Ascension Lutheran Preschool

AAC R9-5-514. D. D. A licensee shall post, near an activity area or a room's designated exit, a building evacuation plan that details the designated exits from the activity area or room and the facility.

“Findings: During the inspection of the licensed activity areas, The Compliance Officer observed that the Beach Buddies room, the Learning Center room, the Cactus Cuties room, and the Little Adventurers room were all missing an evacuation map posted at one of their designated exits.”

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: During the inspection of the Beach Buddies room, the Compliance Officer observed that the refrigerator used to store the children’s food, did not have a thermometer in it.”

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: The Compliance Officer reviewed the two medications with the medication forms for Child 7 and observed that the non-prescription medication was not labeled with the child’s name on it. The prescription medication was dispensed as a two pack but there was only one medication in the box. The instructions on the box say to administer the second medication if needed.”

AAC R9-5-604.B.3. B. A licensee that uses a private pool for an enrolled child shall ensure that the swimming pool and its equipment meet the following requirements: 3. A portable pool that does not meet the requirements of subsection (B)(1) or (2) is prohibited;

“Findings: The Compliance Officers observed that there was a splash pad in use, on the artificial turf, and that there was at least two inches of standing water pooled within the splash pad.”

AAC R9-5-605.B.6. B. A licensee shall ensure that: 6. Except for a room used only for an enrolled school-age child, each unused electrical outlet is covered with a safety plug cover or insert;

“Findings: During the inspection of the Beach Buddies room, the Compliance Officer observed that there were two unused outlets with no covers in them.”

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: During the inspection of the diaper changing areas, the Compliance Officers observed the following: * The infant room (garden babies) - there was a towel, hand lotion, a funnel, and a blue scrub pad at the diapering sink. * The one's room (little adventurers) - There was a small bowl with a sponge in it, a scrub brush, and a tooth brush at the diapering sink. * The two's room (cactus cuties) - there was a small bowl with a sponge in it and two rags at the diapering sink.”

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: During the inspection of the infant room (Garden Babies), the Compliance Officer reviewed the eight enrolled infant files, and observed that Child 6 was missing documentation of an infant feeding instruction form.”

AAC R9-5-501.A.13. A. A licensee shall ensure that:13. Toys and play equipment, required in this Article, are maintained: a. Free from hazards, and b. In a condition that allows the toy or play equipment to be used for the original purpose of the toy or play equipment;

“Findings: The Compliance Officers observed that there were two water tables on the one year-old playground area that had standing water in them.”

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: Compliance Officer 2 reviewed 12 children’s emergency cards and observed the following: * Child 1 was missing the name and phone number for one additional emergency contact and the phone number to the listed health care provider. * Question #4 on the backside of the card for Child 2 was not answered. * Child 3 and Child 4 were missing the parent’s signature on the back of the card. * Child 5 was missing the name of the first person to be contacted in case of injury or sudden illness of the child.”

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: During the inspection of the Beach Buddies room, the Compliance Officer observed that there was a black garbage can with no lid, located next to an exit door, that contained food waste in it.”

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;

“* Upon entrance into the "Jungle Buddies" room, the Compliance Officers observed that the diapering table was not next to the diapering sink and more than two steps away as there was a walkway between the diapering surface and the sink. * Upon entrance into the "Cactus Cuties" room, the Compliance Officers observed that the diapering table was not next to the diapering sink and at least 3.5 feet away from the sink.”

AAC R9-5-510.A.2. A. A licensee shall ensure that a staff member: 2. Teaches, models, and encourages orderly conduct, personal control, and age-appropriate behavior;

“Per allegation and based on interviews with staff, the Compliance Officers were told that a staff member pulled a child off of a tree swing resulting in the child having an injury to their elbow area.”

AAC R9-5-510.B.1. B. A licensee shall ensure that a staff member does not use or permit: 1. A method of discipline that could cause harm to the health, safety, or welfare of an enrolled child;

“Per allegation and based on direct observation of documents provided (Incident/Injury report, medical exam report, police report) and interviews with staff, it was found that a child was injured while on the playground by a staff member. The children from the two year-old room were lining up at a gate getting ready to go back into the building when one child was still on the tree swing. A staff member pulled the child off the swing by their arm to get the child to go line up with the rest of the class. At the time of being pulled off of the swing, the swing came back and hit the child. The child ran to the other staff member that was at the gate and acknowledged that the other teacher hurt their arm. The child required medical attention and was seen by a pediatric orthopedic surgeon. The child was diagnosed with a nondisplaced fracture of neck of left radius and was put in a soft cast with a sling.”

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;

“Upon entrance into the "Jungle Buddies" room, the Compliance Officers observed that the counter area that is part of the diaper changing area had numerous non-related diapering items on it (sponges, bibs, sippy cups, bottles, bottle tops, a snack basket, a plastic shoe box size container, a pacifer, a box of ziploc bags, a water pitcher) and in the diapering sink was a paint brush, a plastic spoon, and a small plastic cup.”

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.

“Compliance Officer 2 reviewed two personnel files and observed the following: * Staff 1 had a negative TB test result dated 06/13/24 (starting date of employment 06/04/24).”

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.

“Compliance Officer 2 reviewed 10 children's emergency cards and observed the following: * Child 1 and Child 2 were missing the date of enrollment. * The questions on the backside of the form for Child 3 were not acknowledged.”

AAC R9-5-305.A. A. A licensee shall not permit an enrolled child to attend a facility until the facility receives: 1. An immunization record for the enrolled child with the information required in 9 A.A.C. 6, Article 7, documenting that the enrolled child has received all current, age-appropriate immunizations required under 9 A.A.C. 6, Article 7: a. Provided by a healthcare provider, or b. Generated from the Arizona State Immunization Information System, which is the Department’s child immunization reporting system established in A.R.S. § 36-135; or 2. An exemption affidavit for the enrolled child provided by the enrolled child’s parent that contains: a. A statement, signed by the enrolled child’s health care provider, that the immunizations required by 9 A.A.C. 6, Article 7 would endanger the enrolled child’s health or medical condition; or b. A statement, signed by the enrolled child’s parent, that the enrolled child is being raised in a religion whose teachings are in opposition to immunization.

“Compliance Officer 2 reviewed 10 children's emergency cards with attached immunization records and observed the following: * The copy of the immunization record for Child 4 was missing the child's name on it and the child's immunizations were not current as the last shots listed were done when the child was 4 months old.”

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;

“* Compliance Officer 1 observed that there was no lesson plan posted in room C2. * Compliance Officer 1 observed that the lesson plan in room C did not have a lesson plan for aftercare (3p-6p). * Compliance Officer 1 observed that there was no lesson plan posted in room F1. The staff said that they post the lesson plan on Brightwheel for the parents, but after looking at Brightwheel, there was no lesson plan for the current week.”

AAC R9-5-502.C.4.g. C. A licensee shall ensure that: 4. When feeding an infant, a staff member: g. Holds and feeds an infant under 6 months of age and an infant older than 6 months of age who cannot hold a bottle for feeding; and

“Upon entrance into the infant room (West Nursery), Compliance Officer 1 observed that there was an infant (Child 5) laying on floor drinking a bottle of milk.”

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;

“During the inspection of the diaper changing areas, Compliance Officer 1 observed the following: * In room F1, the mat found on top of the diapering surface had stitching in it that made the mat non-sanitizable. There were also nylon straps attached to the diapering surface that are not sanitizable. * In the West Nursery room, the diapering surface was not kept clear of items not used for diapering - a bib, a thumb tack, a bottle of glue.”

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;

“During the inspection of the diaper changing areas in room F1 and C5, Compliance Officer 1 observed in both rooms that the diapering table was at least two steps away and not next to the diapering sink as required.”

AAC R9-5-503.F.2. F. A licensee shall ensure that in an activity area with a diaper changing area:2. A staff member: a. Documents each diaper change: i. For an infant, in the infant’s dated, daily, documentation required in R9-5-502(C)(1)(d); or ii. For an enrolled child who is not an infant, in a dated diaper changing log; b. Maintains the diaper changing log on facility premises for 12 months after the date of the diaper changing log; c. Empties clothing soiled with feces into a flush toilet without rinsing; d. Places an enrolled child’s clothing soiled by feces or urine in a plastic bag labeled with the enrolled child’s name, stores the clothing in a container used for this purpose, and sends the clothing home with the enrolled child’s parent; and e. Removes disposable diapers and disposable training pants from a diaper changing area as needed or at least twice every 24 hours to a waste receptacle outside the facility building.

“During the inspection of the diapering area in room F1 (one year-olds), Compliance Officer 1 reviewed the diaper changing log and observed that the staff were not maintaining the log as it showed Child 6 only had one recorded diaper changing between 7:23am-3:00pm.”

AAC R9-5-301.I. I. At least once a month, and at different times of the day, a licensee shall ensure that an unannounced fire and emergency evacuation drill is conducted and each staff member and enrolled child at the facility participates in the fire and emergency evacuation drill. 1. If child care services for a child with special needs are provided at a facility, the licensee shall provide for the enrolled child’s participation in each fire and emergency evacuation drill according to the enrolled child’s individualized plan as specified in R9-5-507(A)(1). 2. A licensee shall document each fire and emergency evacuation drill and maintain the documentation on facility premises for 12 months after the date of the fire and emergency evacuation drill.

“Compliance Officer 2 reviewed the fire drill log and observed that there have been no fire drills documented as conducted since October 2023. The fire drill recorded for September 2023 was dated for 09/30 which was a Saturday.”