LAKE TOXAWAY, N.C. (AP) — North Carolina health officials have told a nature-based therapy program to stop admissions and take other steps to ensure children’s safety during the investigation of a 12-year-old boy’s death earlier this month.

Department of Health and Human Services officials said in a letter to Trails Carolina on Monday that while investigations are ongoing, at least one staffer must be awake when children are asleep and it must stop using bivy bags, weatherproof shelters for one person.

The cause of the boy’s death is still pending, but the Transylvania County Sheriff’s Office said in a news release last week that the pathologist who conducted the autopsy told investigators the death appeared not to be natural. The autopsy was performed because his death appeared suspicious since it occurred less than 24 hours after the boy arrived, the sheriff’s office said.

Trails Carolina, which is in Lake Toxaway, about 35 miles (56 kilometers) southwest of Asheville, describes itself as a nature-based therapy program that helps 10- to 17-year-olds “work through behavioral or emotional difficulties.”

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The boy who died was transported by two men from New York to Trails Carolina on Feb. 2 and assigned to a cabin with other minors and four adult staffers, the sheriff’s office said. The next morning, emergency workers responded to a 911 call reporting that the boy was not breathing.

The sheriff’s office said Trails Carolina hasn’t completely cooperated with the investigation, something the program has disputed. State officials said in their letter that local Department of Social Services staff were on site the day after the boy died, but they couldn’t access the camp’s children until two days later, state health officials said.

In their letter, officials told Trails Carolina that it must allow DSS and law enforcement unlimited and unannounced access to the campsite, staff and clients; provide daily client lists; and report when a child has been restrained in the previous 24 hours. Also, staffers who were in the cabin must be barred from returning to the cabin or campsite.

Trails Carolina said in a statement that it complied with parents’ preferences after seeking permission for children to speak with investigators and children were moved not to avoid investigators but to protect them from seeing what was happening.

“We are a mental health facility treating children with severe, complex mental health diagnoses,” the program said. “Not moving children from the area would have harmed their mental well-being.”

In an affidavit filed with a search warrant that was obtained by WBTV-TV, Detective Andrew Patterson stated that when investigators arrived on Feb. 3, the boy was cold to the touch and his body was in rigor mortis. A CPR mask covered the boy’s face and detectives noted possible bruising around his eye, Patterson stated.

A counselor told detectives that after his arrival, the boy refused to eat dinner and was “loud and irate,” but later calmed down and ate snacks, according to the affidavit. The boy would sleep on the bunk house floor in a sleeping bag inside a bivy that had an alarm on its zipper triggered when someone tries to exit.

The counselor said the boy had a panic attack around midnight and two counselors stood along the wall, but he didn’t mention whether counselors tried to help the boy, according to the affidavit. He said the boy was checked on at 3 a.m., 6 a.m. and when he was found dead at 7:45 a.m., he was stiff and cold to the touch.

In response to details in the search warrant, Trails Carolina said the document contains misleading statements and they were “saddened for the family” to have details made public. The program also maintained that based on available knowledge, there’s “no evidence of criminal conduct or suspicious acts.”