Staff shall be able to hear all children of pre-kindergarten age and younger at all times, shall be able to see the children with a quick glance, and shall be able to physically respond immediately.

While children were eating morning snacks, a child left the kitchen area unnoticed and went to another classroom to play. Staff did not notice the child had left the kitchen for about 5 minutes. During rest time, a child got up and walked to the pre-k classroom where a staff told her to return to the nap room. The child left and went into the kitchen, opened the fridge, took her lunch bag and sat at a kitchen table and began to eat her snack. There were no staff present in the kitchen. The staff did not notice she was there and had to be told by the licensor. On a separate day, the program director stated that all three staff were in the classroom having a heated conversation while children were alone in the back room by themselves. This is a serious violation requiring a parental notification letter.

6.2.6.1 · Not corrected

The licensee shall ensure that the CBCCPP is kept free from rodent and insect infestation.

Mice feces were found on the railing near the entryway to the center and in three upper cupboards in the kitchen. The director stated that the cupboards only contained discarded classroom material.

5.10.4.5.3 · Not corrected

Staff shall wash the hands of children who are unable to wash their own hands and provide developmentally appropriate guidance and supervision to help children learn and practice healthy hand washing.

Children were sent to the bathroom to toilet, one by one. There was no soap or towels available for children to wash their hands when done toileting. Staff watched each child go to the bathroom and return and did not inquire if the children had washed their hands or did not provide instruction to them. No child reported to the teacher that soap and towels were not available.

The licensee, in consultation with the program director, shall establish written program policies and procedures and provide these to staff and to auxiliary staff left alone with children and/or counted in staff/child ratio as specified in the rule 6.2.1.8 of these regulations during an orientation training session approved by the Division prior to being left alone with children. Trainees under eighteen (18) years of age and other staff not left alone with children shall complete the orientation training within at least one (1) month of their first date of working with children. Complete written information and 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, partner staff, auxiliary staff, and business managers; Responsibility to comply with current applicable licensing regulations; Staffing requirements to include opening and closing; and Ensuring children have extra clothes and diapers available.

A review of each staff member's BFIS Quality and Credential account and confirmation that one (1) staff member had not completed the Vermont Orientation as required. They have been working in the program longer than one (1) month.

Staff shall regularly communicate with parents about their child's daily activities and behavior. For children under twenty-four (24) months of age this shall include feedings, diapering, resting, and developmental progress as specified in the rule 6.1.5.1.2 of these regulations.

During review of Child A's account on the communication app Staff A and Staff Z identified as using to communicate with parents, it was found that not all activities required by this rule are being recorded. Only one (1) diaper was recorded for October 22, 2024 and there were no diapers recorded for October 21, 2024. Child A is ten (10) months old. There were no other means of communicating such things as diapering with parents observed or identified by the program.

4.4.1 · Not corrected

Staff shall have an established procedure for checking diapers regularly including visually inspecting children's diapers at least every two (2) hours.

Licensor arrived at the program for this visit at 10:57 am. Six (6) children were observed to be diapers. Upon this Licensor's departure from the program at 1:38 pm, only one (1) child's diaper had been checked.

5.2.3.2 · Not corrected

Written permission from parents to administer medication must include all of the following information for each prescription and non-prescription medication administered to children: * Name of the child; * Child's date of birth; * Any medication allergies; * Name of medication; * Dosage to be given; * Time when medication is to be given; * Route of administration (mouth, ear, nose, topical, inhalation); * Reason for the medication; * Start and end dates for administration of the medication; and * Any special instructions.

When asked about any children receiving medication, Staff Z stated Child C receives a dose of medication daily in the morning and in the afternoon. When asked to review medication forms, Staff Z was unable to produce this required documentation. Staff Z did provide a letter from Child C's doctor indicating this medication is needed, however the letter did not contain all the information required by this rule. The letter also did not contain any parental permission.

The program director 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.

Program was determined to be out of ratio upon this Licensor's arrival. Ages of the children in attendance require a one (1) to four (4) ratio. Staff A was observed to have five (5) children. This is a Serious Violation.

6.2.1.3 · Not corrected

The licensee shall maintain records pertaining to accidents and injuries involving children as required in the rule 5.8.3 of these regulations. These may be kept in children's files or in a separate injury log book. Incident reports related to accidents and injuries shall be kept for a minimum of twenty-four (24) months from the date the incident occurred.

Staff A indicated during the visit that Incident Reports were recorded and maintained through the WonderSchool app, not hardcopy forms. When asked to show this Licensor where in WonderSchool they were kept, Staff A was unable to show Licensor. When asked to provide log in information for the WonderSchool app so further research and investigation could be completed, Staff A would not provide and stated Licensor would not find what they are looking for.

3.4.6.2 · Not corrected

Each diaper changing procedure shall include: * Preparation: assemble supplies, staff member washes hands, prepares changing surface with either a disposable covering or ensure that the surface was recently cleaned and disinfected and bring the child to the diaper changing area. * Dirty Phase: remove soiled diaper, dispose of diaper, and cleanse diaper area of the child. * Clean Phase: put on clean diaper, dress child, and wash the child's hands. * Clean up: clean and disinfect the diaper changing surface, and staff member washes their own hands. * Record diaper change.

Staff shall be able to hear all children of pre-kindergarten age and younger at all times, shall be able to see the children with a quick glance, and shall be able to physically respond immediately.

Based on incident report submitted as well as interviews completed with staff, it was determined while Staff A and Child A were in the kitchen, Staff A was not supervising Child A allowing Child A access to the kitchen stove top and time to turn the stove top on causing a fire. This is a serious violation.

6.2.6.1 · Not corrected

Infants shall be held for bottle-feeding until they are able to hold an unsupported bottle. At no time shall a bottle be propped for feeding an infant.

Upon arrival at the program, Child A was observed sitting propped up in an oversized bean bag chair holding a bottle with the nipple in their mouth. Child A was observed attempting to hold the bottle up high enough so that the milk would go into the nipple of the bottle, however after three (3) attempts to do so, Child A dropped the bottle into their lap. Child A was observed gripping the nipple of the bottle and attempting to pick the bottle up but was unsuccessful. Chld A then sat with the bottle in their lap for five (5) minutes until such time as Staff A approached Child A, picked the bottle up and to the child's mouth and helped the child put their hands around the bottle. Staff A held the bottle for the child for approximately two (2) minutes and then walked away. Child A was observed getting a few sips of milk before dropping the bottle. The bottle rolled onto the floor and was observed being picked up by Staff A and given back to Child A without the nipple being rinsed or cleaned off. Based on conversation with Staff A, this Licensor learned that Child A was five (5) months old. Staff A stated Child A is often placed in the bean bag and trying to hold their own bottle as staff are assisting other children.

5.11.6.4 · Not corrected