A Child's Place At The Ranches

AAC R9-5-501.B.9. B. A licensee shall ensure that a staff member: 9. Does the following when a parent permits or asks a staff member to apply personal products on an enrolled child, such as petroleum jelly, diaper rash ointments, sun screen or sun block preparations, toothpaste, and baby diapering preparations: a. Obtains the enrolled child’s personal products from the enrolled child’s parent or, if the licensee provides the personal products for use by the enrolled child, obtains written approval for use of the products from the enrolled child’s parent; b. Labels the personal products with the enrolled child’s name; and c. Keeps the personal products inaccessible to enrolled children;

“Findings: Based on the Compliance Officers' observations, in the Infant Room, the personal products were not labeled with the child's first and last name.”

AAC R9-5-501.A.3. A. A licensee shall ensure that: 3. For enrolled infants and children five-years or younger, drinking water is available to meet the needs of each enrolled child;

“Findings: Based on the Compliance Officers' observations, the drinking water was not accessible to children in the Toddler Introduction Room.”

AAC R9-5-501.A.18. A. A licensee shall ensure that: 18. Except as provided in subsection (A)(20), the following are stored separate from food storage areas and are inaccessible to an enrolled child: a. All materials and chemicals labeled as a toxic or flammable substance; b. All substances that have a child warning label and may be a hazard to a child; and c. Lawn mowers, ladders, toilet brushes, plungers, and other facility equipment that may be a hazard to a child;

“Findings: Based on the Compliance Officers' observations, there was a plunger accessible to children in the Pre-K Room Restroom.”

AAC R9-5-512.D. D. A licensee shall ensure that toilet bowls, lavatory fixtures, and floors in toilet rooms and kitchens are cleaned and sanitized as often as necessary to maintain them in a clean and sanitized condition or at least once every 24 hours.

“Findings: Based on the Compliance Officer's observations, the following restrooms were not maintained in a clean condition: *Pre-K: The restroom floor had brown smears in front of the toilet area. *School-Age: The East side restroom had yellow liquid inside the toilet, and there were dried yellow spots on the toilet seat. The West side restroom had a build-up of dark scum under the soap dispenser.”

AAC R9-5-516.B.4. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 4. A staff member: a. Administers a prescription medication provided by a parent only from a container dispensed by a pharmacy; b. Administers a nonprescription medication provided by a parent for an enrolled child only from a container prepackaged and labeled for use by the manufacturer and labeled with the enrolled child’s name; c. Does not administer any medication that has been transferred from one container to another; and d. Does not administer a nonprescription medication to an enrolled child inconsistent with the instructions on the nonprescription medication’s label, unless the facility receives written authorization from the enrolled child’s health care provider.

“Findings: Based on the Compliance Officers' observations, the nonprescription medication for Child #1 lacked medical authorization for administration to a child under five years old. The medication label indicated that use for children under five years old is prohibited unless directed by a doctor.”

AAC R9-5-502.A.11. A. A licensee providing child care services for infants shall: 11. Label each food container received from the parent with the infant's name.

“Findings: Based on the Compliance Officers' observations, in the Infant Room, the feeding bottle and baby food container were not labeled with the child's first and last name.”

AAC R9-5-503.E. E. A licensee shall ensure that the written diaper changing procedure in subsection (D) states that an enrolled child’s diaper is changed as soon as it is soiled, and that a staff member, when diapering:1. Uses a separate washcloth and towel only once for each enrolled child; 2. Washes and dries the enrolled child using the enrolled child’s individual personal products labeled with the enrolled child’s name; 3. Uses single-use non-porous gloves; 4. Washes the staff member’s own hands with soap and running water between 86° F and 110° F before and after each diaper change; 5. Washes each enrolled child’s hands with soap and running water between 86° F and 110° F after each diaper change; 6. Cleans, sanitizes, and dries the diaper changing surface following each diaper change; and 7. Uses single-use paper towels from a dispenser to dry the diaper changing surface or the hands of the enrolled child or staff member.

“Findings: Based on the Compliance Officer's observation, in the 1's classroom, a staff member did not wash their hands and the Infant's hands after changing the diaper of an enrolled child.”

AAC R9-5-603.E. E. A licensee shall ensure that the following is provided and maintained within the fall zones of swings and climbing equipment in an outdoor activity area:1. A shock-absorbing unitary surfacing material manufactured for such use in outdoor activity areas; or 2. A minimum depth of 6 inches of a non-hazardous, resilient material such as fine loose sand or wood chips.

“Findings: Based on the Compliance Officer’s observation, the Big Playground lacked the following resilient surfacing: *3 of the required 6 inches of tire chips in the fall zones of the double slide and twirly slide. *4 of the required 6 inches of tire chips in the fall zone of the curved slide.”

AAC R9-5-309.C. C. A licensee shall maintain on facility premises: 1. A current fire inspection report including documentation of any repairs or corrections required by the fire inspection report; and 2. If there are gas pipes that run from a gas meter to an appliance or location on the facility premises, a current gas inspection report including documentation of any repairs or corrections required by the gas inspection report.

“Findings: Based on facility documentation and the Compliance Officer’s observation, the Licensee lacked documentation of a current violation-free fire inspection report as required.”

AAC R9-5-501.A.1. A. A licensee shall ensure that:1. In addition to complying with the requirements in this Chapter, the health, safety, or welfare of an enrolled child is not placed at risk of harm;

“Findings: Per allegation and based on Compliance Officers' review of documentation, video, and staff statements, the health, safety, or welfare of an enrolled child was placed at risk of harm when Staff #1 grabbed a child by one arm, dragged the child 2 feet across the floor, then lifted the child off of the ground by one arm, resulting in an injury to the child's arm requiring medical attention. Staff stated that a child was saying their arm hurt and was crying. Upon review of the video, (Staff #1) had lifted the child by the arm off the ground at approximately 3:35 p.m. and carried (the child) to the diaper-changing table.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on Compliance Officer (CO) #2's observations and a review of facility documentation, the 4's/5's room had 8 children present in the classroom and 7 children noted on the roster as in attendance.”

AAC R9-5-503.A.1. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:1. A nonabsorbent, sanitizable diaper changing surface that is: a. Seamless and smooth, and b. Kept clear of items not required for diaper changing;

“Findings: Based on CO #1's observations, the diaper changing areas in the Infant and 2's room were not kept clear of items: **Infants - Posting on the counter behind the sink fixture **2's - Unopened box of diapers in the diaper changing sink”

AAC R9-5-501.A.1. A. A licensee shall ensure that:1. In addition to complying with the requirements in this Chapter, the health, safety, or welfare of an enrolled child is not placed at risk of harm;

“Findings: Based on CO #2's observations, the health, safety, or welfare of an enrolled child was placed at risk of harm when a staff member placed an infant to sit at the edge of a non-diapering counter while the staff member was looking at an IPad.”

AAC R9-5-512.C. C. A licensee shall ensure that floor coverings are:1. Clean; and 2. Free from: a. Dampness, b. Odors, and c. Hazards.

“Findings: Based on CO #2's observations, in the Pre-K Blue room, there was a 15-foot-long gap between carpet seams.”

AAC R9-5-512.D. D. A licensee shall ensure that toilet bowls, lavatory fixtures, and floors in toilet rooms and kitchens are cleaned and sanitized as often as necessary to maintain them in a clean and sanitized condition or at least once every 24 hours.

“Findings: Based on CO #2's observations, the following toilet rooms were not maintained in a clean and sanitary condition: **Toddler Intermediate and Toddler Advanced - Dirt build-up and caulking separating from the wall at the top of the sink **Pre-K Blue - Build-up of hard water stains around the sink faucet; caulking separating and cracking at the top of the sink”

AAC R9-5-512.F. F. A licensee shall ensure that:1. Each toilet room in a facility contains, within easy reach of enrolled children: a. Mounted toilet tissue; and b. Except as provided in subsection (G): i. A sink with running water; ii. Soap contained in a dispenser; and iii. Disposable, single-use paper towels in a mounted dispenser, or a mechanical air hand dryer; 2. Staff members wash their hands with soap and running water after toileting; 3. An enrolled child’s hands are washed with soap and running water after toileting; 4. Except for a cup or receptacle used only for water, food waste is stored in a covered container and the container is clean and lined with a plastic bag; 5. Food waste and other refuse is removed from the facility building at least once every 24 hours or more often as necessary to maintain a clean condition and avoid odors; 6. A staff member or an enrolled child does not draw water for human consumption from a toilet room handwashing sink; 7. Toys, materials, and equipment are maintained in a clean condition; 8. Plumbing fixtures are maintained in a clean and working condition; and 9. Chipped or cracked sinks and toilets are replaced or repaired.

“Findings: Based on CO #2's observations, in the Toddler Intermediate room, there was heavy dirt buildup on the steps, platform, and bridge of the wooden climber.”

AAC R9-5-516.B.3. B. If prescription or nonprescription medications are administered, a licensee shall ensure that:3. A facility director, or a staff member designated in writing by the facility director, does not administer a medication to an enrolled child unless the facility receives written authorization signed by the enrolled child’s parent or health care provider that includes the: a. Name of the enrolled child; b. Type of the medication; c. Prescription number, if any; d. Instructions for administration specifying the: i. Dosage and route of administration; ii. If indicated, starting and ending dates of the dosage period; and iii. Times and frequency of administration; e. Reason for the medication; and f. Date of authorization; and

“Findings: Based on CO #1's observations and a review of facility documentation, Child #1's medication authorization lacked a start and an end date.”

AAC R9-5-517.A.1. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall:1. Obtain dated, written permission from the enrolled child’s parent before the licensee transports the enrolled child;

“Findings: Based on CO #1's observations and a review of facility documentation, Child #2 lacked documentation of authorization from the enrolled child's parent for the facility to transport the child to/from school.”

AAC R9-5-517.B.3. B. A licensee shall ensure that an individual who drives a motor vehicle used to transport an enrolled child:3. Carries a list stating the name of each enrolled child being transported and a copy of each enrolled child’s Emergency, Information, and Immunization Record card including the attached immunization record or exemption affidavit, in the motor vehicle;

“Findings: Based on CO #1's observations and a review of facility documentation, Emergency Information and Immunization Record cards used when transporting children lacked attached immunizations or an exemption affidavit. **Child #2, Child #3, Child #4, Child #5, Child #6, Child #7, Child #8, Child #9, Child #10, Child #11, Child #12, Child #13, Child #14”

AAC R9-5-603.C. C. Except as provided in subsection (D), a licensee shall ensure that an outdoor activity area:1. Is enclosed by a fence: a. A minimum of 4 feet high; b. Secured to the ground; and c. With either vertical or horizontal open spaces on the fence or gate that do not exceed 4.0 inches; 2. Is maintained free from hazards, such as exposed concrete footings and broken toys; and 3. Has gates that are kept closed while an enrolled child is in the outdoor activity area

“Findings: Based on CO #2's observations, on the Preschool/School-Age playground, a tricycle was missing a pedal.”

AAC R9-5-605.B.16. B. A licensee shall ensure that:16. The fire extinguisher required in subsection (A): a. Is serviced at least once every 12 months; and b. Has a tag attached to the fire extinguisher that specifies the date of the last servicing and the identification of the person who serviced the fire extinguisher; and

“Findings: Based on CO #2's observations, 6 fire extinguishers throughout the facility lacked documentation of service in the last 12 months. The service tags were dated 01/2023.”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on Compliance Officer (CO) #2's observations, in the Toddler Intro room, the ratio was 1:8 with a required ratio of 2:8 for 1-year-olds.”

AAC R9-5-503.A.2. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:2. A hand-washing sink next to the diaper changing surface for staff use when changing diapers and for washing an enrolled child during or after diapering that provides: a. Running water between 86° F and 110° F, b. Soap from a dispenser, and c. Single-use paper hand towels from a dispenser;

“Findings: Based on CO #2's observations, in the Infant room, the water temperature at the diaper changing station was measured at 119° F.”