5.1.1 · The licensee shall ensure that the CBCCPP environment and practices support children's health and safety.

At the end of rest time, staff found a child unresponsive, the staff applied ice packs and tried positioning the child in a sitting and standing position. After 39 minutes the staff called for an ambulance. The child did not come through until the paramedics placed him in the ambulance. The child was transported to the hospital at the request of his parent.

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5.8.2 · Staff shall ensure that if an accident or injury occurs to a child, while in attendance, immediate action is taken to protect the child from further harm and notification of the child's parents as quickly as possible.

A parent was notified 4 hours after their child was hurt at the childcare. Staff stated not being aware that they needed to notify parents as soon as possible.

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5.10.1.1.3 · Furniture and equipment shall be sturdy. Furniture and equipment that present a tipping or falling hazard shall be secured.

Staff interview and video footage showed a bookcase holding materials was pushed by a child which fell hitting two children. The bookcase remained unsecured and accessible to children in the classroom.

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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.

A review of the attendance for January 1, 2025 to March 24, 2025 showed that on 21 occasions the number of children exceeded the maximum group size of 20 children. Staff and program director confirmed the group size exceeded 20 children on several days.

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7.4.4 · All staff shall complete fifteen (15) clock hours of annual professional development activities as required in the rule 7.4.2 of these regulations. Substitutes filling a staff position for less than thirty (30) consecutive days within a 365 day period shall be exempt.

Program is found to be in violation of yearly mandatory 15hrs Professional Development for the following staff C.B., K.C., A.D., K.M., C.B., S.B., and A.T.

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5.10.1.5.5 · The licensee shall ensure that all heating and cooling equipment is safely shielded to prevent injury to children and approved for use by the Vermont Division of Fire Safety.

Heating baseboard covers in the new toddler room (far back room) were detached from the heathers exposing the heating elements where children could put their hands and touch the heating pipe. A child was seen hiding under a table around the heating board for several minutes prior to staff noticing themThis is a repeat violation previously cited on 01/18/2023.

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5.10.1.5.5 · The licensee shall ensure that all heating and cooling equipment is safely shielded to prevent injury to children and approved for use by the Vermont Division of Fire Safety.

Heating baseboard covers in the toddler room (back room) and preschool room (front room) were lose or disconnected exposing the heating elements and sharp edges in six (6) locations posing a hazard to children.

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

Three (3) pieces of rodent feces were observed on a shelf in the kitchen, two (2) on the open shelf and (1) inside a bowl located on the same shelf. This is evidence that rodents remain at the program, in the kitchen.

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5.10.4.5.1 · The program director shall ensure that the CBCCPP, its furnishings, and toys are kept in a clean and orderly condition.

It was observed that there was visible loose dirt and grime accumulated on the diapering mats in the preschool, walker, and toddler group classrooms. A pile of dirty towels and/or clothes was on the floor in the hallway between the preschool and infant rooms. Dirty towels were also observed in the corner of the toddler room near the fireplace. Empty beverage containers, doughnut boxes, and loose clothing items and boxes and totes of clothing were located around the preschool classrooms.

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6.1.5.2.1 · Children two (2) years of age to school-age experience shall experience frequent positive interactions with a consistent staff member or team that provides each child with the following opportunities throughout the day: Face to face interaction; A combination of individual, small group, and large group experiences; Conversation with adults and peers during play, eating, and routine care; Being read to and looking at books, individually and in a group; Space and equipment to support developing gross motor skills such as catching and throwing, balancing, jumping, climbing, running, and skipping; Space and materials to support developing small motor skills such as using manipulatives, scribbling, drawing, and writing; Materials, experiences and support for developmentally appropriate pre-literacy and literacy skills; Materials, experiences, and support for developmentally appropriate mathematical and scientific concepts; Open-ended play and activities; Positive recognition of efforts, not just results; Developmentally appropriate problem solving; Materials, time, and encouragement to engage in extended and complex play alone and with peers; Experiences that promote social competence and cooperative play; Encouragement to explore, experiment and initiate activities; Developmentally appropriate independence; and Time, space, and encouragement to gain mastery through play and learning by doing.

The preschool classroom had sparce materials, which were scattered about the classroom. Staff did not have engaging activities prepared for children, who were not able to settle and engage, which resulted in multiple escalated behaviors throughout the classroom at a given time. No visual schedule or routine was evident. Staff were observed going from issue to issue in the classroom and thus positive interactions, being read to, the space and materials to support various developmental domains, were not ocurring in the classroom. This is a repeat violation, cited on 11/29/2021.

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5.2.3.4 · The licensee shall ensure that there is a sturdy diaper changing area with a clean, washable and non-absorbent surface. The diaper changing area shall not be located in the kitchen or any area where food is stored, prepared or served.

The diaper changing pad in the preschool bathroom had multiple tears, exposing the inner foam of the changing pad. This is a violation because with the tear, it is no longer a nonporous surface that can be cleaned.

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3.4.4.1 · The program director shall maintain a complete and up-to-date enrollment file on-site for each child enrolled in the CBCCPP. A complete file shall contain, at minimum, the following information: A completed child's admission form signed and dated by the parent that includes the first date the child attended the CBCCPP and the days and hours the child is regularly scheduled to attend the CBCCPP; The child's name, current home address, and current home telephone number; Identification of child's home language; The child's date of birth; Name, address, and all applicable current telephone numbers for parents; Name, address, and all applicable current telephone numbers for at least two (2) other people designated by the parents as emergency contacts; Names for all persons authorized to pick the child up from the CBCCPP; Record of an annual physical and health history as required in the rule 5.1.2 of these regulations that includes the name and telephone number of the child's primary health care and dental care providers (if the child has a dental care provider); A description of any special medical, developmental, emotional, or educational needs of the child including allergies, existing illnesses or injuries, previous serious illnesses or injuries and any prescribed medication including those for emergency situations; Written authorization from the parent for the CBCCPP to be able to obtain emergency medical care and transportation; Child's immunization record or Vermont Department of Health approved exemption document as required in the rules in section 5.1.3 of these regulations; Written permission from parents for the CBCCPP to transport the child, if transportation is provided, as required in the rule 5.10.6.6.1 of the regulations; Written permission from parents for the child to participate in swimming activities, if swimming activities are a part of the program, as required in the rule 5.10.5.1 of these regulations; If applicable, a copy of court orders on custody and visitation arrangements as required in the rule 3.6.4 of these regulations; and If applicable, any obvious injuries discovered and documented on daily health check as required in the rule 5.3.2 of these regulations.

After a review of a sample of files, it was determined that five (5) children enrolled for more than forty-five (45) days were missing the required general health exam information and three (3) were missing immunization information.

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

Rodent feces, of varying sizes, was present on one shelf storing electric griddles, on another shelf storing bowls and plates, and some rodent feces was observed inside one of the bowls on the shelf. A total of 21 droppings were counted in the two areas.

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7.3.2.2 · Teacher Associate A teacher associate is at least twenty (20) years of age, is a high school graduate or has completed a GED, and meets one (1) of the following qualifications: * At least a Vermont Early Childhood Career Ladder Level Three (3) Certificate; or * At least an associate degree from an accredited college with a major or concentration in Early Childhood, Child or Human Development, Elementary Education, or Child and Family Services and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or * At least a Certificate of Completion from the Registered Child Care Apprenticeship Program; or * At least a Child Care Certificate from the Community College of Vermont and at least twelve (12) months experience working with groups of children from grade three (3) or younger; or * At least successful completion of twenty-one (21) college credits with an early childhood or school age focus and at least twelve (12) months experience working with groups of children from grade three (3) or younger.

A staff member listed as a teacher associate on the associated parties list and fulfilling the duties of a teacher associate as a lead teacher for a group of children did not meet qualifications for the position held.

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6.2.5.7 · Children shall be attended to when they cry.

It was observed through a window inside the program that a toddler/mobile infant child was sitting on a riding toy, holding their arm and audibly crying for over minute. Staff assigned to the child did not respond to the child or approach the child to check in on them.

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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.

The program failed to comply with the April 1, 2022 deadline for the Essential Maintenance Practices filing. When the program did file a report, it did not accurately reflect the condition of the building. It was determined the progam had additional work to complete on the exterior and interior of the building to come into compliance, which were discrepancies on the report that the program filed. As a result, the program received a Notice of Violation from the Vermont Department of Health outlining the work to complete with deadlines assigned. The exterior of the building in the toddler outdoor play area had paint chips in the vegetation at the base of the building. Both preschool rooms had worn flooring, repair of toddler room interior door, and repairs to the exterior of the building where paint is chipped, worn or peeling. This is a repeat violation, cited previously on 10/07/2021.

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6.1.2.4 · Staff shall be interacting with children during outside play.

Three (3) staff were observed to be congregated together on the side of the building while their group of toddlers and mobile infants were playing outside. Children were using slides, riding toys, were in the sandbox, and playing about the outdoor play area with no staff interaction.

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6.2.7.3 · Staff shall use positive methods of guidance and behavior management that encourage self-control, self-direction, self-esteem, and cooperation.

Video footage was observed and it was found that the preschool group had one teacher doing an art project at the table, and another staff supervising children. Child A was observed to be running about the classroom, pushing a child down, and attempting to hit other children with a toy tractor. Child A was placed in time out by Staff B. Child A then left the area where they were instructed to take a break and threw a puzzle board, harimng another child. After throwing the puzzle board, Child A was restrained by staff B for a period of around three (3) minutes and again for approximately one (1) minute. Staff did not intervene with positive methods of guidance, which resulted in the escalating behaviors. This is a repeat violation, previously cited on 11//29/2021.

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6.2.6.5 · Children shall be protected from the harmful acts of other children.

Video footage shows Child A threw a wooden puzzle board at Child B, causing injury to their head that required medical attention. This occurred because staff did not intervene with escalating behaviors leading up to the incident. Staff are aware that Child A needs additional assistance communicating with peers and engaging in play, and did not provide this support to Child A. This is a repeat violation, previously cited on 04/21/2022.

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6.2.6.5 · Children shall be protected from the harmful acts of other children.

During outdoor play on 4/18/2022, Child A was injured when Child B grabbed them by the feet and pulled their feet out from under them, off of a piece of outdoor play equipment. Child A had an swollen area of their head and it was tender to the touch. Leading up to the altercation, staff were aware that Child A was attempting to engage with Child B, who asked Child A to stop. Staff did not intervene or assist Child A to find a positive way to engage with Child B or engage in another activity, resulting in the altercation and injury.

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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.

The associated parties list was reviewed and the program identified 7 (seven) individuals that had not been active at the program for a time span of a few weeks to six months. This is a violation because the associated parties list is required to be updated within five (5) business days.

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5.1.4 · The licensee 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 11/16/2021 and 12/17/2021, CDD sent two (2) separate emails to all programs, one (1) reminder letter using US Postal Service, one (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. The program confirmed that the report had not been submitted and stated that they lost track of time and realized it the day after the report was required to be entered.

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3.2.1 · Serious injury or death of a child: The licensee shall make a timely report to the Division of any injury or accident involving an enrolled child resulting in in-patient or out-patient medical or dental treatment or death. In the event of a death, a verbal report shall be made immediately followed by a written report within twenty-four (24) hours. In the event of an injury or accident resulting in in-patient or out-patient medical treatment, a verbal report shall be made within forty-eight (48) hours and the written report shall be made within five (5) business days.

Child A was injured at the program on 12/17/2021, requiring follow up dental care. The program failed to notify the Child Development Division. No verbal report was made and no incident report was filed, as required.

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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.

Child A threw an object at another child resulting in an altercation between the children. Child A bumped their face on the pavement, chipping their tooth and requiring medical care. Staff did not intervene to address the initial behavior or the altercation between the children.

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6.1.5.2.1 · Children two (2) years of age to school-age experience shall experience frequent positive interactions with a consistent staff member or team that provides each child with the following opportunities throughout the day: Face to face interaction; A combination of individual, small group, and large group experiences; Conversation with adults and peers during play, eating, and routine care; Being read to and looking at books, individually and in a group; Space and equipment to support developing gross motor skills such as catching and throwing, balancing, jumping, climbing, running, and skipping; Space and materials to support developing small motor skills such as using manipulatives, scribbling, drawing, and writing; Materials, experiences and support for developmentally appropriate pre-literacy and literacy skills; Materials, experiences, and support for developmentally appropriate mathematical and scientific concepts; Open-ended play and activities; Positive recognition of efforts, not just results; Developmentally appropriate problem solving; Materials, time, and encouragement to engage in extended and complex play alone and with peers; Experiences that promote social competence and cooperative play; Encouragement to explore, experiment and initiate activities; Developmentally appropriate independence; and Time, space, and encouragement to gain mastery through play and learning by doing.

It was observed that staff in the preschool group were occupied with escalating attention seeking behaviors and were heard telling children: No thank you, I don't like that, no, you know better, stop it, as children were running in circle, jumping on mats, and throwing things around the classroom. Quiet children are being lost in the chaos of the classroom. Children were told to find something to do. There was no conversation with adults and peers during play and lunch. There were no books, paper, writing materials to engage children. Staff did not provide opportunities for cooperative play, small group activities that would promote problem solving, help develop pre-literacy, literacy, mathematical and science skills, and help children gain mastery.

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6.1.3.1 · Staff shall develop, document, and implement a consistent daily routine that includes a balance of: Opportunities for individual, small group and full group play and learning; Opportunities for child-directed as well as provider-directed activities; Active and quiet play; Rest or quiet time as appropriate; and Indoor and outdoor play.

Staff were not following their posted schedule. Some staff stated being unaware of the schedule and routine in the classroom. There were no staff directed activities, quiet play, small group play and learning. Children were running around the classroom, dumping manipulatives on the floor, and throwing things.

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5.4.3.2 · Children shall not be required to sleep. Children who do not nap shall be provided space and equipment for quiet play.

It was observed that all children in the preschool classroom were told to lay on their mat during rest time. Staff X stated that all children are to lay on their mat for 30 minutes before quiet activities or alternate activities are provided to children who do not sleep.

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6.2.7.3 · Staff shall use positive methods of guidance and behavior management that encourage self-control, self-direction, self-esteem, and cooperation.

Staff from the preschool classroom were not using modeling language to help children manage their behavior. Staff were using phrases such as no thank you, stop it, I know you can stop that, I don't like it instead of using methods of behavior management that encourages self-control, self-direction, self-esteem, and cooperation.

Open Not marked corrected in the state record

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