3.7.1.2 · The licensee shall ensure that all staff are trained on the Emergency Response Plan and are aware of where to find the written plan in the CBCCPP.

Three (3) of the five (5) staff providing care reported not being familiar with the program's emergency response plan. They could not identify where it would be in the building nor could they speak to requirements of certain emergency procedures. A fourth staff person stated she had seen it in years past, but had not reviewed it since moving to a new age group/floor of the building.

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5.8.3 · Staff shall create and file an incident report for each accident, injury or medical emergency that leaves a visible mark, or first aid has been administered, even when medical treatment is not required. An incident report shall include the name of the child, date, description of the injury or medical emergency, how it occurred, adult witnesses, first aid provided, and medical care required. The child's parent shall be provided a copy of the report at pick up that day. Serious injuries, animal bites and death must be reported to the Division as specified in the rules in section 3.2 of these regulations.

The infant room staff confirmed during this visit that a child in care has routinely scratched themselves and left marks upon the child's face. When asked if accident reports were completed for scratches that left a mark staff persons could not confirm such documentation was completed. No accident reports were in the child's file kept in the office nor were any completed accident reports in the child's classroom.

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3.4.6.1 · The licensee shall maintain a record of the date of each evacuation drill as required in the rules in section 3.7.2 of these regulations that includes the number of children and staff evacuated, time taken to evacuate, and notation of the drill conducted while children were sleeping or resting. Evacuation records shall be kept for two (2) years. When the CBCCPP counts lock-down drills as allowed in the rules in section 3.7.2 of these regulations, the licensee shall maintain a record of the date of each lock-down drill, the number of CBCCPP children and staff who participated, and note that the drill performed was a lock-down drill.

The fire drill log for calendar year 2021 show drills were not completed in the months of January, February, April, and June. It was confirmed that the program was in operation for those months.

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7.2.1 · The licensee shall ensure that any new individuals regularly present at the CBCCPP submit a Records Check Authorization form to the Division prior to working with children in the CBCCPP.

The program has had two service providers coming to work directly with children in the program since the fall of 2021 and these individuals have not completed record check authorization forms.

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3.3.5 · The licensee, staff, and auxiliary staff shall be trained in prevention, identification and mandatory reporting of child abuse and neglect.

A staff person who has been employed and counted in staff to child ratio since July 2020 has not completed the required mandatory reporter training.

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5.3.2 · Daily Health Check Upon arrival into the CBCCPP staff shall observe each child for symptoms of communicable disease and signs of injuries. Any obvious injuries shall be documented along with any comments from the parent pertaining to the child's condition. This documentation shall be maintained in the child's file for a minimum of 365 days.

A child in the infant classroom has a red scratch upon their face that is visible from 3 ft away and a smaller scratch near their eye that is visible from within 2 ft. Staff acknowledge seeing the two marks at arrival and did not ask the parent/guardian how the marks occurred nor did staff record the presence of the marks as of 12 p.m. It was confirmed the child arrived in the early to mid morning for care.

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3.7.1.1 · The licensee shall develop and maintain a written Emergency Response Plan to respond to a full range of emergencies both natural and man-made. A complete plan shall include how the licensee will address and manage the following situations and responsibilities: * Evacuations or other emergencies such as leaving the premise and lockdown situations; * Specific concerns related to the location of the program, such as proximity to a nuclear reactor, an area prone to flooding or power loss; * Notifying the local authorities of the emergency; * A system for notifying the parents of the emergency; * Notifying the local emergency planning committee regarding the location of the CBCCPP and using the committee as a resource in emergency planning for the program; * A system of identifying the children and staff present at the time of the emergency and maintaining knowledge of their whereabouts; * A system for handling infants, toddlers and children with special needs; * An established evacuation meeting location within walking distance of the CBCCPP; * A system to account for all children and staff at the evacuation meeting place; * A process for relocation if necessary including safe transportation; * A system for shelter in place if the staff and children present need to remain in the CBCCPP for an extended period; and * Staff chain of command and individual staff roles and responsibilities, (if applicable) during emergencies.

In the Emergency Response Plan, eight (8) of the required twelve (12) items are either missing or incomplete. The missing or incomplete items are: a system for notifying parents of an emergency, notifying the local emergency planning committee regarding the location of the CBCPP and & using the committee as a resource in emergency planning for the program, a system to identify the children and staff present at the time of the emergency and maintaining knowledge of their whereabouts, a system for handling infants, toddlers, and children with special needs, a system to account for all children and staff at the evacuation meeting place, a process for relocation if neccessary, including safe transportation, a system for shelter in place if the staff and children present need to remain in the CBCPP for an extended period of time, staff chain of command and individual staff roles and responsiblities during emergencies,

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2.3.9.3 · The licensee shall ensure that all staff have met ongoing background check requirements by submitting at least once every five (5) years a Records Check Authorization form to the Division and as required shall submit to fingerprinting.

The program was issued a fingerprint authorization letter for Staff person A on 03/12/2018. This letter identified the requirement to have Staff person A submit to fingerprint processing in a timely fashion. As of the date of this visit, 01/09/2020, this person has not completed the required fingerprinting authorization process.

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7.1.2 · First Aid and CPR Staff who are counted in the staff/child ratios shall obtain training in pediatric first aid and infant and child CPR within six (6) months of beginning work in the CBCCPP and remain currently certified.

Staff person A's CPR certification expired October 2019 and his/her First Aid certification expired in November 2019. This Staff person is counted in staff to child ratio during this visit and was confirmed to have been employed during the months of October, November, and December.

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5.11.6.5 · Bottles shall be individually labeled with the infant's name and refrigerated immediately after preparation by staff or upon arrival if prepared by a parent.

Two unlabeled bottles were visible upon a shelf in the classroom. In the refridgerator was another unlabeled bottle. When a staff person was asked whose bottle was in the refridgerator it was identified as a child different than the child's name upon the shelf label. This bottle was moved from the shelf to a bin in the refridgerator with a label matching the name of the child to whom the bottle reportedly belonged.

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3.4.6.5 · Staffing Schedule: A licensee shall maintain a written record of the daily schedule for at least 365 days of all staff including exact days and hours worked and the group of children to whom they are assigned.

The staff schedules do not record who works in place of regularly scheduled staff persons. On 11/15, 11/22, and 11/25 Staff person A was not working. The staff schedule for that week did not identify who worked in place of Staff person A. Staff person B was on vacation 11/7, 11/8, 11/11-11/15 and the schedule for the week does not identify who worked in place of Staff person B.

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5.10.1.8 · Childhood Lead Poisoning Prevention The licensee shall comply with the requirements of 18 V.S.A. Chapter 38 Vermont Lead Law and shall ensure that Essential Maintenance Practices (EMP) is performed. This includes but is not limited to protecting children from peeling or chipping paint, and dust build up from the friction of moving doors or windows.

There is chipping and peeling paint on the rails and outer window sills on the two side porches of the building. There is visible paint chips upon the floor boards of the upper porch. It was confirmed that the the window in the infant room that overlooks the lower porch has an air conditioner installed in the window during warmer months. Staff confirmed other windows on the side of the infant room nearest the porch are opened in warmer months. The windows overlooking the upstairs porch are reportedly opened in the preschool room during warmer weather. It was confirmed that the EMP was submitted in March 2019 and deteorating paint on the porch was identified at that time.

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3.4.7.3 · Within six (6) months of the initial date of employment, staff working with children and the program director shall maintain an up- to-date BFIS Quality and Credential Account. Documentation, verification of qualifications and all annual professional development activities as specified in the rules in sections 7.3 and 7.4 of these regulations shall be submitted to NLCDC to be verified and maintained in BFIS.

Four (4) persons listed on the associated parties and confirmed to be current substitutes for the program do not have documentation confirming completion of a high school diploma or GED in his/her Quality and Credential account. Each person has been listed as a substitute for the program for eleven (11) months or longer. An assistant teacher confirmed to be employed more than two years does not have confirmation of completion of a high school diploma or GED in his/her Quality and Credential acount.

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