American Child Care #48

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 including the attached immunization record or exemption affidavit, in the motor vehicle;

“Findings: Based on the Compliance Officers' observations, the child Emergency, Information, and Immunization Records in the vehicle lacked immunization records for the enrolled children.”

AAC R9-5-306.A. A. A licensee shall: 1. Maintain a dated attendance form containing an enrolled child’s name with the time of each admission and release, and the parent or staff member's signature or other unique identifier. 2. If an electronic signature is used to admit or release the enrolled child, adopt policies and procedures to ensure that the individual whose signature the electronic or digital method of identification represents is accountable for the use of the electronic or digital method; 3. Develop, document, and implement policies and procedures to ensure that the identity of an individual is known to the staff member or is verified with picture identification before releasing an enrolled child to the individual. 4. Not release the enrolled child to an individual other than the enrolled child’s parent or other individual designated in writing by the enrolled child’s parent except when the enrolled child’s parent is unable to collect the enrolled child and authorizes the licensee by telephone to release the enrolled child to an individual not so designated. 5. Not permit the self-admission or self-release of an enrolled child unless the enrolled child is of school-age and the licensee has obtained and verified written permission from the enrolled child’s parent. 6. Maintain the attendance form on facility premises for 12 months after the date of attendance.

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that 3 out of 15 enrolled children's attendance forms reviewed lacked the following required information: Child #1 & Child #2: Arrival signature or unique identifier on 6/3/2026. Child #3: Release signatures or unique identifier on 6/3 and 6/4/2026.”

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 the Compliance Officer's observation, in Room 1 (Infants), the diaper area lacked single-use paper towels from a dispenser.”

AAC R9-5-502.C.1.l. C. A licensee shall ensure that: 1. A staff member providing child care services in an infant room: l. Posts the current written dietary instructions in the infant room and the kitchen and maintains the instructions on facility premises for 12 months after the date of the instructions; and

“Findings: Based on the Compliance Officer's observation, the kitchen lacked posted infant feeding instructions.”

AAC R9-5-502.C.1.lk. C. A licensee shall ensure that: 1. A staff member providing child care services in an infant room: k. Obtains written, current, and dated dietary instructions from a parent or health care provider regarding the method of feeding and types of foods to be prepared or fed to an infant at the facility;

“Findings: Based on facility documentation and the Compliance Officer's observations, the written feeding instructions for 7 of 7 infants were not complete.”

AAC R9-5-502.A.8.b. A. A licensee providing child care services for infants shall: 8. Provide a crib for each infant that: b. Has a commercially waterproofed mattress; and

“Findings: Based on the Compliance Officer's observations, in Infant room #1, 3 of 8 mattress pads were torn with exposed foam. In Infant room #2, 7 of 8 mattress pads were torn with exposed foam.”

AAC R9-5-403.A. A. Within 10 calendar days of the starting date of employment or volunteer service, a licensee shall provide, and each staff member who provides child care services shall complete, training for new staff members that includes all of the following: 1. Facility philosophy and goals; 2. Names and ages of and developmental expectations for enrolled children for whom the staff member will provide child care services; 3. Health needs, nutritional requirements, any known allergies, and information about adaptive devices of enrolled children for whom the staff member will provide child care services; 4. Lesson plans; 5. Child guidance and methods of positive discipline, including separation; 6. Hand washing techniques; 7. Diapering techniques and toileting, if assigned to diaper changing duties; 8. Food preparation, service, sanitation, and storage, if assigned to food preparation; 9. If a staff member is assigned to feeding infants, the preparation, handling, and storage of infant formula and breast milk; 10. Recognition of signs of illness and infestation; 11. Child abuse or neglect detection, prevention, and reporting; 12. Accident and emergency procedures; 13. Staff responsibilities as required by A.R.S. Title 36, Chapter 7.1, Article 1 and this Chapter; 14. Sun safety policies and procedures; 15. Safety in outdoor activity areas; 16. Transportation procedures, if applicable; 17. Field trip procedures, if applicable; 18. Infant tummy time, if applicable; 19. Prevention of sudden infant death syndrome and use of safe sleeping practices, if applicable; and 20. Prevention of shaken baby syndrome, pediatric abusive head trauma, and child maltreatment.

“Findings: Based on the Compliance Officer's observations of 6 staff files, the file for Staff #1 (DOE 3/30/2026) lacked new staff training within 10 calendar days of the starting date of employment.”

AAC R9-5-603.D. D. 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 Officers' observations, on the Preschool playground, three separate fall zone areas lacked resilient surfacing. The turf lacked shock-absorbing material to meet the requirements for a resilient surface.”

AAC R9-5-512.F.1. 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;

“Findings: Based on the Compliance Officer's observation, in Room 3 (3s) toilet room, there were no paper towels; the dispenser was empty.”

AAC R9-5-512.F.8.9. F. A licensee shall ensure that: 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 the Compliance Officer's observations, in both Infant rooms, the sinks would not drain. The water pooled in both sinks.”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 3. A child educator is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience if working with enrolled children five years old and younger, or three months of child care experience if working with school-aged children; and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on facility documentation, the Compliance Officer's observations and staff statement, it was determined that Staff #1 (DOE 3/30/2026) was a child educator. Staff #1 was not qualified as a child educator because their file lacked documentation of a valid high school/ high school equivalency diploma. Staff stated that Staff #1 has worked alone with children.”

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 Compliance Officer's observation, in Room 4 (3s - S/A), there were 13 enrolled children present and 3 children were marked on the roster.”

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 observation, in Room 3 (3s) toilet room, the toilet lacked caps covering the tightening screw, and there was a build up of dirt and grime on them.”

AAC R9-5-511.A.1.2.3.4.5. A. A licensee shall provide each enrolled child who naps or sleeps at the facility with a separate cot or mat or a crib that meets the requirements of R9-5-502(A)(8) and ensure that: 1. A cot, mat, or crib used by the enrolled child accommodates the enrolled child’s height and weight; 2. A staff member covers each cot, or mat with a clean sheet that is laundered when soiled, or at least once every seven days and before use by a different enrolled child; 3. A clean blanket or sheet is available for each enrolled child; 4. A rug, carpet, blanket, or towel is not used as a mat; 5. Each cot, mat, or crib is maintained in a clean and repaired condition;

“Findings: Based on the Compliance Officer's observation and staff statement, in Room 4 (3s - S/A), there was a child laying on a wooden bench, rather than a mat or a cot. Staff stated “the child was not feeling well”.”

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 the Compliance Officer's observation and a discussion with staff, a ratio of 1:7 was observed in the one & two-year-old room. A ratio of 0:6 was observed in the three & and four-year-old room. The teacher stated she had stepped out of the room to retrieve children from another room.”

AAC R9-5-404.C.3. C. A licensee shall ensure that when there are: 3. Six or more enrolled children are present in a facility, an infant is not placed for supervision with a child who is not an infant.

“Findings: Based on the Compliance Officer's observation and a discussion with staff, 2 one year old children were observed in the infant room. Both of the children were observed walking. The staff acknowledged the children were able to walk and stated the children were normally in the one-year-old room but stated since staff had called out that morning, these 2 children were placed in the infant room.”

AAC R9-5-510.A.1. A. A staff member shall provide guidance to help children respond to difficult situations. To develop self-regulation, children should receive adult support that is individual to the child and adapts as the child develops internal controls. This process should include: 1. Forming a positive relationship with the child, which occurs when the adult spends time talking to the child, listening to the child, following the child’s lead, playing with the child, and responding to the child’s needs; 2. Base expectations on the child’s developmental level; 3. Establishing and being proactive in teaching and supporting children in learning simple rules; 4. Modifying the learning/play environment to support the child’s appropriate behavior; 5. Creating a predictable daily routine and schedule; 6. Modeling desired behavior; 7. Showing children positive alternatives; 8.Using deliberate redirection, the staff member should encourage the child to use appropriate behavior, and provide positive feedback when the child exhibits the behavior; 9. Individualized positive discipline strategies based on the individual needs of children, such as using a buddy system, individualized schedule, special break, or another applicable positive discipline strategy; and 10. If applicable, a licensee shall develop a written plan with the enrolled child's parent to provide individualized social and emotional intervention supports for the enrolled child that includes methods for understanding the enrolled child's behavior, and developing, adopting, and implementing a team-based positive behavior support plan.

“Findings: Based on the Compliance Officer's interview with staff and on a review of the video of the incident that was provided by the licensee, Staff #1 failed to model desired behavior and show children positive alternatives and use deliberate redirection to encourage the child to use appropriate behavior. Staff #1 said Child #1 had been hitting other children while the class was outside on the playground. Staff #1 stated they held the child's hand to prevent them from hitting other children. The video shows Staff #1 held Child #1's by their hand without releasing the child's hand for 5 minutes and 35 seconds. Multiple times in the video the child was seen pulling backwards and attempting to have the staff release their hand. The child is seen dropping to the ground on their knees twice and Staff #1 is seen picking the child off the floor by lifting the child off the floor by either one hand or both hands. Multiple times, Staff #1 is seen dragging the standing child behind her by the child's hand as Staff #1 is moving around the room.”

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 the Compliance Officer's observation, 4 children were present in the infant room but the names of only 3 children were listed as present on the room's roster.”

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 Compliance Officer's interview with staff and on a review of the video of the incident that was provided by the licensee, the health, safety and welfare of an enrolled child was placed at risk of harm when an enrolled child received an injury to their elbow, when Staff #1 held the child's hand by their hand without releasing the child's hand for 5 minutes and 35 seconds. The child was seen pulling backwards and resisting four different times and dropping to the ground on their knees twice. Staff #1 is seen picking the child off the floor by lifting the child by one of the child's hands and another time by lifting the child off the floor by picking the child up by both of the child's hands. During the 4 times when the child is resisting and pulling backwards, Staff#1 is seen dragging the standing child behind her as Staff #1 is moving forward. The child received medical attention for an injury to their elbow (nurse's elbow).”

AAC R9-5-301.B. B. A licensee shall ensure that a facility director: 1. Designates, in writing, an individual who meets the requirements of R9-5-401(2) to act on behalf of the facility director when the facility director is not present in the facility; 2. Supervises or assigns a teacher-caregiver to supervise each staff member who does not meet the qualifications of R9-5-401(3); 3. Prepares a dated attendance record for each day and ensures that each staff member documents on the attendance record the time of each arrival and departure of the staff member; and 4. Maintains on the facility premises, the dated attendance record required in subsection (B)(3) for 12 months after the date on the attendance record.

“Findings: Based on the Compliance Officer's observations and a review of Staff #2's file (DOE 1/20/25), Staff #2 was observed working alone and unsupervised in the infant room at the time of the inspection. A review of Staff #2's file determined the staff did not meet the minimum requirements of a teacher caregiver and is required to be supervised at all times.”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:3. A teacher-caregiver is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on the Compliance Officer's review of Staff #2's file (DOE 1/20/25), Staff#2 is an infant room teacher and the staff's file contained documentation of foreign education. The file lacked documentation of the verification of the education's equivalency and it could not be determined if the staff met the minimum qualifications of a teacher caregiver.”

AAC R9-5-501.C.5. C. A licensee shall ensure that a staff member:5. Except as provided in subsection (D), prepares and posts a dated lesson plan in each indoor activity area for each calendar week, which is maintained on facility premises for 12 months after the lesson plan date and provides opportunities for each child to: a. Gain a positive self-concept; b. Develop and practice social skills; c. Think, reason, question, and experiment; d. Acquire language skills; e. Develop physical coordination skills; f. Participate in structured large muscle physical activity; g. Develop habits that meet health, safety, and nutritional needs; h. Express creativity; i. Learn to respect cultural diversity of children and staff; j. Learn self-help skills; and k. Develop a sense of responsibility and independence;

“Findings: Based on the Compliance Officer's observation, the School-age room lacked a posted lesson plan.”

AAC R9-5-502.C.1.l. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: l. Obtains written, current, and dated dietary instructions from a parent or health care provider regarding the method of feeding and types of foods to be prepared or fed to an infant at the facility;

“Findings: Based on the Compliance Officer's observations and a discussion with the infant room staff, the following written infant feeding instructions lacked information and had not been updated: *Child 1- Staff stated the child was on formula but the instructions lacked the amount and frequency of the formula feedings; *Child 2- Staff stated the child was eating pureed foods but the form stated the child was drinking breastmilk and the form had not been updated since 9/2024; *Child 3- Staff stated the child was eating pureed foods but the form stated the child was drinking formula and the form had not been updated since 9/2024; *Child 4- Staff stated the child was eating pureed foods but the form stated the child was drinking formula and the form had not been updated since 2/2025; *Child 5-Staff stated the child was drinking formula but the form did not state the amount and frequency of the feedings; and *Child 6- Staff stated the child was eating pureed foods but the form stated the child was drinking formula.”

AAC R9-5-502.C.3.a. C. A licensee shall ensure that: 3. When preparing, using, or caring for an infant's feeding bottles, a staff member: a. Labels each bottle received from the parent with the infant's name;

“Findings: Based on the Compliance Officer's observations, 2 bottles in the older infant room were not labeled with the infant's first and last name.”

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 the Compliance Officer's observation, the paper towel dispenser at the diaper changing table in the 2 year old room was empty and the roll of paper towels was not mounted.”

AAC R9-5-503.C. C. A staff member who provides child care services to an infant:1. May throughout the time the staff member provides child care services to the infant: a. Change the infant’s diaper, and b. Prepare the infant’s formula or cereal; and 2. Is prohibited from other food preparation after changing the infant’s diaper.

“Findings: Based on the Compliance Officer's observation, numerous pieces of Cheerios cereal were in the diapering sink in the 2 year old room, clogging the sink, leaving standing water in the sink.”

AAC R9-5-509.C.21. C. A licensee shall ensure that: 21. Perishable foods are covered and stored in a refrigerator at a temperature of 41° F or below;

“Findings: Based on the Compliance Officer's observation, the refrigerator in the older infant room lacked a thermometer.”

AAC R9-5-512.B. B. A licensee shall maintain facility premises and furnishings:1. In a clean condition, and 2. Free from odor.

“Findings: Based on the Compliance Officer's observation, the Alphabet rug in younger infant room had numerous brown stains on it and was dirty.”

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 and on a discussion with the Director and the Licensee, artificial turf had been installed within the last year under the playground climbing equipment and in the fall zones. The Licensee acknowledged that the required resilient surfacing in the fall zones had not been installed and was in the process of being redone to meet the rule requirements.”

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 the Compliance Officer's observation, a ratio of 1:7 was observed in the one year old room. The second staff was observed in the hallway.”

ARS § 36-883.02.C. C. Applicants, licensees and child care personnel shall attest on forms that are provided by the department that:1. They are not awaiting trial on or have never been convicted of or admitted in open court or pursuant to a plea agreement committing any of the offenses listed in section 41-1758.07, subsection B in this state or similar offenses in another state or jurisdiction. 2. They are not parents or guardians of a child adjudicated to be a dependent child as defined in section 8-201. 3. They have not been denied or had revoked a certificate to operate a child care group home or a license to operate a child care facility in this or any other state or that they have not been denied or had revoked a certification to work in a child care facility or child care group home.

“Findings: Based on facility documentation and the Compliance Officer's observations of 4 staff files, Staff #1’s Criminal History Affidavit was not complete. The three questions had not been addressed. ***Previously cited 12/19/22 & 6/28/23”

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 the Compliance Officer's observations of the outdoor activity areas, the following hazards were accessible to enrolled children: Preschool playground: There was a large basketball hoop laying forward on the ground. Toddler playground: There were sharp plastic edges on the top of the lion rider. ***Previously cited 7/8/21, 10/18/21, 7/12/22, 6/28/23, & 1/11/24”

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 the Compliance Officer's observations, the following was observed: Preschool playground: There was food waste in an uncovered container with a warped lid. Toddler playground: *There was food waste in an uncovered grey container. *There was discarded trash on the ground. School-age room: There was discarded food waste in a blue trash container that lacked a lid. 4’s toilet room: There was a yellow substance inside the left toilet. 3’s toilet room: The left toilet seat was nicked. ***Previously cited 7/8/21, 10/18/21, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-512.B. B. A licensee shall maintain facility premises and furnishings:1. In a clean condition, and 2. Free from odor.

“Findings: Based on the Compliance Officer's observations, the following was not maintained in a clean condition: Toddler playground: There were dirty discolored dark smears on the handles of 2 walkers. 2’s room: There was exposed wood on the side edge of a cabinet and sticky tape residue on 2 cabinets. 1’s room: *There was exposed wood on the top surface of a clothing shelf, and on the bottom of the oven set. *There was exposed wood on the sides of a shelf with sticky tape residue on the top and middle shelf. *There was peeling laminate on the top surface of a wooden cabinet. *There were chipped edges on a rectangular table with exposed wood. School-age room: There were dirty discolored smears on the red and white doll house. 4’s room: There were discolored smears on the side of the wooden theater. ***Previously cited 7/8/21, 10/18/21, 3/31/22, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-509.C.22. C. A licensee shall ensure that:22. A refrigerator at the child care facility maintains a temperature of 41° F or below, as shown by a thermometer kept in the refrigerator at all times;

“Findings: Based on the Compliance Officer's observation, Infant room 1 lacked a thermometer in the white refrigerator. (There was children's food in the refrigerator.) ***Previously cited 7/8/21, 10/18/21, 7/12/22, & 6/28/23”

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 Infant room, a staff member was observed changing a infant's diaper and then placing the infant on the floor without washing the infant’s hands, and then touched the infant feeding plans and a child’s bag without washing their own hands.”

AAC R9-5-503.D. D. A licensee shall ensure that a written diaper changing procedure is posted and implemented in each diaper changing area.

“Findings: Based on the Compliance Officer's observation, the 1's room lacked a posted diaper changing procedure. ***Previously cited 6/28/23”

AAC R9-5-503.A.4. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:4. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled clothing.

“Findings: Based on the Compliance Officer's observation, in the 2's room, the soiled clothing container lacked a liner. (There were soiled clothes in the container.) ***Previously cited 7/8/21, 7/12/22, & 6/28/23”

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 the Compliance Officer's observations, in the 1's room, the water temperature in the diaper changing sink measured 116 degrees F, rather than between 86 - 110 degrees F as required.”

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 the Compliance Officer's observations, the 2's room diaper changing area was not seamless and smooth and kept clear of items not related to diaper changing. *There was a clear cup with 2 paint brushes on the diaper surface. *There were gaps between the wall and the diaper surface on the back and right sides. *There was broken laminate on the right side of the diaper surface. ***Previously cited 7/8/21, 10/18/21, 3/31/22, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-502.C.1.m. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: m. Posts the current written dietary instructions in the infant room and the kitchen and maintains the instructions on facility premises for 12 months after the date of the instructions; and

“Findings: Based on the Compliance Officer's observation, the kitchen lacked posted written dietary instructions for infants. ***Previously cited 6/28/23”

AAC R9-5-502.C.1.l. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: l. Obtains written, current, and dated dietary instructions from a parent or health care provider regarding the method of feeding and types of foods to be prepared or fed to an infant at the facility;

“Findings: Based on facility documentation and the Compliance Officer's observations, in the Infant room, the staff lacked written feeding instructions for Child #1 & Child #2. Child #3, Child #5, and Child #7 lacked written feeding schedules. Child #4 and Child #8 lacked all of the food items the infants currently eat. Child #6 lacked the front page of the feeding plan. ***Previously cited 6/28/23 & 1/11/24”

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 Officer's observations, staff failed to label each food container received from the parent with the infant's name. In Infant room 1, there were 2 frozen packets of a white substance labeled with a child's first name only. In Infant room 2, there was a packet with a white substance and a container of pears labeled with a child’s first name only. ***Previously cited 1/11/24”

AAC R9-5-502.A.8.c. A. A licensee providing child care services for infants shall: 8. Provide a crib for each infant that: c. Is furnished with clean, sanitized, crib-size bedding, including a fitted sheet and top sheet or a blanket;

“Findings: Based on the Compliance Officer’s observations, in Infant room 1 there were 4 loose grey crib sheets with stars and 1 loose purple crib sheet, rather than tight-fitted sheets as required. ***Previously cited 7/8/21, 6/28/23, & 1/11/24”

AAC R9-5-502.A.5.a. A. A licensee providing child care services for infants shall:5. Develop, document, and implement tummy time policies and procedures that: a. Provide an opportunity for a non-crawling infant to experience tummy time each day: i. While the infant is awake, and ii. On the infant’s stomach;

“Findings: Based on staff statement, tummy time was not being documented for infants.”

AAC R9-5-501.C.9. C. 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 Officer’s observations and staff statement, the following items lacked a label of the child's first and last name as required: Infant room: 1 unlabeled diaper ointment, 2 containers of wipes labeled with a child’s first name only, and 1 container of baby powder labeled with a child’s first name and last initial only. 2’s room: 1 unlabeled container of wipes and a container of wipes labeled with a child's first name only. 1’s room: 1 unlabeled container of wipes, 1 diaper rash ointment and 1 container of wipes labeled with a child’s first name only. Staff stated the facility provides the wipes to use on enrolled children. The facility lacked written approval for use of the wipes from enrolled children's parents. ***Previously cited 7/8/21, 7/12/22 & TA given 6/28/23”

AAC R9-5-501.A.12. A. A licensee shall ensure that: 12. The facility premises, including the buildings, are maintained free from hazards;

“Findings: Based on the Compliance Officer's observations, the following hazards were accessible to enrolled children: School-age room: There was loose baseboard on the lower section of the wall to the left of the black animal cage. 2’s room: There was peeling paint on the wall near the book shelf. ***Previously cited 7/8/21, 10/18/21, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:3. A teacher-caregiver is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that Staff #2 was a teacher caregiver in the 4's room at the time of the inspection. Staff #2 was not qualified as a teacher caregiver because their file lacked documentation of 3 months of previous child care experience. ***Previously cited 6/28/23”

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 gas inspection. The last gas inspection was dated 6/15/2023.”

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 Compliance Officer's observation, in the 4's room, there were 12 children present and 11 children were listed on the roster. ***Previously cited 7/8/21, 10/18/21, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-303.A. A. A licensee shall post in a place that can be conspicuously viewed by individuals entering or leaving the facility or activity area, the:1. Facility’s license; 2. Name of the facility director; 3. Name of the individual designated to act on behalf of the facility director when the facility director is not present in the facility, as prescribed by R9-5-301(B)(1); 4. Schedule of child care services fees and policy for refunding fees as prescribed by A.R.S. § 36-882(P); 5. Breakfast, lunch, dinner, and snack menus for each calendar week at the beginning of the calendar week; 6. Notice of the presence of any communicable disease or infestation listed in 9 A.A.C. 6, Article 2, Table 2, from the date of discovery through the incubation period of the communicable disease or infestation; 7. Notice of the Department’s intent to deny, revoke, or suspend as prescribed by A.R.S. § 36-888 at the expiration of time in the notice for the licensee to respond; 8. Notice of an intermediate sanction imposed as prescribed by A.R.S. § 36-891.01 within 10 calendar days after the licensee received notice of the intermediate sanction; 9. Notice of a legal injunction imposed as prescribed by A.R.S. § 36-886.01 when the licensee receives the legal injunction; and 10. Notice of the availability of facility inspection reports for public viewing at the facility premises.

“Findings: Based on the Compliance Officer's observations, the main posting area lacked the name of the facility director and the name of the individual designated to act on behalf of the facility director when the facility director is not present in the facility.”

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 observations of 2 playgrounds, the following was observed: Preschool playground lacked: *2” of the required 6” of resilient surfacing (wood chips) in the fall zones of the yellow step climbers. *3” of the required 6” of wood chips in the fall zones of the blue twist and yellow slide. *2” of the required 6” of wood chips in the fall zones of the orange slide. *5” of the required 6” of wood chips in the fall zones of the yellow ladder. Toddler playground lacked 4” of the required 6” of wood chips in the fall zones of the blue slide. ***Previously cited 7/8/21, 10/18/21, 7/12/22, 6/28/23, & 1/11/24”

AAC R9-5-512.B. B. A licensee shall maintain facility premises and furnishings:1. In a clean condition, and 2. Free from odor.

“Findings: Based on the Compliance Officer's observations, the following was not maintained in a clean condition: School-age room: There were dried smears and discolored stains on a table. School-age toilet room: There was a fluffy brown substance on the ceiling vent. 3’s toilet room: There was a container of fish food on a shelf. 1’s room: There were stains and debris on a wooden shelf. ***Previously cited 7/8/21, 10/18/21, 3/31/22, 7/12/22, & 6/28/2023”

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 the Compliance Officer's observations, the following diaper changing areas were not kept clear of items not required for diaper changing: Infant room: There was a bottle warmer, a clear container, a pacifier and 2 spoons on the diaper surface. 1’s room: There were wood chips and a gray sippy cup on the diaper surface. ***Previously cited 7/8/21, 10/18/21, 3/31/22, 7/12/22, & 6/28/2023”

AAC R9-5-502.C.1.l. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: l. Obtains written, current, and dated dietary instructions from a parent or health care provider regarding the method of feeding and types of foods to be prepared or fed to an infant at the facility;

“Findings: Based on facility documentation and the Compliance Officer's observations, in the infant room, the following written feeding instructions were not current and did not reflect the foods the infants were currently eating: Child #3 (DOB 12/14/2022): The plan was dated 7/12/2023. Child #4 (DOB 3/27/2023): The plan was dated 10/9/2023. Child #5 (DOB 2/10/2023): The plan was dated 7/12/2023. ***Previously cited 6/28/2023”

AAC R9-5-502.A.8.c. A. A licensee providing child care services for infants shall: 8. Provide a crib for each infant that: c. Is furnished with clean, sanitized, crib-size bedding, including a fitted sheet and top sheet or a blanket;

“Findings: Based on the Compliance Officer's observations, in the Infant room, there were 2 crib sheets that were loosely gathered under the mattress pads, rather than tight-fitted sheets as required. *** Previously cited 7/8/2021 & 6/28/2023”

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 the Compliance Officer's observations, the following was observed: On the Toddler playground, there was discarded trash in 2 uncovered containers, and there was discarded trash and feathers on the ground. On the Preschool playground, there was discarded trash in an uncovered container, and there was discarded trash and feathers on the ground, and a pile of feces near the west side wall. *** Previously cited 7/8/21, 10/18/21, 7/12/22, & 6/28/2023”

AAC R9-5-517.A.10. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall:10. Ensure that the motor vehicle is: a. Maintained in a clean condition, b. In a mechanically safe condition, and c. Free from hazards; and

“Findings: Based on the Compliance Officer's observations, in the vehicle used to transport enrolled children, there was a lollipop stick, a bag of food, and debris on the floor. ***Previously cited 6/28/2023”

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 the Compliance Officer's observations of 2 outdoor activity areas, the following hazards were accessible to enrolled children: Preschool playground: There was a cracked plastic turquoise cart with sharp edges on the ground, the Astro turf was piled up, unsecured and lifted in the dirt, and there were large chunks of concrete in multiple areas, including one near the end of a slide. ***Previously cited 7/8/21, 10/18/21, 7/12/22, & 6/28/2023”

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 observations of 2 playgrounds, the following was observed: Toddler playground lacked: * 3" of the required 6” of wood chips in the fall zones of the turquoise slide and orange steps. * 2” of the required 6” of wood chips in the fall zones of the blue slide. Preschool playground lacked: *3” of the required 6” of wood chips in the fall zones of the Landscape structure's slides (2). *2” of 6” of wood chips in the fall zones of the 5 yellow steps and the blue twist slide. *4” of 6” of wood chips in the fall zones of the yellow slide. ***Previously cited 7/8/21, 10/18/21, 7/12/22, & 6/28/2023”

AAC R9-5-502.A.1. A. A licensee providing child care services for infants shall: 1. Provide a wall-enclosed room for infants that provides exits required by R9-5-601(1);

“Findings: Based on the Compliance Officer's (CO) observation, the Infant room door was open when the CO arrived.”

AAC R9-5-501.A.18. A. A licensee shall ensure that:18. Each enrolled child’s pacifier is labeled with an identifier that is specific to the enrolled child and maintained in a clean condition;

“Findings: Based on on the Compliance Officer's observation, in the infant room, there was a pacifier that lacked an identifier specific to an enrolled child. ***Previously cited 6/28/2023”

AAC R9-5-501.A.12. A. A licensee shall ensure that: 12. The facility premises, including the buildings, are maintained free from hazards;

“Findings: Based on the Compliance Officer's observations, the following hazards were accessible to enrolled children: School-age room: There was exposed raw wood on the edges of a teachers table. School-age toilet room: There was a fluffy brown substance on the ceiling vent. 2’s room: There was sticky tape residue on a wooden shelf. 1’s room: There was exposed raw wood on the top surface of a refrigerator play set.  ***Previously cited 7/8/21, 10/18/21, 7/12/22, & 6/28/2023”

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 the Compliance Officer's observation and staff statement, in the 1’s room, the staff to child ratio was 1:7, with a required ratio of 2:7. Staff stated she had 7 alone for "barely an hour". ***Previously cited 6/28/2023”

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 on facility documentation and the Compliance Officer's observations, in the Infant room there were 5 children present and 4 children were marked on the roster. In the 1’s room there were 5 children present and 6 children were marked on the roster. ***Previously cited 7/8/21, 7/12/22, & 6/28/2023”

AAC R9-5-306.A. A. A licensee shall maintain a dated attendance form containing an enrolled child’s name with the time of each admission and release of the enrolled child. 1. Except as provided in subsection (A)(2), a licensee shall ensure that the attendance form is signed with at least a first initial of an individual’s first name and the individual’s last name by each enrolled child’s parent or individual designated by the enrolled child’s parent, each time the enrolled child is admitted or released. 2. An electronic fingerprint verification or an electronic signature may be used in place of a signature of the enrolled child’s parent or designated individual to admit or release the enrolled child. 3. If an electronic signature is used to admit or release the enrolled child, the licensee shall adopt policies and procedures to ensure that the individual whose signature the electronic or digital method of identification represents is accountable for the use of the electronic or digital method; 4. A licensee shall develop, document, and implement policies and procedures to ensure that the identity of an individual is known to the staff member or is verified with picture identification before releasing an enrolled child to the individual. 5. A licensee shall not release the enrolled child to an individual other than the enrolled child’s parent or other individual designated in writing by the enrolled child’s parent except when the enrolled child’s parent is unable to collect the enrolled child and authorizes the licensee by telephone to release the enrolled child to an individual not so designated. a. The licensee shall verify the telephone authorization using a means of verification that has been agreed upon between the licensee and the enrolled child’s parent at the time of enrollment. b. The licensee shall document the means of verification in subsection (A)(5)(a) on the enrolled child’s Emergency, Information, and Immunization Record card. 6. A licensee shall not permit the self-admission or self-release of an enrolled child unless the enrolled child is of school age and the licensee has obtained and verified written permission from the enrolled child’s parent. 7. A licensee shall maintain the attendance form on facility premises for 12 months after the date of attendance.

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that 1 out of 5 enrolled children's attendance forms reviewed lacked the following required information: Child #2: Release signature on 1/5/2023. *** Previously cited 7/8/21, 10/18/21, 7/12/22 & 6/28/2023”

AAC R9-5-304.B. B. Except as required in A.R.S. § 36-3009, before an enrolled child receives child care services, a licensee shall require the enrolled child’s parent to complete a Department-provided Emergency, Information, and Immunization Record card that is signed by the enrolled child’s parent containing: 1. The child’s name, home address, city, state, zip code, home telephone number, sex, and date of birth; 2. The date of the child’s enrollment; 3. The name, home address, city, state, zip code, and contact telephone number of each parent of the child; 4. The name and contact telephone number of at least two individuals authorized by the child’s parent to collect the child from the facility in case of emergency, or if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s health care provider; 6. The written authorization for emergency medical care of the enrolled child when the parent cannot be contacted at the time of the emergency; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. The written instructions of a child’s parent or health care provider for nutritional and dietary needs of the child including, if applicable, the request in R9-5-509(C)(9); and 9. A written record completed by the child’s parent or health care provider noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance.

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that 1 out of 3 enrolled children's Emergency Information and Immunization Record Cards reviewed lacked the following required information: Child #1: Health care provider name and phone number. (Nearest urgent care and 911 were listed). ***Previously cited 7/8/21, 7/12/22, & 6/28/2023”

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 the Compliance Officer's observations, floor coverings in the following areas were not maintained in a clean condition: 1’s room: There was debris and crumbled crackers on a gray rug. 4’s room: There was a dried liquid stain on the floor. *** Previously cited 7/8/21 & 10/18/2021”