A Great Beginning

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 facility documentation and the Compliance Officer’s observation, the medication for Child #1 lacked 1 of the 2 medications as dispensed by the pharmacy”

AAC R9-5-605.B.1. B. A licensee shall ensure that:1. All designated exits, corridors, and passageways that provide escape from the building are unobstructed and unlocked during hours of operation;

“Findings: Based on the CO's observation, in the Monkeys and Turtles classrooms, the designated exit to the outside was locked when children were present.”

AAC R9-5-301.F. F. A licensee shall ensure that a staff member submits, on or before the starting date of employment or volunteer services, one of the following as evidence of freedom from infectious active tuberculosis: 1. Documentation of a negative Mantoux skin test or other tuberculosis screening test recommended by the U.S. Centers for Disease Control and Prevention, administered within 12 months before the starting date of employment or volunteer service, that includes the date and the type of tuberculosis screening test; or 2. If the staff member has had a positive Mantoux skin test or other tuberculosis screening test, a written statement that the staff member is free from infectious active tuberculosis that is signed and dated by a health care provider within six months before the starting date of employment or volunteer service.

“Findings: Based on facility documentation and the Compliance Officer's (CO's) observation, the file for Staff #1 lacked documentation of negative Mantoux test administered within 12 months before the starting date of employment (Start date: 5/13/2024, Mantoux Test: 1/14/2023).”

ARS § 36-883.02.A. A. Except as provided in subsection B of this section, child care personnel, including volunteers, shall submit the form prescribed in subsection C of this section to the employer and shall have valid fingerprint clearance cards issued pursuant to section 41-1758.07 before starting employment or volunteer work.

“Findings: Based on facility documentation and the CO's observation, Staff #2 lacked a valid fingerprint clearance card prior to their starting date of employment. (Start Date: 12/12/2023 Application Received: 12/18/2023 Decision Date: 12/26/2023)”

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 facility documentation and the COs' observations, it was determined that the roster in the 4/5's classroom did not reflect the number of children present (15 children present, 13 children listed on the roster).”

AAC R9-5-511.C. C. A licensee shall provide an unobstructed passageway at least 18 inches wide between each row of cots or mats to allow a staff member access to each enrolled child.

“Findings: Based on CO #2's observation, in the 2's classroom, 2 of the occupied mats were spaced 2-3 inches apart rather than the required 18 inches between rows as required. In the 4/5's classroom, there was 1 occupied mat that lacked an 18-inch unobstructed passageway. The mat was located between the wall and the home living units.”

AAC R9-5-510.B.4. B. A licensee shall ensure that a staff member does not use or permit: 4. Discipline associated with: a. Eating, napping, sleeping, or toileting; b. Medication; or c. Mechanical restraint; or

“Findings: Per allegation, based on staff statements, mechanical restraint was used in the 1's classroom. Staff stated that enrolled children are placed in a table bucket seat (with seat belt buckled) if multiple attempts to redirect their behavior (hurting themselves or others) is not successful.”

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 the COs' observations, the health, safety, and welfare of enrolled children were placed at risk of harm. *In the 2's classroom, there was a sleeping child covered from head to toe in a blanket. Staff were unable to observe the sleeping child's face. *In the 3's and 3/4's classrooms, there was not sufficient lighting to supervise sleeping children faces. The room was dark and the CO's were unable to see all of the children in the room.”

AAC R9-5-203.C. C. Except as provided in A.R.S. § 41-1758.03, a licensee shall ensure that each staff member, before starting date of employment or volunteer service, submits to the licensee a copy of the staff member’s valid fingerprint clearance card, front and back, issued under A.R.S. Title 41, Chapter 12, Article 3.1.

“Findings: Based on facility documentation and the Compliance Officer (CO) #2's observation, the file for Staff #1 and Staff #2 lacked a copy of the back of the valid fingerprint clearance card.”