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.

A review of staff BFIS accounts reflected that Staff A, B and C had not received fingerprint supported background check clearances from the Division. Staff B and C were present at the program and having direct contact with children during the visit on 07/15/2024. The program was not able to provide evidence that any of the three (3) listed staff had yet submitted to fingerprinting. Staff A has worked with the program for five (5) months. Staff B has worked with the program for six (6) months. Staff C has worked with the program for fifteen (15) months. Staff B and C were not observed to be left alone with children during the visit.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Upon review of staff sign in/sign out sheets for the week 11/27/2023-12/1/2023, staff did not sign out six (6) times. This is a repeat violation.

Open Not marked corrected in the state record

Open / not marked corrected.

3.4.3 · A system for taking attendance, including documentation of the time when each child arrives and departs each day he/she attends the CBCCPP, shall be established. The licensee shall save all daily attendance records identifying the hours of children's attendance for at least twelve (12) months from the date that care is provided.

Upon review of attendance the week of 11/27/23-12/1/23, ten (10) times children were not signed out, and three (3) times children were signed out but had not been signed in. This is a repeat violation.

Open Not marked corrected in the state record

Open / not marked corrected.

2.4.1 · When violations are found to exist, the Division will offer the licensee the opportunity to develop a program improvement plan whereby the violations will be corrected within a time period mutually agreeable to the Division and the licensee.

A program improvement plan was created and agreed upon on 11/02/2023 that outlined which staff would be assigned to each classroom, their specific days and hours worked to confirm consistent staff in rooms, and to meet the requirement of having a lead teacher 75% of the time children are in care. Additionally, as part of the Program Improvement Plan, the program stated that all staff schedule modifications or shifts in placement of children in assigned classrooms would be made by the Program Director, to include when off-site as designated staff would contact the Program Director prior to modifications being made. The program modified the Program Improvement Plan without consultation with the Division to include modifying staff days and hours worked, staff employment ending and placement of new staff in classrooms, as well as coverage for breaks. As a result of those changes, the program has not maintained consistent staff in classrooms, nor met the requirement of staff meeting Teacher Associate or higher with all groups of children 75% of the time. Additonally, when asked, the Program Director indicated they had not approved changes to staff coverage as indicated on staff sign in and out sheets.

Open Not marked corrected in the state record

Open / not marked corrected.

6.2.7.1 · The program director shall develop and implement a policy in plain language regarding positive guidance and behavior management of children. The policy shall be routinely provided to staff and parents.

Upon discussion with staff and the Program Director it was shared that children have attended the program who have demonstrated repetitive aggressive behaviors towards staff and other children. It was determined that a procedure has not been created or implemented to ensure children are adequately protected from the harmful acts of other children to include 1) documenting children's behavior, 2) troubleshooting solutions to address behaviors, 3) providing staff with support to ensure safety is maintained, 4) communicating with families and, if applicable service providers, and 6) establishing check-ins to determine next or additional steps to support children and staff.

Open Not marked corrected in the state record

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

During a forty-one (41) minute observation made of outdoor play, two (2) - four (4) staff were on the playground at one (1) time with eight (8) children. Staff A was observed pushing two (2) children on the swings for a combined total of thirty-six (36) seconds. Beyond that, staff were not interacting with children.

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.

During a forty-one (41) minute observation of staff outdoors with children; all four (4) staff were observed on their phones multiple times, to include two (2) staff being on their phone at one (1) time, staff viewing their phone upwards of two (2) minutes at one (1) time, and staff showing their phone screens to other staff. During the duration of the forty-one (41) minutes, to include when staff were on their phones, staff stood in close proximity to each other, often with their backs to children and/or leaning on the fence making observations of people in the parking lot, while children were observed on areas of the playground staff were unable to view them. Children remained in those areas for several minutes at a time without staff supervision.

Open Not marked corrected in the state record

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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.

Through discussions with staff it was determined not all were aware parents shall receive a copy of the incident report on the day the incident occurred. The practice of offerring or providing a copy of the incident report has not consistently been occurring in the program.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Upon review of staffing schedules, it was noted there were multiple days over several weeks that staff either failed to sign in, failed to sign out, or both. As a result it appears either a lack of staffing coverage required for the number of children in care, or no staff present with a group of kids as staff failed to reflect their arrival and departure times. This rule was previously cited on 2/26/2020.

Open Not marked corrected in the state record

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6.2.6 · Supervision of Children Staff shall ensure visual supervision of children, except as allowed in rules 6.2.6.1-6.2.6.4 of these regulations.

Through staff interviews it was confirmed that Child B was observed near the road outside of the playground fence on 9/21/23 around 4:08 pm without staff knowledge. Staff A confirmed that a passerby honked their horn and verbally alerted there was an unattended child near the road. Staff A stated they retrieved the child and brought them back into the fence. Staff confirmed that the program did not discuss this event, nor plan how to avoid this from occurring in the future. This rule was previously cited on 9/18/2018. This is a serious violation.

Open Not marked corrected in the state record

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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.

Upon review of staff schedules, and through interviews with staff it was determined that the preschool classroom has continued to not have a qualified lead teacher meeting requirements for this rule. This rule was previously cited on 8/2/23, 3/31/23 and 8/28/19.

Open Not marked corrected in the state record

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6.1.1 · The program director shall manage the programming of educational and developmental activities to ensure curriculum is developmentally appropriate as required in the rules in section 6.1 of these regulations.

During interviews with staff they stated they submit lesson plans to the Director for review. Staff expressed not receiving feedback on the lesson plans, indicated they are not observed and provided feedback on the implementation of the lessons, nor have adequate resources available to support them in creating curriculum. This was previously part of the corrective action required when previously cited on 8/2/23.

Open Not marked corrected in the state record

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3.2.5 · Self-reported violations: If an incident or situation occurs in a CBCCPP while children are present that could be considered a serious violation as defined in the rule 2.2.50 of these regulations, the licensee has a responsibility to self-report this to the Division within twenty-four (24) hours of the incident. A complete report will include a description of the incident, what the licensee has done to verify the particulars of what occurred, and how the licensee has taken corrective action to ensure the safety and well-being of children and to prevent a future serious violation. If such a report is received in a timely manner from a licensee with a history of consistent regulatory compliance, no child has been seriously injured or harmed as a result of the incident or situation, and the licensee has taken prompt and appropriate corrective action; the Division may, on a case by case basis and at the Division's discretion, elect to issue a warning, rather than a violation related to that incident or situation.

The program had an incident occur on 9/21/23 that rose to a serious violation with a lack of supervision. Staff B, who is identified as one (1) of the two (2) people in charge during the Directors absence stated they were aware a self-report needed to be made, but did not make this report, nor did they inform the Program Director of this incident. The Division learned of the concern through a report from the community.

Open Not marked corrected in the state record

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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.

The preschool classroom does not have someone who minimally meets teacher associate qualifications with that group of children at least 75% of the hours of operation. This rule was previously cited on 3/31/23, and a subsequent variance was denied for Staff A to serve as the lead teacher in the preschool classroom on 4/17/23. The denial letter stated for the program to continue to address the lack of a qualified lead teacher in the preschool classroom through corrective action. On 5/24/23 the program was contacted via email to address overdue corrective action for this rule, to inquire the timeframe for Staff A to become qualified, and to express the room has gone a significant amount of time without a qualified lead teacher. It was identified that the infant room had two (2) lead teachers, and one (1) could serve in the preschool room to meet compliance to this rule. The program continued to have Staff A serve as the lead teacher in the preschool classroom despite not being qualified.

Open Not marked corrected in the state record

Open / not marked corrected.

6.1.1 · The program director shall manage the programming of educational and developmental activities to ensure curriculum is developmentally appropriate as required in the rules in section 6.1 of these regulations.

When asked who manages the curriculum for the program, Staff B stated they create the curriculum for the preschool classroom without oversight or monitoring. Staff A when asked what the curriculum was for the day stated they do not create the curriculum and didn't know what to do, so decided they will just do random things as the lead teacher was not present that day and plans were not previously provided to them.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.1.3 · The licensee shall ensure the hand washing procedures include the following steps in order: * Use of warm running water and liquid soap; * Moistening hands with water, applying soap, and washing hands for a minimum of twenty (20) seconds; * Rinsing hands under running water; * Drying hands with a single use towel or paper towel; and then * Disposing of the towel.

Staff A was observed assisting children in washing their hands upon returning inside after outdoor play. Staff A turned on only the cold water for the duration of the handwashing, was observed placing soap in children's hands while they stood in line waiting and prior to them moistening, and had children wash their hands between five (5) and eight (8) seconds before rinsing. Staff A was observed washing children's hands and their own hands as part of the diaper changing process and was found to wash for two (2) to three (3) seconds before rinsing. Failure to follow handwashing requirements have been cited in previous visits.

Open Not marked corrected in the state record

Open / not marked corrected.

6.1.4.2.3 · Children shall be engaged in developmentally appropriate play, sensory activities, and learning experiences in each of the following areas: * Communication and Expression: Language and literacy development, and creative arts; * Learning about the world: social studies, science, and math; and * Developing of self: approaches to learning, social and emotional development, growing, moving, and being healthy.

When asked how social studies and science are incorporated into the Jungle Room, Staff A expressed surprise this content would be expected for that age agroup, and was unable to describe developmentally appropriate activities that encompass those content areas. In the preschool classroom, Staff B stated that science and social studies are not provided to children in that group.

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3.4.3 · A system for taking attendance, including documentation of the time when each child arrives and departs each day he/she attends the CBCCPP, shall be established. The licensee shall save all daily attendance records identifying the hours of children's attendance for at least twelve (12) months from the date that care is provided.

A child was listed as signed out of the program at 9:30 a.m. This child was observed being picked up by the child's parent at 10:46 a.m.

Open Not marked corrected in the state record

Open / not marked corrected.

6.2.5.10 · Staff's voices shall not dominate the overall sound of the group.

While at the program, Staff A was heard from other classrooms speaking to children, resulting in difficulty having a conversation with individuals in those rooms, and rooms adjoining.

Open Not marked corrected in the state record

Open / not marked corrected.

6.1.4.2.1 · The amount of awake time children under twenty-four (24) months of age spend in any confining equipment, such as a crib, playpen, port-a-crib, swing, or seat shall be limited to less than thirty (30) minutes in any two (2) hour period.

Child A was observed in an infant rocker seat from 8:55 until 9:04 and then again from 10:38 until 11:33, at which time Staff C was advised the child had exceeded the amount of time in confining equipment and was removed.

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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.

Staff A was observed holding a bottle feeding an infant while they were seated in an infant rocker seat.

Open Not marked corrected in the state record

Open / not marked corrected.

5.10.1.1 · General Safety: The licensee shall ensure the physical facilities of the CBCCPP, grounds, equipment, and toys present no hazard to the health, safety, and well-being of the children.

On the floor outside of the jungle room, in the hall, near children's cubbys was a black bucket filled with bleach water as confirmed by Staff B, and toys being soaked. Children were observed walking past this area when they left the building to go outdoors and upon returning to the building. A table in the preschool classroom was found with a broken bar underneath, and the table top worn with exposed particle board; Staff C confirmed being aware of this. This rule was previously cited on 8/9/2022.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Doors and baseboard in the preschool classroom have chipping and peeling paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.1.1 · CBCCPP staff shall ensure that adults and children wash their hands: * Upon arrival at the CBCCPP; * Before they eat, prepare or handle food; * Before and after handling raw meat; * Before feeding children; * After toileting or diapering; * After cleaning; * After taking out the garbage; * After handling animals; and * After outdoor play.

Staff C was observed preparing a bottle for a child and had not washed their hands prior, Staff A was observed feeding a child and had not washed their hands prior, Staff D was observed changing a diaper without washing their hands before recording the diaper change, and then did not wash their hands after cleaning and just prior to another diaper change.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Upon arrival Staff D in Group One stated that Child B was in the room to get their diaper changed. Child B was signed in at 8:00 in the preschool classroom. Two (2) staff confirmed that Child B had been in Staff D's classroom upon arrival at 8:00 until the onset of the licensing visit at the program at 8:55. There were four (4) other children in the room in addition to Child B with only one (1) staff upon arrival. A review of Group One's attendance, and the confirmation that Child B was present since 8:00, the group was out of ratio starting at 8:35 until 8:55. Based on the ages of those children, an additional staff person was required to be in the room. This is a serious violation.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Staff C's record check authorization form expired on 1/22/2023; an updated record check had not been received by the Division. Staff C confirmed they had not submitted an updated record check but had recently renewed their fingerprints.

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.

The staffing pattern was reviewed and staff reported that the preschool classroom has not had a lead teacher since Staff E left which was 9/23/22. Two (2) staff on site confirmed that they had been covering that room since then; neither meet Teacher Associate qualifications.

Open Not marked corrected in the state record

Open / not marked corrected.

2.3.1.5 · The licensee shall not interfere with, impede, deter, provide false information or cause another to do any of the aforementioned, or in any manner hinder the Department or its agent(s) in an investigation or inspection.

Upon arrival Staff D reported that Child B was in their room to get their diaper changed, and was immediately transitioned to the adjoining preschool classroom. Two (2) other staff confirmed that Child B was in the room from the time they arrived at 8:00 until being transitioned back to the classroom they were signed in to upon the start of the licensing visit. The documentation and Staff D's statement were not accurate.

Open Not marked corrected in the state record

Open / not marked corrected.

6.1.4.2.3 · Children shall be engaged in developmentally appropriate play, sensory activities, and learning experiences in each of the following areas: * Communication and Expression: Language and literacy development, and creative arts; * Learning about the world: social studies, science, and math; and * Developing of self: approaches to learning, social and emotional development, growing, moving, and being healthy.

Observations made of the classrooms found children in each room playing independently. Staff were not observed reading to children or engaging them in any of the identified learning experiences as stated by this rule. Staff A and Staff E stated they try to do activities with the children but they don't have set things they do.

Open Not marked corrected in the state record

Open / not marked corrected.

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 three (3) fire extinugishers mounted at the program were last inspected in September 2021. The extinguishers required inspection or replacement in September 2022; six (6) months prior to the visit.

Open Not marked corrected in the state record

Open / not marked corrected.

6.1.5.1.3 · Children under twenty-four (24) months of age 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; Being held and carried; Individual and parallel play; Cooperative play and small group activities; Being talked to during play, feeding, and routine care; Being read to and looking at books; Naming of objects and experiences in the environment; Space and equipment to support developing gross motor skills such as rolling over, sitting, scooting, crawling, standing, climbing, and walking; Space and materials to support developing small motor skills such as eating finger foods, stacking, balancing, scribbling, and drawing; Developmentally appropriate problem solving; Encouragement to explore, experiment and initiate activities; Open ended play and activities; and Time and space to gain mastery through play and learning by doing.

During the licensing visit Child C was moved to the Jungle Room and Child D was moved to the infant room to allow Child B to be in Group One. When asked, staff state that the transition of children between classrooms has been an ongoing occurrence. Child D is reported to being new at the program and was observed crying when in the classroom transitioned to.

Open Not marked corrected in the state record

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6.1.2.1 · Except as specified in rule 6.1.2.2 of these regulations, children shall be provided opportunities for moderate to vigorous play and gross motor activity outdoors on the premises or within a safe walking distance of the CBCCPP for at least sixty (60) minutes each day. For programs that operate less than four (4) hours per day, staff shall ensure that children are provided at least thirty (30) minutes of outside physical activity each day.

On three (3) occassions observations were made at the program during morning outdoor play time (twice) and afternoon outdoor play time (once). During those observations Group A was observed outside on one (1) day during the morning; no other groups were observed outside during any of the observations. Interviews with staff confirmed that Group B and Group C consistently do not go outside.

Open Not marked corrected in the state record

Open / not marked corrected.

5.10.1.1 · General Safety: The licensee shall ensure the physical facilities of the CBCCPP, grounds, equipment, and toys present no hazard to the health, safety, and well-being of the children.

Children were observed attempting to open drawers in the preschool classroom that are held together with duct tape. A fence blocking the registers in the preschool classroom is broken, resulting in a jagged edge. Rugs throughout the program are torn, frayed and folded resulting in tripping hazards.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

The preschool clasroom floors were observed with dried on substances which can be removed by scraping, behind the fence blocking the heaters dirt, debris and grime were noted. Sections of walls and baseboards throughout the program were found with dirt and grime, and around the gates in classrooms, dirt and debris were observed. This is a repeat violation.

Open Not marked corrected in the state record

Open / not marked corrected.

7.5.2 · The program director shall ensure that job descriptions for all staff include the job title, job duties, the staff member responsible for supervision, and the identity of the staff member responsible for evaluating the position.

Of the ten (10) staff interviwed, three (3) of them had job descriptions from a previous hired date, and not a current job description upon being re-hired. Two (2) staff have a job description for a position other than the one (1) they are serving in. One (1) staff stated they never received a job description and one (1) was not located in that staff's file. One (1) staff stated they received a job description but it was not located in their file, and one (1) staff did not have a signed job description.

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.

Upon review of staff files, and through interviews, it was determined that five (5) staff were not provided a staff handbook upon hire, or upon being re-hired at the program. Two (2) of those staff had documentation to confirm the most recent handbook they had been provided was prior to October 2019 when the handbook was last updated.

Open Not marked corrected in the state record

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6.2.5.2 · Staff shall appropriately hold, touch, smile and talk to children.

Staff A has been observed on different occassions yelling at children, speaking to children with a harsh tone resulting in children at times crying. This is a repeat violation of the program.

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 B was observed changing diapers; of the four (4) changes obserevd, Staff B did not wash their own hands prior to starting the diaper changes for any of them, did not wash the childs hands three (3) out of the four (4) times after the diaper was changed, and did not disinfect the changing table three (3) of the four (4) changes. Staff B was observed wiping spit up off the diaper changing mat that had not previously been disinfected then was observed using the same wipe to clean the childs face. Staff C was observed changing a diaper but did not wash their hands prior to starting the change, did not wash the childs hands or their own upon completion of the diaper change, and did not disinfect the changing mat. This is a repeat violation, as it was cited in non-compliance on 8/12/2020 and 4/17/2019.

Open Not marked corrected in the state record

Open / not marked corrected.

5.4.2.8 · Infants shall not be placed in cribs or port-a-cribs with bottles. Pacifiers are permitted in cribs and port-a-cribs with parental permission. Pacifiers may not have cords or clips that may pose a strangulation risk.

Child D and Child E were observed in port-a-cribs with pacifiers in their mouths while sleeping. A review of files for Child D and Child E did not reflect permission granted from their parent allowing for their use. The program does have a spot for parents to grant permission for this on the enrollment forms.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Child D, Child E, and Child F were observed sleeping directly on the base mat without a linen while in port-a-cribs. This is a repeat violation.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Child D and Child E were observed in port-a-cribs wearing bibs and cords for pacifiers while sleeping.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Upon review of BFIS Quality and Credential accounts and confirmation from the Director, Staff C and Staff H did not complete the required fifteen (15) hours of professional development within their annual period.

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 H, Staff J, and Staff K have not completed the background clearance process to include fingeprinting; the fingerprint authorization forms were generated between two (2) and nine (9) months ago. Staff C submitted a record check authorization form that had not been processed at the time of the visit; Staff C was observed taking a child to the bathroom alone which is not permitted as they had not been cleared to do so by the Division.

Open Not marked corrected in the state record

Open / not marked corrected.

5.2.6.2 · All sanitizing and disinfecting solutions shall be EPA registered and used according to the manufacturers' instructions.

Upon observations of the infant classroom during diaper changes, Staff B & C both sprayed the cleaning product on the diaper changing mat and wiped it off within fifteen (15) seconds. The cleaning product indicates that in order to disinfect, it must sit on the item for five (5) minutes. This is a repeat 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 B & C were observed during diaper changes. Staff B & C were observed cleaning the changing table without washing their hands after, nor washing their hands prior to the next diaper change. Staff B was observed laying Child A on the floor to put back on his diaper after he took it off. Staff B did not wash her hands prior, did not disinfect the floor area prior to laying the child on this surfance, did not disinfect the floor area after it being used, and did not wash the child's hands or her own hands once the change was completed. During the time Child A had his diaper off, he was seen touching his bottom. This is a repeat violation.

Open Not marked corrected in the state record

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7.4.1 · The program director shall ensure within six (6) months of starting work in the CBCCPP, staff shall have an Individual Professional Development Plan (IPDP). This shall be documented in the individual's BFIS Quality and Credential Account or in the staff file on site. IPDPs shall be updated at least once every 365 days.

Upon review of staff files it was noted that Staff B & D did not have an updated IPDP. Staff B's most recent IPDP in her file was not dated, but had deadlines for her goals to be completed between 08/2019-10/2019. Upon review of Staff B's quality and credential account, there was an IPDP which was dated 10/08/2018. In the file for Staff D, the most recent IPDP was dated 06/2017.

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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; * 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.

Upon review of five (5) children's files, all had missing documentation required to be in their files. Four (4) files were missing the annual health exam and addresses for parents. Three (3) files were missing immunization records or exemption form, dentist name, and start date. Two (2) files were missing addresses for the emergency contacts. One (1) file had the admission form, but it was not signed by the parent.

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5.10.1.4.1 · Garbage and compost shall be in containers that are securely covered.

Three (3) garbages in the program did not have covers; one (1) in the kitchen and two (2) next to the handwashing sink outside the kitchen. Children have easy access to all three (3) garbages.

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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.

Upon review of sign in sheets, it was found that Staff B had not signed in to the group of children she was working with, nor did she sign out when she was observed to go on her break. Staff C was present covering Staff B's break but had not signed in on the schedule. When asked, Staff C stated she had forgot to sign in and updated the sign-in sheet at that time, to also include the time she was previously in the classroom covering another break. On the same sign in sheet, Staff D and E had signed in, but had not signed out. Both Staff D and E were working with children in different classrooms.

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7.6.6 · A licensee shall maintain a complete and up-to-date personnel file for the business manager. A complete file shall contain, at minimum, the following information: * Name, date of birth, home address and telephone number; * Signed statement verifying understanding of legal requirement to report suspected child abuse or neglect; * Documentation of a current Records Check Authorization form; * Documentation of compliance as in the rule 7.6.12 of these regulations; * Job description; * Application for employment; * Employment start date; * Documentation of completed Orientation Training; * Employment end date and reason for leaving, if applicable.

Upon review of staff files, it was found that Staff F was missing a signed statement acknowledging her legal requirement to report abuse and neglect, a job description, verification of completing the Orientation Training, a signed statement about reading, having access and understanding licensing regulations.

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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.

A sign in sheet was posted in the kitchen area for volunteers and Partner Staff. Upon review it was found that Partner Staff A was present seven (7) times between 01/13/2020-02/14/2020. Partner Staff A was not listed on the Associated Parties list. Staff A went through a file containing background checks for Partner Staff, and did not locate one for Partner Staff A. Childcare Business Technician A confirmed the Division had not received a background check.

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