5.4.2.5 · Soft objects, toys or loose bedding shall not be used in infants' 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.

An infant younger than twelve (12) months old was sleeping with a blanket during this licensing visit. The teacher stated the infant needs it for comfort.

Open Not marked corrected in the state record

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5.2.3.12 · The licensee shall post the diaper changing procedure at each diaper changing area.

The diaper changing procedure was not posted in the preschool bathroom near the changing table or in the toddler classroom near the changing table where diapers were changed the day of this licensing visit.

Open Not marked corrected in the state record

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5.10.1.2.1 · The licensee shall ensure that the CBCCPP is in compliance with Vermont Division of Fire Safety rules at all times. This includes but is not limited to: * Complying with Vermont Division of Fire Safety inspection reports; * Having regular fire systems inspected with violations identified during the inspection noted as corrected; and * Having fire extinguishers tagged with valid inspection tags.

The fire extinguisher in the kitchen and in the classroom did not have a tag with a valid inspection date. The fire extinguisher did have a receipt dated 4/4/2023. The fire panel was dated 2025.

Open Not marked corrected in the state record

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6.2.7.2 · Staff's expectations of children's behavior and responses to children's behavior shall be appropriate to each child's level of development and understanding. Guidance shall be designed to meet the individual needs of each child.

A child refused several times to wash their hands at the kitchen sink where all the children were washing hands. Staff A told the child several times they cannot eat until they wash their hands. Staff A took the child's lunch box out of the refrigerator, showing the child their lunch box. This child refused to wash their hands, looking sad. When Staff A asked the child if they were hungry, the child said yes, but continued to refuse to wash their hands at the kitchen sink. After saying several times, if you don't wash your hands, you cannot eat your snack. Staff A took the child's lunch box and put it in their cubby which was out of the kitchen. This child was not offered a snack. Staff A's expectation was not developmentally appropriate and did not meet the needs of this child.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.3.11 · 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.

A soiled diaper was found by this Licensor at approximately 2:00 on the changing table in the preschool bathroom. The teacher stated it had been left since the morning when a child took off their diaper. At approximately 2:15 a plastic bag with dirty diapers was found hanging off a mirror in the toddler classroom near a changing table. The soiled diapers were not disposed of properly according to this rule. This rule was cited previously on 2/26/2024 and 10/23/2024.

Open Not marked corrected in the state record

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5.4.1.4 · Cots, mats, and mattresses shall be nonporous or have nonporous coverings. Each child shall be provided clean, individual bed linens either by the licensee providing them directly or requiring parents to provide them. No child shall nap directly on nonporous coverings.

The preschool napping cots did not have sheets and children were observed sleeping directly on the nonporous covering during this licensing visit. The preschool teacher stated they took away the sheets because the children would take them off and wrap them around their heads.Two (2) out of the three (3) infant cribs used by children the day of this licensing visit did not have crib sheets and an infant was observed sleeping directly on the crib mattress.

Open Not marked corrected in the state record

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5.10.1.1.1 · The licensee shall ensure that children are protected from electrical outlets, such as by using protective covers, tamper-proof outlets, or other devices manufactured for this purpose.

In the preschool classroom, on the wall where children were playing during this licensing visit were two (2) outlets that did not have safety covers.

Open Not marked corrected in the state record

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5.10.3.1.4 · If fencing is used, it shall be sturdy, safe, and reinforced to give support, constructed to discourage climbing, and shall not prevent visual supervision of children by staff.

The wooden fence enclosing the playground is broken in two (2) different spots; to include broken wooded posts or missing wooden posts. In some areas the posts are split, and the broken pieces are in reach of children. In another area the post is missing which can cause an entrapment hazard.

Open Not marked corrected in the state record

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7.1.2.2 · Staff who are counted in the staff/child ratios and 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 shall obtain training in pediatric first aid and in infant and child CPR within three (3) months of beginning work in the CBCCPP and remain currently certified.

A review of staff's BFIS quality and credential account and verbal confirmation from one (1) staff member that they had not renewed their CPR and First Aid certificate prior to the expiration date. One (1) staff member did not complete a CPR and First Aid course within their first three (3) months of hire as required in this rule. The CPR and First Aid certificate expired on 5/4/2025.

Open Not marked corrected in the state record

Open / not marked corrected.

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 documentation was missing evacuation drills from January, February, April and June of 2025. The staff and director stated they did complete the drills but did not document them.

Open Not marked corrected in the state record

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7.1.3 · 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.

Open Not marked corrected in the state record

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5.2.1.5 · Sinks used for hand washing shall have hot and cold running water that comes from a single spigot. The hot water shall not exceed 120*F.

The two (2) makeshift sinks near the infant changing table and the toddler changing table did not have hot and cold running water. The makeshift sink was a pitcher with a spigot located in an empty bin to catch the water. Both pitchers did not have water for handwashing during this licensing visit.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.3.7 · The container for diapers shall be within arm's reach of the diaper changing area.

In the preschool bathroom the changing table had a soiled diaper sitting on the table. The teacher stated the diaper was there since this morning and carried it to the infant classroom to dispose of it. In the toddler classroom the soiled diapers were in a plastic grocery bag hanging from a mirror in the classroom. Both locations did not have a diaper container within arm's reach of the diaper changing table.

Open Not marked corrected in the state record

Open / not marked corrected.

5.10.3.2.1 · All outdoor play equipment shall be 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.

A plastic slide on the toddler playground was cracked and had holes where children's fingers could be pinched or severely hurt.

Open Not marked corrected in the state record

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7.1.2.2 · Staff who are counted in the staff/child ratios and 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 shall obtain training in pediatric first aid and in infant and child CPR within three (3) months of beginning work in the CBCCPP and remain currently certified.

Review of BFIS credential account for Staff Z, as well as follow up during this visit it was determined Staff Z's certification has not been renewed since it's expiration on 2/28/22. Verification of certification for Staff C was provided to Licensor on site by Staff C. Staff X to complete this training by 11/1/24.

Open Not marked corrected in the state record

Open / not marked corrected.

7.2.2 · The licensee shall ensure that all new staff and auxiliary staff, prior to working with children in the CBCCPP; and any new individual designated as the representative of the licensee shall submit a Records Check Authorization form to the Division and shall submit to fingerprinting at a location designated by the Division after having received the Fingerprinting Authorization Certificate by the Division.

Staff Y was observed as being present in the program and working with children. Staff A identified Staff Y began employment one (1) month prior. Staff Y is not listed on the program's Associated Parties list.

Open Not marked corrected in the state record

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3.4.7.5 · The licensee shall maintain a current list of the licensee or designee, staff, auxiliary staff, and volunteers as in the rules in section 7.7.5 of these regulations, as applicable in BFIS. Any changes shall be reported through BFIS within five (5) working days of the change.

Staff A indicated during review of Associated Parties list that Staff D has not been employed with the program since May 2024.

Open Not marked corrected in the state record

Open / not marked corrected.

3.4.5.1 · A licensee shall maintain a complete and up-to-date personnel file for staff working at the CBCCPP. A complete file shall contain, at minimum, the following information: Name, date of birth, home address and telephone number; Copies of current first aid and CPR certification; Signed statement verifying understanding of legal requirement to report suspected child abuse and neglect; Documentation of a current Records Check Authorization form; Documentation of having read and having ready access to a current copy of applicable child care licensing regulations; Administration of Medication training certification (if applicable); Signed statement verifying current job title and supervisor's name; Application for employment including references or reference checks; Employment start date; Documentation of completed orientation Training; Employment end date; IPDP (Substitutes filling a staff position for less than thirty (30) consecutive days within a 365 day period shall be exempt); and Written annual performance reviews (Substitutes filling a staff position for less than thirty (30) consecutive days within a 365 day period shall be exempt).

When asked for staff files for review, Staff A looked through filing cabinet on site and indicated unable to find any files. When asked where staff files were kept, Staff A indicated they were possibly at her home, or maybe on her computer. Staff A was unable to produce staff files.

Open Not marked corrected in the state record

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4.4.1 · 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.

Open Not marked corrected in the state record

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5.2.3.2 · 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.

Open Not marked corrected in the state record

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5.2.3.11 · 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.

Upon this Licensor's arrival at the program at 10:57 am, a small, clear plastic bag containing a diaper was observed sitting on the changing table in the infant space. Inspection of the diaper determined the diaper to be soiled based on discoloration of the diaper. At 12:09 pm, Staff A was observed lying child B on the changing table. The bag containing the dirty diaper remained on the changing table at the top right corner near Child B's head. Staff A did not clean the changing mat prior to laying Child B down. After checking Child B's diaper, Staff A then threw the plastic bag with the dirty diaper away.

Open Not marked corrected in the state record

Open / not marked corrected.

5.6.4 · 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.

Open Not marked corrected in the state record

Open / not marked corrected.

5.6.7 · A record of the administration of all medications shall be made including medication dosage, time of administration, name of staff administering, and any adverse effects observed. These records shall be maintained for 365 days from the start date of medication administration and may be kept in the child's file or in a medication administration log.

Staff Z identified Child C receives medication daily at the program in the morning and in the afternoon. When asked if Child C had received their dose at the program the morning of the visit. When asked to procude record of medication administration, Staff Z was unable to provide such documentation or clearly identify the process for which medication administration is recorded. Staff A was also unable to provide such documentation and information.

Open Not marked corrected in the state record

Open / not marked corrected.

3.7.2.2 · The licensee shall ensure that evacuation drills are conducted at least once a month, and children and staff are evacuated in under three (3) minutes. Licensees of a CBCCPP located within a public or independent school building may count a lock-down drill performed while the CBCCPP is in operation in place of a monthly evacuation drill with the CBCCPP children and staff and at least three (3) of the monthly drills conducted within 365 days shall be evacuation drills.

Review of evacuation drill record for October 2023 through September 2024, as well as conversations with Staff A and Staff Z, revealed drills were not completed December 2023, or February, March, May, June, July and August 2024.

Open Not marked corrected in the state record

Open / not marked corrected.

6.2.4.3 · The program director shall ensure that each group of children is led by a staff member who is at least qualified as a teacher associate for at least 75% of the hours of operation.

Conversation with Staff A confirmed Staff C is the lead teacher for the preschool group. Based on review of BFIS account for Staff C they do not meet the qualifications of this position.

Open Not marked corrected in the state record

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3.4.6.2 · 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.

Open Not marked corrected in the state record

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6.2.1.3 · 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.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.3.11 · 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 were observed placing wet and/or soiled disposable diapers into reusable washable bags for parents to bring home and dispose of diapers at home.

Open Not marked corrected in the state record

Open / not marked corrected.

6.2.6.1 · 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.

Open Not marked corrected in the state record

Open / not marked corrected.

5.11.6.4 · 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.

Open Not marked corrected in the state record

Open / not marked corrected.