WSESD @ Birge St.

Regulation 5.10.3.3: Safe Use Zones For all play equipment that is thirty (30) inches or higher from the ground, including climbing equipment, slides, swings and other similar equipment, the licensee shall ensure that the surface under and around the equipment, including recommended use zones, is of approved resilient material that protects children if they fall. * Materials in the use zone shall consist of wood chips, pea stone, mulch, engineered wood fibers, sand, safety-tested shredded or rubber like material or rubber mats designed for protective cushioning; * Materials used in the use zone shall follow the recommendations listed in the most recent publication of U.S. Consumer Product Safety Commission's Public Playground Safety Handbook regarding critical depth of tested materials determined by the height of the highest climbing surface of the equipment; * Materials used in the use zone shall be installed and maintained according to the manufacturer's instructions; * If the loose material such as sand, mulch, or shredded rubber is used in use zones, the licensee shall ensure that the material is raked regularly and replenished to maintain depth and resilience; and * If the resilient material in use zones freezes, staff shall ensure that children will not play on the equipment until the resilient material has thawed and is once again resilient.

“The geodome in the front play area requires cushioning material. The area underneath and around the structure is grass. Children are observed sitting upon the top of the structure and hanging upside down from the center. Corrective Action: As required during the visit, use of the play item is to be restricted to prevent children from reaching a height of over thirty (30) inches from the ground. Notify Licensing Field Specialist Crawford of the plan to either remove the play item or to installed appropriate cushioning material at the needed depth by 01/15/2026.”

Correction date in the state record: Jan 15, 2026

Regulation 6.2.7.4.2: No form of inappropriate discipline or corporal punishment shall be used with children such as but not limited to: Restricting a child's movements or actions through use of physical force, binding, tying, use of any other mechanical restraint, or using medication without written parental permission, without following the medicine's label, and/or without following medical prescription;

“A video provided to CDD showed a program staff member initially holding a child in their lap with their arms around the child's arms and torso. After efforts were made by the child to stand up and get away, the staff member put the child down on the ground with the child's side down. The staff person used their arms to hold the child's arms and legs and put a knee on the child's hip area. The child continued to wiggle and move arms and legs in efforts to get free while being held, ultimately rolling over onto their stomach. The physical engagement between the staff and child lasted one minute and 19 seconds. Corrective Action: Create a program improvement plan that addresses, but is not limited to, the following items: Additional training provided to staff regarding positive guidance and behavioral management, trauma informed practices, use of physical intervention, protocol for reporting incidents of physical intervention or restraint and how staff will be instructed in this, supports put in place for staff and children when leadership changes occur to support continuity of care. Additionally, the staff handbook should be updated to include these changes. Email the plan and updated handbook to Elaine.Crawford@vermont.gov for approval. This is a serious violation which requires that a Parental Notification Letter be sent to all families of children enrolled in your program. Please also send to Elaine.Crawford@vermont.gov names and contact information for parents who will be sent the Parental Notification Letter.”

Correction date in the state record: Jul 9, 2025

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

“As of the date of this visit there is a person is listed as an assistant who reportedly finished employment in August 2021, a person listed as a aide who reportedly finished with the program at the end of Ocober 2021, and a person listed as a partner staff who is known to have retired from their role prior to March 2020. Corrective Action: Remove persons no longer associated with the program from the associated parties list. Identify a system to ensure compliance to this rule will be met in the future.”

Correction date in the state record: Feb 22, 2022

Regulation 3.4.7.3: Within six (6) months of the initial date of employment; staff and auxiliary staff left alone with children and/or counted in staff/child ratio as specified in the rule 6.2.1.8 of these regulations, and the program director shall maintain an up-to-date BFIS Quality and Credential Account. Documentation, verification of qualifications, and all annual professional development activities as specified in the rules in sections 7.3 and 7.4 of these regulations shall be submitted to Northern Lights at CCV to be verified and maintained in BFIS.

“Substitute A, who has been associated with the program since 2017, and Substitute B who has been associated with the program since 2019, have incomplete BFIS quality and credential accounts. They are each missing documentation confirming a High School Diploma or equivalent, documentation of completed orientation, and documentation of the required mandatory reporter training. It was confirmed during the visit on 01/19/2022 that the program still considers these two individuals as substitutes to contact to count in staff to child ratio if needed. Corrective Action: Review each staff person's role and required documentation that is to be within the individual's BFIS quality and credential account based upon the individual's role within the program. Send a plan to this licensor by the noted corrective action date that notes the identified documentation each staff person needs to submit and the planned timeframe to have the submissions to the Norther Lights at CCV for uploading into the quality and credential accounts.”

Correction date in the state record: Feb 22, 2022

Regulation 3.4.6.1: The licensee shall maintain a record of the date of each evacuation drill as required in the rules in section 3.7.2 of these regulations that includes the number of children and staff evacuated, time taken to evacuate, and notation of the drill conducted while children were sleeping or resting. Evacuation records shall be kept for two (2) years.

“The program did not have documentation confirming emergency evacuation drills were performed for January, March, May, June, or July 2019. Corrective Action: Establish a system that ensures monthly evacuation drills are conducted and recorded as required. Send confirmation of the system put in place to this licenser.”

Correction date in the state record: Nov 18, 2019

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.

“On 10/11/2019, child A received a visible injury to the skin on his abdomen and it was seen by two staff persons. The child's parent was not notified of the injury when the child was picked up at the end of the day. An incident report was not completed by staff persons until 10/11/2019. The child's parent was not given a copy of the incident report as of morning drop off on 10/14/2019. Corrective Action: Establish and review with each staff person an accident/incident procedure that meets the requirements of this rule. Submit the reviewed practice and procedure to this licenser for review.”

Correction date in the state record: Oct 30, 2019