the required depths at the fall zones. Ms. Springs stated that she had ordered the mulch and was awaiting delivery. The facility does not provide transportation. The following violations were cited during today’s visit: Violation Number Comment Rule 1867 The depth of the loose surfacing was not based on critical height of the equipment. Mulch at at large climbing/slide structure measured less than 6 inches. .0605(k)(1-4) All violations must be corrected immediately. You must submit documentation on how each violation was corrected to Ms. Childress by February 12, 2024. The documentation should be submitted by email to Ms. Childress at tammy.childress@dhhs.nc.gov. Include in the documentation the following: 1. Name of your facility and ID# 2. Date of the Visit 3. Date of the Documentation you are submitting 4. Each Item Number of the Violations Cited 5. Date of when each item number was corrected 6. How the item was corrected and how you will prevent the violation from reoccurring 7. Signature of the person submitting the documentation Your compliance history affects the star rating. It is imperative that staff maintain compliance with child care rules and requirements at all times. Violations of child care requirements affect the facility’s compliance history. You must maintain a minimum compliance history of seventy-five (75) percent. Prior to expiration of the Temporary License, you may apply for a star rated license assessment in order to earn a two to five star rated license. Education for staff will be assessed as part of the rated license. Please ensure that all staff members have a WORKS Account and are updated with their correct educational information. The information on each staff member’s WORKS Qualification Letter and what is shown in the DCDEE WORKS system is what will be used to determine the points in education for your license. Instructions for the DCDEE WORKS system is located in the DCDEE website at https://ncchildcare.ncdhhs.gov. During today’s visit we discussed the two-component rated license process to assist Ms. Springs in deciding if she wishes to request a Rated License Assessment and an Environment Rating Scale Assessment in order to obtain a 2-5 star rated license. Begin reviewing the Early Childhood Environment Rating Scale (revised edition) booklets, and visit the North Carolina Rated License Assessment Project website at www.ncrlap.org. The NCRLAP website offers training and additional notes on topics such as activity areas, indoor and outdoor materials, daily schedules, sanitation, and interactions. You should also contact your local resource and referral agencies, listed below, for additional resources and technical assistance: Smart Start of Forsyth County 7829 North Point Boulevard #200 Winston-Salem, NC 27106 336-725-6011 https://smartstart-fc.org/ Child Care Resource Center 500 West Fourth Street, Suite 202 Winston-Salem, NC 27101 (336)245-4900 https://childcareresourcecenter.org/ Consultation was provided during today’s visit on the following: We discussed the required depth of mulch surfacing for the large climbing/slide structure and how far the surfacing should extend, based upon the child care rule noted below, during today’s visit. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (k) The depth of the loose surfacing material shall be based on the critical height of the equipment, which is defined as the maximum height that a child may sit, or stand, as follows: (1) equipment with a critical height of 5 feet or less shall have 6 inches of loose surface materials; (2) equipment with a critical height of more than 5 feet, but less than 7 feet, shall have 6 inches of loose surfacing material, except for sand; (3) equipment with a critical height of 7 feet to 10 feet shall have 9 inches of any of the loose surfacing material, except for sand; and (4) when sand is used as a surfacing material for equipment with a critical height of more than 5 feet, 12 inches shall be required. (l) Protective surfacing shall cover the area under and around equipment where a child may fall, referred to as the fall zone. The area for fall zones is as follows: (1) for stationary outdoor equipment used by children under two years of age, the protective surfacing shall extend beyond the external limits of the equipment for a minimum of three feet, except that protective surfacing shall be required at all points of entrance and exit for any structure that has a protective barrier; and (2) for stationary outdoor equipment used by children two years of age or older, the protective surfacing shall extend beyond the external limits of the equipment for six feet; The following Technical Assistance was provided during today’s visit: Register with Department of Justice You must register with the Department of Justice to receive e-mail or phone call notification if a sex offender moves into your area. To register, call 1-877-627-2826 or you may register on line at: http://sexoffender.ncdoj.gov/. To reference the law concerning Sex offender and Public Protection Registration Programs you may go to: http://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_14/Article_27A.html. Contact the local Sheriff's Department if a sex offender email or phone notification is received from the NC Sex Offender Registry. Emergency Preparedness and Response Plan You must have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completes the required training within four months of the vacancy. Documentation of completion of the training shall be maintained in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. Once the Emergency Preparedness and Response Training has been completed, you must complete an EPR Plan on a template at the following website https://rmp.nc.gov/portal/portal.aspx within four (4) months of licensure (April 1, 2024). A copy of the EPR plan must be printed and on file at the facility for review. After you complete the Emergency Preparedness and Response in Child Care training, you must conduct either a shelter-in-place or a lockdown drill every three months. Use the Emergency Drill Log to document these additional drills as well as the fire drills. The form is located under the Provider Documents tab on the DCDEE website at www.ncchildcare.ncdhhs.gov. The EPR Plan will be reviewed with all staff upon hire during orientation, whenever changes to the plan occur, and at least yearly. The date of the review of the plan with staff should be documented on the Staff and Training Worksheets. In addition, the administrator must review the plan annually in the portal and make updates if required. Once reviewed, print off the first page of the plan which will reflect the date of the review. The EPR training can be obtained from one of your local resource and referral agencies referenced in this Visit Summary. Recognizing and Responding to Child Maltreatment All staff must complete Recognizing and Responding to Child Maltreatment within 90 days of hire. The training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center A summary of today’s was reviewed with and provided to Ms. Springs, and she was given the opportunity to ask any questions. If you have any further questions about today’s visit, please contact Ms. Childress at tammy.burcham@dhhs.nc.gov or by telephone at (336)317-6436. You may also contact the Licensing Supervisor, Pamela Hauser, at pamela.hauser@dhhs.nc.gov if you have concerns regarding today’s visit or any violations documented. 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