Little Sparrow Learning Nest

Regulation 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. Corrective Action: Submit a program improvement plan on the placement of staff on the playground to ensure supervision is maintained at all times. As part of that plan, address zones staff must monitor if the number of staff present do not allow for staff to remain in one (1) portion of the playground.”

Correction date in the state record: Oct 24, 2023

Regulation 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. Corrective Action: Submit a program improvement plan that 1) ensures this rule is reviewed with staff, 2) identifies ways staff can engage with children during outside play, 3) identifies a plan to model outdoor play for staff, and 4) monitors compliance to this rule.”

Correction date in the state record: Oct 24, 2023

Regulation 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. Corrective Action: Submit a program improvement plan that 1) creates a form for staff to doucument specific activities that support learning objects in rule 6.1.4.2.3, to include what specific books, toys, materials, and activities are scheduled to be used, 2) identifies the tool used by the Program Director to observe staff implementing their lesson plans in order to provide them with feedback, 3) the observation and feedback schedule for each classroom, 4) states where observation and feedback documentation provided to staff will be stored on site, and 5) supports and/or trainings provided to staff on creating and implementing curriculum.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Submit a program improvement plan on 1) reviewing with all staff the requirement of self-reported violations being shared with the Division, 2) who is responsible for submitting the report to the Division, to include in the absense of the Program Director, 3) who collects timely written information from staff on the events leading up to, and during the incident that occurred, and 4) the measures put in place to announce the concern to staff, and how the program will move forward to correct the identified concern from occurring again.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Sumbit a program improvement plan that 1) identifies how staff will safely transition children to and from outdoor play areas, 2) identifies the plan to ensure adequate supervision is maintained to include at gates as parents and/or the public transition in and out of the fenced play area to ensure only children safely released exit, 3) identifies the accounting for all children as staff transition in and out of the play area with children, to inlcude announcing how many children remain in each group, 4) ensure the gates have additional safety measures on them to prevent children from having the ability to open the gate without staff or parent assistance, and 5) the system to monitor for ongoing compliance to the identified plan.”

Correction date in the state record: Oct 24, 2023

Regulation 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. Corrective Action: Review with staff the complete procedure on creating and filing an incident report as outlined in this rule, to include ensuring parents are provided a copy of the report. As part of the review ensure staff are aware how to make a copy of the report and document a copy has been provided to the family.”

Correction date in the state record: Oct 24, 2023

Regulation 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. Corrective Action: Submit a program improvment plan that 1) documents all staff listed on attendance sheets for each classroom with a section for their arrival, break start, break end and departure by 10/17/23, 2) reviews the updated system with staff to ensure they understand the corrected staff schedule requirement, and 3) identifies the schedule to monitor the ongoing compliance to this rule. Provide the staff schedule for each classroom to Licensor [name] for review for dates 10/18/23-10/23/23.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Submit the staff schedule showing the lead teachers assigned to each group, and the days and hours work by 10/17/23. Additionally, provide Licensor [name] with staff schedules from each classroom for the period 10/10/23-10/23/23.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Review the handwashing procedures with all staff to ensure they understand the steps as outlined in this rule. Post the requirements of this rule at each handwashing sink. Identify what tool (song, timer) will be used to ensure staff and children wash their hands as required.”

Correction date in the state record: Aug 22, 2023

Regulation 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. Corrective Action: Submit a program improvement plan for approval on the developmentally appropriate play, sensory activities, and learning experiences for each group of children as outlined in this rule. As part of this plan, identify resources used to develop appropriate activities to inlcude, and how those resources will be available ongoing for staff to continue to create experiences as outlined, and how staff will be properly trained to implement activities effectively. Additionally include in the plan a supply and material list that supports activities and learning experiences for each area identified in this rule.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: By 8/25/2023 submit a program improvement plan that defines the roles of the Director, Teacher Associate, and Teacher Assistants in the creation and implementation of curriculum for each group of children. Indicate the tool that will be used to ensure educational content identified in 6.1.4.2.3 are captured in specific activities. In doing so, submit the monthly curriculum (lesson plans) developed for each group for September and October to Licensor [name] for review. By 9/8/23, as part of the program improvement plan indicate what the schedule will be for the Director to monitor, assess, and document staff are implementing developmentally appropriate curriculum as stated by these rules, and the tool used to document such monitoring. Include how written documentation of monitoring and feedback provided to staff will be obtained on site for review. By 9/15/23 provide documentation of the monitoring and feedback provided to each group of teachers using the tool previously provided to Licensor [name].”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Submit a program improvement plan that identifies the qualified lead teacher with each group of children 75% of the hours of operation. As part of the plan submit the staffing pattern that demonstrates the required hours each staff are with their assigned group.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: As required during the site visit and discussed again by telephone on 06/08/2023, the attendance records are to reflect the actual arrival and departure times for children. Review with all staff persons that attendance records are to be completed at time of arrival and time of departure.”

Correction date in the state record: Jun 14, 2023

Regulation 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. Corrective Action: Review this rule with all staff and develop a plan that addresses staff volume in the moment, and strategies for Staff A to be aware of their volume and ensuring it is reduced to not dominate the overall sound of the group.”

Correction date in the state record: May 8, 2023

Regulation 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. Corrective Action: Ensure a record check is submitted to the Division for Staff C.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Submit a program improvement plan on how children will remain in classrooms with their assigned staff. As part of this plan indicate how Child B will be integrated into their assigned room without disrupting teachers or children from their assigned group.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Ensure the areas of compromoised paint are stabilized by a licensed RRPM (Repair, Renovation, Paint and Maintenance) individual or contractor. Comply with any additional deadlines from the Vermont Department of Health, to include but not limited to filing an inspection report.”

Correction date in the state record: Apr 7, 2023

Regulation 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. Corrective Action: Review this rule with all staff. Develop a system to ensure compliance to this rule is met, maintained, and monitored.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Effective immediately ensure each classroom is in ratio and does not exceed maximum group size. Submit a program improvement plan identifying children's names, dates of birth, assigned classroom, assigned staff and schedule. As part of the plan ensure staff have a solid understanding on ratios and what the system is to ensure compliance is maintained to this rule.”

Correction date in the state record: Apr 19, 2023

Regulation 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. Corrective Action: Ensure buckets of water are kept out of reach of children at all times. Remove the preschool table from the program. Develop a system to ensure identified areas of concern are corrected in a timely manner and that hazards are not accessible to children.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Review the handwashing requirement with all staff. Develop a system to monitor for ongoing compliance.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Ensure all infants are held when bottle fed. Review this rule with all staff and monitor for ongoing compliance.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Ensure documentation is accurately reported to include, but not limited to children's attendance. Review with staff the importance of providing accurate information at all times to include during investigations and inspections.”

Correction date in the state record: Apr 6, 2023

Regulation 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. Corrective Action: Provide a list of staff assigned to each group and their schedule that ensures each is led by a teacher associate 75% of the hours of operation.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Submit a program improvement plan that identifies how support will be provided to staff to ensure children are provided learning experiences as required by this rule. As part of the program improvement plan provide a detailed outline on what materials the program has to support the stated learning opportunities and a schedule that will guide staff to ensure all experiences are provided.”

Correction date in the state record: Nov 2, 2023

Regulation 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. Corrective Action: Ensure the extinguishers are inspected or replaced by the due date. Develop a system to ensure that ongoing compliance to this rule is met.”

Correction date in the state record: Apr 18, 2023

Regulation 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. Corrective Action: Ensure each group of children are outside daily as required by this rule. Provide a schedule of when each group will be outdoors daily, what outdoor play ground they will use, and how the program will ensure that this rule is in compliance.”

Correction date in the state record: Nov 30, 2022

Regulation 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. Corrective Action: Ensure all identified areas are cleaned as required. Develop a system to ensure that staff responsible for ensuring the program, the furnishings and toys are clean and orderly know what is expected of them, and monitoring is completed to ensure thoroughness.”

Correction date in the state record: Aug 30, 2022

Regulation 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. Corrective Action: Ensure the drawers and fence in the preschool classroom are repaired, and that rugs that are torn, and/or frayed are removed.”

Correction date in the state record: Aug 30, 2022

Regulation 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. Corrective Action: Ensure all staff have received and reviewed the most recent staff handbook. Develop a system to ensure new employees, and re-hired employees receive a copy of the most receent staff handbook. Ensure all staff receive copies of any future handbooks if changes are made. Maintain documentation in staff files to confirm the dates they received the most recent handbook.”

Correction date in the state record: Aug 29, 2022

Regulation 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. Corrective Action: Ensure each staff member has an updated/current signed job description as stated in this rule for the position they currently are serving in. Develop a system to ensure as job descriptions are updated, or positions changed, that staff receive the updated/corrected job description.”

Correction date in the state record: Aug 29, 2022

Regulation 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. Corrective Action: Submit a program improvement plan identifying how Staff A will be provided feedback, support and ongoing monitoring to ensure interactions with children are appropriate. As part of the program improvement identify how concerns with staff interactions will be 1) addressed in a timely manner, 2) documented to include the concern, what interventions and/or support were provided to the staff person, and 3) how ongoing monitoring and feedback will be provided to the staff person the concern was regarding.”

Correction date in the state record: Jun 27, 2022

Regulation 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. Corrective Action: Ensure Staff C and Staff H complete the hours of annual professional development that were not obtained during the previous annual period in addition to the current annual period. Develop a system to ensure that all staff complete the required annual professional development hours.”

Correction date in the state record: May 15, 2022

Regulation 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. Corrective Action: Review the diaper changing procedure with all staff. Submit a program improvement plan identifying how staff will be monitored and provided feedback on an ongoing basis to ensure compliance to this rule.”

Correction date in the state record: Apr 18, 2022

Regulation 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. Corrective Action: Ensure all staff submit to fingerpringting who have not already done so. Develop a system to ensure new staff submit to fingerprinting in a timely manner and are not left alone with children until cleared to do so by the Division.”

Correction date in the state record: May 15, 2022

Regulation 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. Corrective Action: Ensure infants do not have items in their sleeping areas as stated in this rule. Review safe sleep practices with all staff to ensure their understanding. Develop a system for ongoing monitoring to ensure compliance to this rule.”

Correction date in the state record: Apr 22, 2022

Regulation 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. Corrective Action: Discontinue allowing infants to have pacifiers while in cribs or port-a-cribs unless parental permission is granted. Develop a system that advises staff which infants have parental permission to use a pacifier while in cribs or port-a-cribs.”

Correction date in the state record: May 2, 2022

Regulation 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. Corrective Action: Ensure children do not sleep directly on nonporous coverings. Review this rule with all staff to ensure their understanding.”

Correction date in the state record: Apr 18, 2022

Regulation 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. Corrective Action: Review the diaper changing procedure and develop a system to ensure ongoing monitoring and compliance to this regulation.”

Correction date in the state record: Aug 17, 2020

Regulation 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. Corrective Action: Educate staff of the requirement to use cleaning products as outlined on the product instructions. Develop a system to ensure if changes are made to the sanitzing and disinfecting solutions, that staff review the product guidelines prior to use.”

Correction date in the state record: Sep 4, 2020

Regulation 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. Corrective Action: Develop a system to ensure staff update their IPDP's at least once every 365 days.”

Correction date in the state record: Sep 3, 2020

Regulation 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. Corrective Action: Review all children's files to ensure each file contains complete documentation as required by this regulation.”

Correction date in the state record: Sep 15, 2020

Regulation 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. Corrective Action: Submit a program improvement plan identifying how the program will monitor and ensure ongoing compliance to this regulation.”

Correction date in the state record: Feb 27, 2020

Regulation 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. Corrective Action: Ensure all garbages are securely covered.”

Correction date in the state record: Feb 27, 2020

Regulation 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. Corrective Action: Update Staff F's file to ensure compliance to this regulation.”

Correction date in the state record: Mar 12, 2020

Regulation 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. Corrective Action: Submit a background check for Partner Staff A. Provide a program improvement plan identifying how ongoing compliance to this regulation will be met.”

Correction date in the state record: Mar 9, 2020

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

“Observations of Staff A and C were completed while they were on the playground with children. Staff A was observed having inappropriate interactions with children on seven (7) occasions. Within those seven (7) occasions, Staff A was observed kicking at a child while walking across the road one (1) time, holding on to a child's wrist as the child resisted three (3) times, seen dragging children by the arm on two (2) occasions, picking children up and slamming them down to sit or to stand on three (3) occasions, holding a male child one (1) time against her waist as the child resisted, and ripping items out of children's hands on two (2) occasions. Staff B was observed holding on to the wrist of a child one (1) time who was observed resisting Staff C's hold. The program was cited with a serious violation on 7/29/2019 for similar interactions with children. Children being held while resisting, being dragged on the ground by one (1) arm and kicking at children while they are walking across the street puts them at significant risk for injury. These actions towards children is a serious violation. Corrective Action: Submit a program improvement plan outlining how Staff A & C will immediately be monitored, provided feedback and mentored. Additionally, within this plan indicate what the schedule will be for continuous observations, the method of providing active ongoing feedback, and who the identified person will be to provide mentoring for all staff.”

Correction date in the state record: Oct 11, 2019

Regulation 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.

“The Licensee stated that parents are notified immediately of any injury to a child's head or of any bite. Random incident reports were pulled from files of Child X, Y and Z. The five (5) reports reviewed reflected either a head injury or a bite. All five (5) reports stated that the parent was notified at the end of the day during pick up. Corrective Action: Develop a procedure regarding injuries that occur at the program. Within this procedure, identify when the Director is notified, who completes the incident report, who notifies parents and the criteria used to determine if a call is required, and what, if any corrospondance needs to be done with the Division.”

Correction date in the state record: Sep 30, 2019

Regulation 6.1.2.4: Staff shall be interacting with children during outside play.

“Staff A, B and C were observed talking to each other, while not interacting with children, a combined total of twenty-four (24) minutes out of the hour and twenty-four (24) they were on the playground with children. Corrective Action: Submit a plan that identifies how staff will be observed and provided feedback regarding their interactactions with children during outside play. Include in this plan how compliance to this regulation will be monitored.”

Correction date in the state record: Oct 11, 2019

Regulation 5.3.1: The licensee shall develop and implement a plan for the management of communicable disease in the CBCCPP including the following: * Naming and identifying symptoms of illnesses for which a child will be excluded or sent home from the CBCCPP; * Identifying communicable diseases for which a child will not be admitted to the CBCCPP without a statement from a health care provider; and * Written notification to parents when children may have been exposed to a reportable communicable disease.

“The Licensee confirmed that hand-foot and mouth was present at the program on three different occassions within a month and a half time frame. The Licensee confirmed that parents were not notified of this communicable disease for any of those occurrences. Corrective Action: Develop a system to ensure that any report of a communicable disease within the program is shared with parents. Within this plan, identify how the Director will be notified if someone else in the program was advised of the communicable disease.”

Correction date in the state record: Oct 8, 2019

Regulation 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.

“Three (3) children in the classroom with Staff A were observed resting directly on mats. Corrective Action: Effective immediately, ensure each child has a barrier between them and the non-pourous mat they rest on.”

Correction date in the state record: Oct 1, 2019

Regulation 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.

“In the infant classroom, a yellow plastic bin was observed with dirt and grime along the bottom and inside edges. This bucket stores infant toys. Also in the infant room, the jungle mat with the turtle in the center has stains on the cloth portions, a playskool infant musical toy has dirt and grime in the crevices, and all three (3) rock n' sleepers have dirt on the cloth portions. In the group one classroom the tumbling mats have two sections that have reflective material that is cracked. Corrective Action: Submit a program improvement plan outlining how compliance to this regulation will be corrected and maintained. A previous violation was cited on 3/4/2019 for non-compliance to this regulation.”

Correction date in the state record: Oct 1, 2019

Regulation 7.3.2.4: "Trainee" A trainee is at least fifteen (15) years of age, able to comprehend basic written format, and meets one (1) of the following qualifications: 1) At least a high school graduate or has completed a GED and completes the Fundamentals for Early Childhood Professionals'course or the Vermont Afterschool Essentials Certificate within the first twelve (12) months of employment; or 2) At least a high school graduate or has completed a GED and successful completion of a three (3) college credit course in child or human development or in school age care and education within the first twelve (12) months of employment; or 3) At least is enrolled in or has received a State Board of Education approved Human Services Program Certificate that emphasizes child development or early childhood education.

“Staff A, C, E and J have been employed at the program over 12 (twelve) months and have not met qualifications as a Trainee. Staff C and E have a high school diploma and no further education. Staff A has 6 (six) college credits, but not in child or human development, or school age care and education. Staff J has completed Fundamentals and has a Level I early childhood certificate, but does not reflect having a high school diploma or GED. Corrective Action: Submit a program improvement plan to identify how the program will ensure staff are qualified for the position they are serving in the program.”

Correction date in the state record: Oct 24, 2019

Regulation 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 licensee confirmed in three (3) of the five (5) classrooms the staffing pattern does not have at least one staff member that meets teacher associate qualifications leading the group at least 75% of the time. In the Pre-K room, Staff C and H are the teachers with this group at least 75% of the time. Staff C no longer meets the qualifications of a trainee, and Staff H meets the qualifications of trainee. In the Infant room, Staff E and G are the teachers with this group at least 75% of the time; Staff E no longer meets the qualifications for trainee, and Staff G meets qualifications as a trainee . Corrective Action: Submit a program improvement plan that identifies how each group of children will be led by a staff member who is at least qualified as a teacher associate as this rule requires.”

Correction date in the state record: Oct 28, 2019

Regulation 5.10.4.5.5: Hard surfaces accessible to children shall be smooth, non-porous, and easy to clean. See the rules in section 5.2.6 of these regulations for a schedule for cleaning, disinfecting and sanitizing of specific surfaces and items.

“The shelving units in the infant classroom, group one classroom and group two classroom all have exposed unsealed wood. The changing mat in the group one classroom has a rip exposing foam. On the end of the castle structure, between the infant and group two classroom, bare wood is exposed where wallpaper is torn. Corrective Action: Remedy the shelving units to ensure the structures are non-porous. Replace the changing mat in the group one classroom. Repair the castle structure so bare wood is not exposed.”

Correction date in the state record: Sep 9, 2019

Regulation 6.2.1.4: Staff who are qualified as defined in the rules in section 7.3 of these regulations, meet professional development requirements as defined in the rules in section 7.4 of these regulations, and are physically present and working with children may be counted in staff/child ratios.

“Upon review of professional development documentation it was found that Staff B was short 4.5 hours between 2/13/2018-2/12/2019, Staff C was short two (2) hours between 3/5/2018-3/4/2019, Staff D was short 8.5 hours between 5/29/2018-5/28/2019, and Staff E was short one (1) hour between 6/11/2018-6/10/2019. Corrective Action: Monitor professional development hours for all staff to ensure required trainings and required hours are met. For those staff who were short professional development hours, have them make up the shortage by adding those hours on to the current year. Develop a system to ensure staff meet this requirement.”

Correction date in the state record: Sep 6, 2019

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

“Upon observations of staff on the playground with children, Staff A was heard saying to a child not to be a whiny pants while the child was crying due to his cup being dropped. Staff A was observed saying to Child X that he would have to sit longer next time and that he should have thought about that. Staff A was overheard saying to children let's go, get out and no in an agrresive tone. Staff H was overheard saying to Child X that next time he let go he would have to sit longer; referencing the rope children held on to while walking to the playground. Staff F was observed grabbing a sippy cup from a child as the child held it to his mouth. Staff F threw the sippy cup back in the bucket and stated that the cup was empty anyways. Staff C was observed standing over a child pointing her finger at the child. Corrective Action: Effective immediately, children shall be spoken to, held and looked at in an encouraging and compassionate manner. Of those staff identified to have interacted with children inappropriately, they must complete a training regarding positive communication with children. Advise Licensor [name] of the staff person, the title of the training and the date the training will be completed.”

Correction date in the state record: Aug 8, 2019

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

“Through observations done while staff were on the playground with children on 7/12/2019, 7/24/2019 and 7/29/2019, it was found that staff were providing inappropriate guidance and discipline. Staff A was observed picking children up by their upper arms with their feet coming off the ground three (3) times, grabbing a child by the upper arm and sliding the child across wood chips, and grabbing hold of a child's shirt through the slots on the play structure as the child resisted the hold. Staff A was observed reaching around the opening for the slide and grabbing ahold of this child with her right hand, releasing the shirt with her left hand, and pulling the child down the slide. Staff B was observed pulling a child out of a Little Tykes car by the child's upper arms and while doing so the child's arms and legs hit the side of the car. Staff C was observed grabbing the same child twice by her right wrist lifting the child up causing her feet to come off the ground. Staff D was observed standing above a child while holding on to the child's wrist for six (6) minutes while the child was in a sitting position on the ground trying to free himself from the hold. Staff E was observed walking and carrying a child with her right arm, while holding the wrist of another child with her left hand. The child being held by Staff E's right arm was resisting the hold and started slipping causing his body to turn upside down; head facing the ground. Staff E was observed holding onto a child's wrist for nine (9) minutes as the child resisted the hold and tried to break free. Staff F was observed approaching a child who was struggling to transition from the playground to inside. Staff F did not attempt any techniques to address the child's behavior. Staff F picked the child up in a cradle style hold and walked him across the street. During this time, the child was kicking, screaming and trying to break free from the hold resulting in his body dropping into a V shape; head and feet higher than his torso. Staff F continued to walk, holding the child in this manner. Children being grabbed and held while resisting puts them at significant risk for injury and is a serious violation. Corrective Action: Effective immediately children should not be grabbed or held unless they are in immediate risk of hurting themselves or others. It is the responsibility of the Director to ensure that staff adhere to this expectation. Advise Licensor [name] how staff will be supported and supervised to ensure compliance. Staff who were observed grabbing and/or holding children must complete a training regarding appropriate guidance and discipline. Advise Licensor [name] of the staff person, the training title and date the training will be completed.”

Correction date in the state record: Aug 8, 2019

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

“Staff D admitted to holding a baby out in front of her body and then throwing the baby straight up in the air and catching the child after being released from Staff D's hands. Staff D was doing this as a way to entertain the child. Corrective Action: Effective immediately children must never be thrown in the air. While this wasn't a shaken baby incident, staff need to have a solid understanding of brain development and the impact on young children. By 7/2/2019 all staff who haven't already done so, must complete a shaken baby syndrome course and submit verification of this to Northern Lights.”

Correction date in the state record: Jul 3, 2019

Regulation 5.10.1.11.1: The licensee and the program director shall ensure that the use of tobacco and tobacco substitutes (including e-cigarettes), alcohol and illegal drugs is prohibited at the CBCCPP (both indoor and outdoor environments used by children) and also in any vehicle used to transport children.

“Staff A admitted to vaping in a classroom during program hours. Staff A stated she was witnessed to have done this, she has been written up and the smoking policy has been updated to include vaping. Staff B, Staff C, and Staff D all confirmed that Staff A had vaped while working. Corrective Action: Effective immediately advise staff of the non-smoking policy to include e-cigarettes. Retain a signed statement from each staff person within their personnel files that this policy was reviewed with them and they understand this regulation.”

Correction date in the state record: Apr 18, 2019

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

“It was observed that each classroom contained the same product used to clean the diaper changing mats. Each time diaper mats were cleaned, staff were observed immediately wiping the product off. Upon review of the manufacturer's instructions, it indicated to spray the area and let sit for ninety (90) second before wiping or to let air dry for this length of time. Corrective Action: Review manufactuers' instructions for any santizing and disinfecting product within the program. Review with staff the proper use of those products.”

Correction date in the state record: Apr 26, 2019

Regulation 6.1.4.1.2: Toys, materials and equipment shall support developmentally appropriate and meaningful learning experiences and meet the needs and interests of each child.

“It was observed that school aged children joined the preschool classroom for the day with Staff E and Staff H. They were without toys, materials and equipment that were designed for their age group. The items within this classroom were age appropriate for toddlers and/or preschoolers. Additional equipment was not presented to the school aged children while they were in this space. The school aged children present were following the same routine and activities of the preschool aged students. Corrective Action: Submit a program improvement plan to the Division that outlines how the developmentally appropriate needs of school aged children will be met. This plan should indicate the space that will be used to provide care to this group during after school hours, and vacations. The plan also needs to include what materials will be available to this age group to support their learning.”

Correction date in the state record: May 14, 2019

Regulation 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.

“It was observed that three groups of children and their teachers; Staff C, Staff H and Staff F did not wash their hands upon returning indoors from playing outside. Staff C did not wash her hands after wiping a child's nose. Prior to handling and passing food directly from a container to infants, Staff G had not washed her hands or the hands of any of the children she was feeding. Staff D did not wash her hands prior to making or feeding Child Q his bottle, which was immediately after his diaper change at which time handwashing had not occurred. Corrective Action: Review the handwashing requirements with staff, and monitor to ensure this practice is implemented properly.”

Correction date in the state record: Apr 26, 2019

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

“A review of sign in sheets compared to the number of children in care were conducted in both preschool rooms. There were fourteen (14) children signed into Staff H's classroom, but there were only eleven (11) children in the room. Child X and Child Y had left early and were not signed out until the discrepancy was noted. Child Z was signed into a different classroom but was in Staff H's room. There were thirteen (13) children signed into Staff F's room, but there were fourteen (14) children in the room. Child V and Child W were in Staff F's room but were signed into Staff H's room. Child U was observed asking Staff E if he could return to his classroom and be with his regular teacher. Staff E told Child U he couldn't because the school aged kids were there and he couldn't go back and forth because they would lose track of head counts. Staff E proceeded to tell Licensor [name] that the rooms have been adjusted because the school aged kids were attending and some kids work better with them than others so things are switched around. Corrective Action: Submit a program improvement plan regarding the policy of children being removed from their consistent classrooms and assigned to a different room as needed. Include in that plan the procedure staff will take to properly reflect any changes on their sign in sheets when this does occur. As part of the plan review the policy and procedure with staff to ensure children are not removed from their assigned classrooms as disciplinary measures, or to meet the needs of the program before meeting the needs of the children.”

Correction date in the state record: May 14, 2019

Regulation 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 A was observed changing a child's diaper. Staff A and had not washed her hands prior, did not wash the child's hands, the mat, or wash her own hands upon completion. Staff C was observed changing four children's diapers. Staff C did not wash the hands of any of those children upon completion, did not wash the mat one out of the four required times, and was observed once washing her own hands prior to cleaning the mat and did not wash her hands again after. Staff D was observed changing two children's diapers. Staff D did not wash her hands prior to either diaper change, did not wash either child's hands, the mat or her own hands upon completion. Staff D was observed holding Child Q after removing his diaper and prior to placing a new diaper on him. Staff E was observed changing a child's diaper. Staff E did not wash her hands prior to, did not wash the child's hands, did not clean the mat and did not wash her hands upon completion. Staff F was observed changing a child's pull-up and did not wash her hands prior to, and did not cleanse the diaper area before placing a new pull-up on the child. Staff did not follow the required diaper changing procedure as required even though the procedure is posted in each room. Corrective Action: Review the diaper changing procedure with staff, and montior to ensure this procedure is implemented properly.”

Correction date in the state record: Apr 26, 2019

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

“Staff person B and Staff person D stated that Staff person A sometimes uses a harsh tone with children. Staff person C stated that Staff person A has been observed to use an aggressive tone with children. Staff person E has stated that at times Staff person A has been observed to use a rougher tone when speaking with children. Staff person D has stated that Staff person A has been observed to use a rougher tone when speaking with children. Staff person A acknowledges that her tone can be attention seeking. Corrective Action: Develop and submit a program improvement plan outlining the methods to support Staff person A to increase her understanding of child development and appropriate interactions with children. Include in this plan specific trainings Staff person A will obtain and dates of those trainings. Also, starting immediately, identify who Staff person A will have as a mentor/model to provide her with examples of appropriate interactions with children. Include details in this plan on when Staff person A would have the mentoring/modeling occur within her work schedule.”

Correction date in the state record: Apr 24, 2019

Regulation 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.

“Upon observation of the program, the kitchen, bathroom, common areas and classrooms were found with dirt and grime on window sills, walls, doors and vents. The toilets in the bathroom had dirt and grime at the base of the toilets. Fabric dolls were found to be stained and dirty, and other infant toys had dirt and grime build up. Curtains in the infant room were stained and the changing table in the infant room had dirt and other particles in the corners. Floors throughout the program had sticky spots and the thresholds had dirt and grime on them and in the crevices. Light switches had visible dirt and grime buildup. Carpets had particles of paper and food. Corrective Action: Effective immediately, establish and maintain a practice that ensures the kitchen, bathroom, classrooms and common areas are clean, free of dirt, and grime. In addition, all toys and furniture are clean and free of stains, dirt, and grime buildup. Submit a program improvement plan to the Division outlining how this practice will be maintained.”

Correction date in the state record: Mar 4, 219

Regulation 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.

“During the morning of 08/23/2018 two groups of preschool and school-aged children with their staff members were using the public playground located across from the program on River St. The attendance sheet reflects that there were a total of 22 children. In one group were teachers Brittany MacMurray and [name] with thirteen children ages 3 to 4 years old and the other group were teachers [name] and [name] with nine children ages 4 to 9 years old. When all of the staff members with all of the children left the playground as one group and returned to the preschool facility, a four year boy was left behind, alone, and unsupervised for up to five minutes. This boy was noticed by a parent in the program's parking lot who told a program staff person named [name] as she was arriving to work and she retrieved the boy. This is a serious violation. Corrective Action: Effective immediately ensure that all staff members are visually supervising and accounting for the whereabouts and actions of each child in care as specified in this rule. By 11/13/2018 submit a program improvement plan that identifies how staff members will maintain supervision to include a group transition plan which accounts for each child, and mail the parent notification letter as outlined in this report, submit the list of parents, their contact information and who received the parent notification letter to this licensor.”

Correction date in the state record: Nov 12, 2018