3.3.7.3 · Within six (6) months of initial date of employment, the FCCP and all staff 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 sections 7.3 and 7.4 of these regulations shall be submitted to NLCDC to be verified and maintained in BFIS.

The provider's current first aid/CPR certification is not in BFIS. The substitute's qualification documents, mandated reporter, orientation, and first aid/CPR are not in BFIS.

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7.4.4 · All staff, with the exception of substitutes, shall complete fifteen (15) clock hours of annual professional development activities as required in the rule 7.4.2 of these regulations.

The provider completed seven (7) out of fifteen (15) hours for the year of 9/30/2022 - 9/29/2023 and a violation was cited at the 4/3/2024 visit. The provider did not make up the hours as directed in corrective action. The provider completed seven (7) hours out of fifteen (15) required hours for the year 9/20/2023 - 9/29/2024. This leaves a deficit of sixteen (16) hours that must be completed in addition to the fifteen (15) hours of required annual professional development due by 9/29/2025, for a total of thirty-one (31) hours.

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2.3.7.10 · The prospective FCCP shall ensure that the drinking water system complies with the testing requirements in the Vermont Water Supply Rule and have a first draw test for lead analyzed by a Drinking Water Laboratory certified by the State of Vermont according to 18 V.S.A. S501b. * Results shall meet Vermont standards. * Water may be remedied and retested to ensure potability if any test(s) are elevated. * Bottled water for drinking shall be provided until such time as the drinking water system meets Vermont standards. * Information from this water test shall be included in the initial application.

A review of the Vermont Department of Health Lead in Schools website and communication with the Vermont Department of Health shows that the water tested at above the acceptable limit. The kitchen sink and dowstairs bathroom sink were replaced in 2020, but not tested for lead again. The upstairs bathroom sink was tested and found to be within acceptable limits in August 2019, but has not been tested since. Testing is due every three (3) years.

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5.10.3.2.1 · All outdoor play equipment is sturdy, safe, clean and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts. * To prevent entrapment, no openings in equipment shall be between 3.5 and nine (9) inches. * Chains on swings shall have protective coverings and swing seats shall be made of soft materials with no sharp edges.

There is a climbing structure in the yard where enrolled children play that is made with wooden pallets and other reclaimed wood. The structure is rough and the children can get splinters from it. The structure is also approximately thirty-two (32) inches tall and there is no cushioning material in the use area of the structure. The provider stated that children have been using the climber.

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3.3.7.3 · Within six (6) months of initial date of employment, the FCCP and all staff 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 sections 7.3 and 7.4 of these regulations shall be submitted to NLCDC to be verified and maintained in BFIS.

A review of the provider's BFIS quality and credential account shows that the provider has not submitted First Aid/CPR and Emergency Management training certificates. A review of Staff A's BFIS account shows that qualifications and certificates for mandatory trainings have not been uploaded to BFIS.

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7.4.4 · All staff, with the exception of substitutes, shall complete fifteen (15) clock hours of annual professional development activities as required in the rule 7.4.2 of these regulations.

A review of the provider's BFIS account and conversation with the provider showed that the provider was missing eight (8) hours of professional development between 9/30/2022 and 9/30/2023. The provider has completed three (3) hours of professional development between 9/30/2023 and 4/3/2024. This leaves a total of twenty (20) hours of professional development that must be completed by 9/30/2024.

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7.2.3 · The Division, at its discretion, may use the results of a background check on file with the Division as long as it has been completed within the last five (5) years and instead of requiring a new background check.

The provider did not submit the Record Check Authorization certificate to the Child Development Division before the due date of 6/1/2023. A review of documents in the provider's BFIS account shows that letters to remind the provider were sent on 7/24/2022 and 07/24/2023. The provider showed proof of fingerprinting on 2/6/2024 but did not submit the Record Check Authorization form to the Division until 3/26/2024.

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7.1.2.1 · The FCCP shall have successfully completed pediatric first aid and CPR prior to being licensed and must remain currently certified.

An audit of the FCCP's BFIS quality and credential account and a conversation with the FCCP show that the FCCP does not hold current pediatric first aid and CPR certification. The FCCP stated that she had begun an online First Aid/CPR course last year and had not finished it and has plans to complete the training next month with a local provider group.

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5.10.1.10.3 · All poisonous or toxic materials shall be inaccessible to children.

There were three spray bottles of cleaning fluids and a pump bottle of hand sanitizer within reach of the children in the play space.

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5.10.1.2.5 · There shall be at least one (1) easily accessible dry chemical fire extinguisher which has at least a 2-A: 10BC classification. This fire extinguisher shall be maintained in operating condition. It shall bear an official tag, properly signed, attesting to current operating condition.

The tag on the fire extinguisher shows that it was last inspected in March 2022.

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5.10.3.3 · Safe Use Zones For all play equipment that is thirty (30) inches or higher from the ground, including climbing equipment, slides, swings and other similar equipment, the FCCP shall ensure that the surface under and around the equipment, included recommended use zones, is of approved resilient material that protects children if they fall. * Materials in the use zone shall consist of wood chips, pea stone, mulch, engineered wood fibers, sand, safety-tested shredded or rubber like material or rubber mats designed for protective cushioning; * Materials used in the use zone shall follow the recommendations listed in the most recent publication of U.S. Consumer Product Safety Commission's Public Playground Safety Handbook regarding critical depth of tested materials determined by the height of the highest climbing surface of the equipment; * Materials used in the use zone shall be installed and maintained according to the manufacturer's instructions; * If the loose material such as sand, mulch, or shredded rubber is used in use zones, the FCCP shall ensure that the material is raked regularly and replenished to maintain depth and resilience; and * If the resilient material in use zones freezes, the FCCP shall ensure that the children will not play on the equipment until the resilient material has thawed and is once again resilient.

A dome climbing structure that allows children to reach a height of over 30 inches is placed directly on grass with no cushioning material.

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6.2.1.5 · The registered FCCP shall ensure that the number of staff present meets requirements described in the chart below for ages of children, maximum group size, and staff/child ratios at any time of day.

Nine children were present at the program. Eight of the children were under school aged and one child was school aged. This is two children over ratio. This is a serious violation.

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7.1.3 · Orientation of FCCP and New Staff The FCCP shall complete an orientation training session approved by the Division prior to beginning care for children. The FCCP shall ensure staff complete an orientation training session approved by the Division prior to being left alone with children. Trainees shall complete the orientation training within one (1) month of their first date of working with children. The orientation training session shall include: * Basic knowledge of child growth and development; * Routine and emergency health protection of children including health related exclusions; * Safety and sanitation requirements including handling and storage of hazardous materials and disposal of bio contaminants; * Positive behavior management; * Supervision of children; * Child accident and injury procedures including building and physical premises safety; * Safe sleep practices; * Administration of medication requirements; * Emergency and evacuation requirements; * Nutrition and food safety including prevention of and response to emergencies due to food and allergic reactions; * Recordkeeping; * Transportation and child passenger safety; * Release of children; * Respectful engagement of families; * Preventing, recognizing, and reporting child abuse and neglect, including information about the signs and symptoms of sexual abuse, sexual violence, grooming processes, recognizing the dangers of child sexual abuse, and other predatory behaviors of sex offenders; * Recognition of and response to the symptoms of common childhood illnesses; * Preventing the spread of infectious disease; * Providing developmentally appropriate activities and experiences for children; * Inclusion of children with special needs; * Guidelines for volunteers, trainees, and partner staff; * Responsibility to comply with current applicable licensing regulations; * Background check requirements to include changes in situations, restrictions, and exceptions for those prohibited by these regulations; * Staffing requirements to include opening and closing; and * Ensuring children have extra clothes and diapers available.

A review of BFIS Quality and Credentialing accounts and statements made by the provider show that one (1) substitute who has worked with children has not completed an approved orientation training or mandated reporting training as required.

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3.3.6.1 · The FCCP shall maintain a record of the date of each evacuation drill as required in the rules in section 3.6.2 of these regulations that includes the number of children, 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.

The provider said that evacuation drills have been occurring monthly but have not been documented.

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3.6.3 · Emergency preparedness Training: Within 365 days of opening a FCCH, the FCCP shall attend emergency preparedness training which shall include content specifically related to sheltering in place in the event of an emergency in which the FCCP and children present need to remain in the FCCH for an extended period.

A review of the provider's BFIS Quality and Credential Account prior to the visit, the staff file on-site, and the provider's statement confirm an emergency preparedness training has not been completed.

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5.8.3 · The FCCP 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 3.1 of these regulations.

There were two injuries that occurred with an infant in care and incident reports required to be completed by the provider were not available. The provider indicated she had completed the incident reports in the parent communication app used to communicate daily with parents, however proof the incident reports had been completed could not be verified. The provider gave the parent completed hand- written incident reports in January 2020 stating one injury occurred in October 2019 and one occurred in November 2019.

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6.2.3.5 · The FCCP or at least one (1) staff member shall sit with children during meals and snacks.

The provider stated she has given an infant a snack while he was sitting in a high chair then went to another floor of the home to get something, leaving the infant unsupervised while eating.

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5.4.2.3 · The FCCP and staff shall ensure that infants sleep in cribs or port-a-cribs. Infants shall not be placed to sleep on soft surfaces, such as a couch or sofa, pillow, quilts, sheepskins or blankets. Infants shall not be placed in car seats, swings, high chairs, jumping chairs or similar equipment for sleep. A child that falls asleep in this type of equipment shall be gently transferred to a crib or port-a-crib as soon as feasible.

As Licensor stood in the doorway of the provider's child care space upon arriving, an infant under 12 months of age was observed to be sleeping in an infant swing. The infant woke up as the licensor entered from the doorway and the provider took him out of the swing. The provider stated the infant had been asleep in the swing for approximately one hour. The provider stated she allows the infant to fall asleep in the swing and leaves him in the swing while he sleeps.

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5.4.2.5 · Soft objects, toys or loose bedding shall not be used in infant sleep areas. Soft or loose bedding includes: bumper pads, pillows, quilts, comforters, sheepskins, blankets, flat sheets, cloth diapers, and bibs. Infants shall not be swaddled for sleep.

There was a boppy pillow in a port-a-crib. The provider stated she allows the infant to lay on the boppy pillow while the infant sleeps in the port-a-crib.

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6.2.4.1 · The FCCP and/or staff may need to step away from the children to meet basic care needs throughout the day. This shall be time limited; and the FCCP and/or staff shall be able to hear all children of pre-kindergarten age and younger at all times; and shall be able to physically respond immediately.

The provider stated after laying an infant on the changing table located in the hall, she went into the bedroom across the hall from the changing table to get diapers. The distance between the changing table and the bedroom was approximately ten feet. This distance does not allow the provider to quickly respond to the infant if they were to roll or fall off the changing table.

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5.1.4 · The FCCP shall submit a Vermont Child Care Immunization Report at least once every 365 days to the Vermont Department of Health, Immunization Office as required by 18 V.S.A. SS 1120 - 1129.

Between 11/5/2018 and 12/21/2018, CDD sent 2 separate emails to all programs, 1 reminder letter using US Postal Service, 1 reminder letter sent through the program's BFIS account, and a final email reminder. This communication provided the link to be used and CDD contact information for questions or challenges with submitting the report.

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3.3.6.1 · The FCCP shall maintain a record of the date of each evacuation drill as required in the rules in section 3.6.2 of these regulations that includes the number of children, 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.

There were no evacuation drills documented for January, February and March 2019.

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5.10.1.2.6 · The extinguisher shall be visibly mounted to the wall near an exit door.

The fire extinguisher was not visibly mounted.

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