American Child Care #50

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 following diaper changing sink temperatures were not maintained between 86 ° F and 110° F as required: One's Room: The diaper changing sink temperature was measured at 69.2 ° F; and Two's Room: The diaper changing sink temperature was measured at 71.6 ° F.”

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 observation, the following hazards were accessible to enrolled children: Pre K Room: *There were chunks of laminate missing from the wood block shelf, exposing areas of splintering raw wood; School Age Room: *The plastic kitchen stove was cracked and broken with sharp plastic edging; and School Age Bathroom: *There were 3, 1/2 inch holes in the wall behind the sink, exposing the interior dry wall.”

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 Officer's observation, the following personal products lacked a label with the child's first and last name as required: Two's Room: *1 anti-itch cream lacked a label; and One's Room: *1 aquaphor and 1 diaper cream lacked a label.”

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 following areas were not maintained in a clean condition: Pre K Room: *There was a buildup of dirt on the windowsill; School Age Room: *There was a buildup of dirt on the toy kitchen, counter behind the classroom sink, and bathroom floor; *There were crumbs and stains on the rug at the front of the room, and Two's Room: *There was staining on the shape rug.”

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 observation, the following was observed on vehicle CL56529: *The left side double door was broken and did not open; and *There was a tear in the first seat near the seat belt, exposing the interior foam.”

AAC R9-5-603.B. B. 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 observation, the following hazards were accessible to enrolled children in the outdoor activity area: Preschool Playground: *The plastic filling between the play structure and the green climber was cracking, causing sharp plastic edges; 1's Playground: *The yellow bee on the tree climber was cracked and broken, causing sharp plastic edging.”

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 Officer's observation, the blue Little Tikes climber and Wesco bridge on the Preschool Playground lacked 4 of the 6 inches of resilient surfacing 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 observation, the following diaper changing areas were not maintained clear of items not required for diaper changing: Two's Room: There was a buildup of wood chips in the corner of the diaper changing surface; and One's Room: Toys were drying on the diaper changing surface.”

AAC R9-5-302. A. A licensee shall prepare a written statement of child care services provided by the licensee that includes the following:1. A description of the facility’s child care services classifications in R9-5-204; 2. Hours of operation; 3. The facility’s street address, city, state, zip code, mailing address, and telephone number; 4. Child enrollment and disenrollment procedures; 5. Charges, fees, and payment requirements for child care services; 6. Child admission and release requirements; 7. Age-appropriate discipline guidelines and methods; 8. Transportation procedures; 9. Field trip requirements and procedures; 10. Responsibilities and participation of parents in facility activities; 11. A general description of activities and programs; 12. A description of the liability insurance required by R9-5-308 that is carried by the licensee and a statement that documentation of the liability insurance coverage is available for review on the facility premises; 13. Medication administration procedures; 14. Accident and emergency procedures; 15. A notice stating inspection reports are available on-site; 16. A provision stating that the facility is regulated by the Arizona Department of Health Services including the Department’s local street address, city, state, zip code, and local telephone number; 17. The procedures for notifying a parent at least 48 hours before a pesticide is applied on a facility’s premises; and 18. A statement that a parent has access to the areas on facility premises where the parent’s enrolled child is receiving child care services. B. A licensee shall provide a copy of the written statement of child care services: 1. To the Department: a. Before the facility receives a license, and b. Every 12 months after the date of the license as required by A.R.S. § 36-883.01; and 2. To a parent when the parent requests a copy of the written statement of child care services.

“Findings: Based on the Compliance Officer's observation, the facility's written statement of child care services lacked a statement on the refund requirements and a notice stating inspection reports are available on-site.”

AAC R9-5-203.G. G. If required by A.R.S. § 8-804, before an individual’s starting date of employment or volunteer service, a licensee shall comply with the submission requirements in A.R.S. § 8-804(C) for the individual.

“Findings: Based on the Compliance Officer's observation, the files for Staff #1 (DOE 1/6/2025) and Staff #2 (DOE 10/2/24) lacked a completed background check before their starting date of employment. The background check results were received after the staff's starting date of employment.”

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 observation, the pony door to the infant room was broken and unable to close, leaving half of the door open exposing the infant room to the main hallway.”

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 following diaper changing sink temperatures were not maintained between 86° F and 110° F as required: Two's Room: The diaper changing sink temperature was 78.2° F; and One's Room: The diaper changing sink temperature was 75.5 ° F.”

AAC R9-5-404.C.3. C. A licensee shall ensure that:3. When 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, upon the arrival of the Compliance Officer in the infant room, there was a one-year-old child mixed with infants. Staff stated the 1's start in the infant room and then get moved later in the morning.”

AAC R9-5-403.B. B. A licensee shall ensure that:1. Each staff member who provides child care services completes 18 or more actual hours of training every 12 months after the effective date of this Chapter or the staff member’s starting date of employment or volunteer service in at least two topics listed in this subsection: a. Child growth and development, including: i. Infant growth and development, which may include sudden infant death syndrome prevention; ii. Developmental psychology; iii. Language development; iv. Observation and child assessment; v. Developmentally-appropriate activities; vi. Child guidance and methods of discipline which may include training on the appropriate techniques to prevent a child from harm or to prevent the child from harming others; and vii. Developmentally-appropriate activity areas; b. Health and safety issues, including: i. Accident and emergency procedures, including CPR and first aid for infants and children; ii. Recognition of signs of illness and infestation; iii. Nutrition and developmentally-appropriate eating habits; iv. Child abuse detection, reporting, and prevention; v. Safety of indoor and outdoor activity areas; and vi. Sun safety policies and procedures; c. Program administration, planning, development, or management; and d. Availability of community services and resources, including those available to children with special needs; and 2. As part of the required 18 hours of training in subsection (B)(1): a. A staff member who has less than 12 months of child care experience before the staff member’s starting date, completes at least 12 hours in one or more of the topics in subsection (B)(1)(a) in the staff member’s first 12 months at the facility; b. A staff member who has 12 months or more of child care experience, completes at least 6 hours in one or more of the topics in subsection (B)(1)(a) every 12 months after the staff member’s starting date; c. A staff member who provides child care services to an infant completes at least 6 hours in subsection (B)(1)(a)(i) every 12 months after the staff member’s starting date; and d. A facility director completes at least 6 hours in subsection (B)(1)(c) every 12 months after the facility director’s starting date.

“Findings: Based on the Compliance Officer's observation, the following staff files lacked documentation of 18 total hours of annual training as required: Staff #3 (DOE 6/15/23): Lacked 5 of the 18 hours required for 6/15/24-6/15/25; Staff #4 (DOE 1/6/23): Lacked 18 of the 18 hours required for 1/6/24-1/6/25; Staff #5 (DOE 12/16/02): Lacked 13 of the 18 hours required for 12/16/23-12/16/24.”

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 observation, Staff stated Child #1 was eating baby food and other solid foods, however formula was the only listed item on Child #1's dietary instructions.”

AAC R9-5-509.C.23. C. A licensee shall ensure that:23. A freezer at the child care facility maintains a temperature of 0° F or below, as shown by a thermometer kept in the freezer at all times; and

“Findings: Based on the Compliance Officer's observation, the thermometer in the kitchen freezer was reading at 14 ° F rather than 0° F or below as required.”

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 following areas were not maintained in a clean condition: 3's Room: There was brown splatter staining on the blinds of the window; and School Age Room: There was a build up of dirt around the classroom sink and in the caulking around the perimeter of the counter.”

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 observation, in the 3's Bathroom and School-Age Bathroom there were rolls of exposed paper towels on the shelf above the toilets.”

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 observation, the following hazards were accessible to enrolled children: 3's Bathroom: There was a 2x3 inch hole in the wall next to the trashcan exposing the interior dry wall; Pre K: There was a 15 1/2 inch strip of laminate missing from the top of the block shelf exposing raw splintering wood, and there were two 2x2 inch spots on the same block shelf that were missing laminate exposing raw wood.”

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 the Compliance Officer's observation, 9 of 25 Emergency, Information, Immunization Record cards lacked the following: Child #1 and Child #5: The name and contact telephone number of the second individual authorized by the child's parent to collect the child form the facility in case of emergency; Child #2 and Child #7: The name and contact telephone number of the child's health care provider; Child #3 and Child #9: The home address, city, state, zip code of the second parent of the child and the name of the individual to be contacted in case of injury or sudden illness of the child; Child #4: The home address, city, state, zip code of the second parent of the child ; Child #6: The name, home address, city, state, zip code, and contact telephone number of the second parent of the child; and Child #8: The home address, city, state, zip code of the second parent of the child and the name and contact telephone number of the second individual authorized by the child's parent to collect the child form the facility in case of emergency.”

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 the Compliance Officer's observation, 3 of 25 child admission and release forms lacked the following: Child #10: The admission and release forms on 6/2 and 6/5 were signed with a first name only, the admission forms on 6/6 and 6/20 were signed with a first name only, and the release forms on 6/19 and 6/20 were signed with a first name only; Child #7: The admission forms on 6/5 and 6/6 were signed with a first name only, the release forms on 6/5 and 6/18 were signed with a first name only, the admission and release forms on 6/9 and 6/20 were signed with a first name only; Child #11: The release form on 6/6 lacked a time and signature.”

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 and review of facility documentation, it was determined that the roster was not accurate in the School-age classroom. There were 20 children present in the classroom but the roster reflected the presence of only 19 children.”

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 observation, it was determined that there was a magic eraser on the diaper changing surface in the 2's classroom.”

AAC R9-5-516.I. I. Except as specified in A.R.S. § 36-2229(B) through (D), a licensee shall ensure that a facility does not stock a supply of medications for administration to enrolled children, including:1. Any prescription medication; or 2. A nonprescription medication such as aspirin, acetaminophen, ibuprofen, or cough syrup.

“Findings: Based on the Compliance Officer’s observation, it was determined that the first-aid kit on the facility vehicle had the following stock medication: *Sting relief-9 sachets *Burn Cream-4 sachets *Asprin-2 sachets *Ibuprofen-2 sachets”

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, it was determined that the ratio in the Infant classroom was 1:6 instead of the required ratio of 2:6.”

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 the Compliance Officer’s observation and review of facility documentation, it was determined that the facility lacked a current fire inspection.”

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 the Compliance Officer’s observation and review of facility documentation, it was determined that on the facility vehicle, the children's Emergency, Information, and Immunization Record cards lacked page 2.”

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, it was determined that the diaper changing area in the Infant classroom lacked single-use paper hand towels from a dispenser. Additionally, the water temperature in the diaper handwashing in the 1's classroom was 79.8° F.”

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, it was determined that the children's extra clothing were stored in plastic bins in the 3’s/4’s and School-age restroom.”

AAC R9-5-404.C.3. C. A licensee shall ensure that:3. When 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, it was determined that a 1-year old child was present in the Infant classroom, when there were more than 6 children present at the facility.”

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 observation, it was determined that there was no toilet paper in the School-age restroom. Additionally, the caulking around the sink in the School-age classroom had buildup of dirt and separating at the back of the sink making it not sanitizable.”