Baby Steps Childcare/ Yolanda I Nunez

AAC R9-3-202.I I. Within 30 calendar days after the day of a staff member’s or adult resident’s 18th birthday, the staff member or adult resident shall provide to the certificate holder copies of a valid fingerprint clearance card and a valid background check document specified in subsection (C).

“Findings: Based on the Group Home documentation and the Compliance Officer's observation, it was determined that Resident 1 lacked a valid fingerprint clearance card. Resident 1 turned 18 years of age and had not yet obtained a fingerprint clearance card.”

AAC R9-3-202.I I. Within 30 calendar days after the day of a staff member’s or adult resident’s 18th birthday, the staff member or adult resident shall provide to the certificate holder copies of a valid fingerprint clearance card and a valid background check document specified in subsection (C).

“Findings: Based on the Group Home documentation and the Compliance Officer's observation, it was determined that Resident 1 lacked a valid fingerprint clearance card. Resident 1 turned 18 years of age and had not yet obtained a fingerprint clearance card.”

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“Findings: The Compliance Officer observed that the menu posted was dated for 9/2/25 to 9/5/25 and not for the current week.”

AAC R9-3-309.F.2. F. Except as provided in subsection (G), a certificate holder shall ensure that: 2. Medication belonging to a staff member or resident is stored in a locked, leak-proof storage cabinet or container that is separate from the storage container for enrolled children’s medications.

“The Compliance Officer observed a container of Aspirin on the kitchen counter accessible to the enrolled children, not stored in a locked container.”

AAC R9-3-206.A. A. An applicant, certificate holder, or provider shall allow immediate access to all areas of the premises that may affect the health, safety, or welfare of an enrolled child or to which an enrolled child may have access during hours of operation to representatives from: 1. The Department, 2. The local health department, 3. Arizona Department of Child Safety, or 4. The local fire department or State Fire Marshal.

“The Compliance Officer (CO) arrived at 1:42pm and did not gain access to the home until 1:50pm. The CO rang the Ring doorbell, waited, went around to the side of the house and knocked on the metal screen door, and then came back to the front door and rang the bell again. Staff 1 opened the door and stated that she had not heard the door, and that the Ring camera goes to the Provider's phone who was not home at the time of the inspection.”

AAC R9-3-401.B.3.c. B. A certificate holder shall ensure that: 3. The toys, materials, and equipment for use by enrolled children: c. Are accessible to enrolled children; and

“The CO observed two children present. Neither child had access to age appropriate activities. The CO inquired with Staff 1 as to why there were no toys accessible, Staff 1 reported that when there are only a couple of kids that are not here very long they do not take everything out. The CO inquired as to how long the children had been there on 3/3/2025. Staff 1 reported that the children had been there since the morning.”

AAC R9-3-401.A. In addition to complying with the requirements in this Chapter, a certificate holder shall ensure that the health, safety, or welfare of an enrolled child is not placed at risk of harm.

“The CO inspected the outdoor activity area and observed the following hazards that placed the enrolled children at risk of harm: Beer cans were stored within reach in the children's play kitchen and in a metal barrel sitting on the ground. Cigarette butts littered the ground around the children's play equipment.”

AAC R9-3-508.5. A certificate holder shall ensure that: 5. Pets and animals are controlled so that the cleanliness of the child care group home is maintained and no enrolled child, staff member, or other individual at the child care group home is endangered;

“The CO observed animal feces in outdoor activity area. Staff 1 reported that the children had gone out to play earlier in the day.”

AAC R9-3-507.B.1. B. A certificate holder shall ensure that: 1. A staff member: a. Cleans, sanitizes, and dries a diaper-changing surface using a single-use paper towel before and after each diaper change; b. Washes the staff member’s hands with soap and running water before and after each diaper change; c. Wears single-use non-porous gloves during each diaper change; d. Washes an enrolled child’s hands with soap and running water or with a washcloth or disposable wipe after the enrolled child’s diaper is changed and uses each washcloth or disposable wipe on only one child and only one time before it is laundered or discarded; and e. Documents the daily diaper changes for each enrolled child in a dated diaper-changing log after changing the enrolled child’s diaper;

“The CO requested to see the diaper log for Child 1. Staff 1 reported that she did not have a diaper log for Child 1 for 3/3/2025.”

AAC R9-3-402.A. A. A certificate holder shall ensure that: 1. Each enrolled child who naps or sleeps at the child care group home is furnished with a bed, cot, mat, or crib that accommodates the enrolled child’s height and weight; 2. The bed, cot, mat, or crib is not used by another individual while in use by the enrolled child; 3. The cot, mat, or bed’s mattress is covered with a clean sheet that is laundered when soiled, at least once every seven calendar days, and before use by a different enrolled child; 4. The crib mattress is covered with a clean fitted-sheet designed for the crib mattress size that is laundered when soiled, at least once every 24 hours, and before use by a different enrolled child; and 5. A clean blanket or sheet is provided to each enrolled child.

“The CO inquired as to where Child 1 slept. Staff 1 reported that she pulls a crib in from the other room. The crib was observed to have a dirty sheet.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“The Compliance Officer reviewed 5 EIIR cards. The following information was not documented: Child 1- no physicians name and phone number, no who to call first in the event of an emergency. Child 2- no who to call first in the event of an emergency. Child 3- no physicians name and phone number.”

AAC R9-3-302.E. E. A certificate holder shall ensure that a staff member required by R9-3-301(I) meets all of the following: 1. The staff member obtains first aid training specific to infants and children; 2. The staff member obtains CPR training specific to infants and children, which includes a demonstration of the staff member’s ability to perform CPR; 3. The staff member maintains current training in first aid and CPR; and 4. The staff member provides the certificate holder with a copy of the front and back of the current card issued to the staff member upon completing first aid and CPR training as proof of completion of the requirements in this subsection.

“The Compliance Officer observed that Staff 1 was the only person present at the group home during the inspection. Staff 1 did not have documentation of having a current CPR and First Aid certification. A conversation with the Provider on 3/7/2025 documented that Staff 1 does not have documentation elsewhere, and is signed up for a class. The CO informed her that Staff 1 may not be left alone at the group home when enrolled children are present.”

AAC R9-3-301.G. G. A certificate holder shall ensure that a staff member posts in a place that can be conspicuously viewed by individuals entering or leaving the child care group home: 1. The child care group home certificate; 2. The name of the provider; 3. The name of the staff member designated to act on behalf of the certificate holder when the provider is not present at the child care group home; 4. The hours of operation for the child care group home; 5. The weekly activity schedule required in R9-3-401(B)(4)(b); 6. The amount of time in minutes enrolled children may watch television, videos, or DVDs at the child care group home; and 7. The weekly menu, required in R9-3-406(F), before the first meal or snack of the week.

“The CO observed the posted menu was dated 1/12-1/18/25.”

AAC R9-3-301.A.4.d. A. A certificate holder shall: 4. Ensure that the provider: d. Prepares a dated attendance record for each day and ensures that each staff member records on the attendance record the staff member’s start time and end time of providing child care services for the child care group home;

“The CO observed that neither the Provider nor Staff 1 documented their attendance for 3/3/2025.”

AAC R9-3-309.F.2. F. Except as provided in subsection (G), a certificate holder shall ensure that: 2. Medication belonging to a staff member or resident is stored in a locked, leak-proof storage cabinet or container that is separate from the storage container for enrolled children’s medications.

“Senior Compliance Officer observed allergy nasal spray located in the medicine cabinet in the bathroom utilized by the enrolled children. According to the Provider, the medication belongs to the residents.”

AAC R9-3-505.D.5. D. A certificate holder shall ensure that: 5. Except as provided in R9-3-503(C)(4) and subsection (D)(6)(d), the following are stored in a labeled container separate from food storage areas and are inaccessible to an enrolled child: a. Materials and chemicals labeled as a toxic substance, and b. Substances that have a child warning label and may be a hazard to a child;

“Senior Compliance Officer observed a can of Febreeze next to the bathroom sink utilized by the enrolled children, and a lighter in the medicine cabinet.”

AAC R9-3-506.5. A certificate holder shall ensure that: 5. Each bathroom used by an enrolled child at the child care group home has the following within the reach of enrolled children: a. Mounted toilet tissue, b. Soap contained in a dispenser, and c. Singly dispensed paper towels;

“Senior Compliance Officer observed that the bathroom utilized by the enrolled children did not have paper towels.”

AAC R9-3-301.N. When the premises of a child care group home are left unoccupied during hours of operation or the child care group home is temporarily closed due to an unexpected event, a certificate holder shall ensure that a staff member notifies the Department before leaving the child care group home unoccupied or closing the child care group home, stating the period of time during which the child care group home will be unoccupied or closed.

“Upon arriving to the home, Compliance Officer rang the ring doorbell. No one answered. CO rang the doorbell a second time. CO heard footsteps, and heard a voice saying in Spanish that someone was at the door. CO received an email from the Provider while the CO was standing at the door at 10:40 a.m. The email stated "I will be closed today Monday". The CO received another email from the Provider at 1:30 p.m. stating "I will reopen today at 2:30 pm" Previously cited on 9/12/23 and 11/2/23.,”

AAC R9-3-504.A.3. A. A certificate holder shall ensure that: 3. Each smoke detector required under subsection (A)(2): a. Is maintained in an operable condition; and b. Is either battery operated or, if hard-wired into the electrical system of the child care group home’s residence, has a back-up battery;

“Senior Compliance Officer observed that the new addition did not have a smoke detector.”

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“According to the Provider, bananas, Ritz crackers and milk was served for the a.m. snack. The menu stated pretzels, grapes and milk. The food substitutions were not noted on menu.”

AAC R9-3-202.F. F. A certificate holder shall ensure each staff member and each adult resident submits to the certificate holder documentation of the staff member’s or adult resident’s valid: 1. Background check issued under A.R.S. § 46-811(A) within 10 calendar days after stating date of employment or volunteer service; and 2. Background check each time the background check document is issued or renewed every five years.

“Compliance Officer reviewed two personnel files. The file for Staff 1 and 2 did not have documentation of their direct service background check.”

AAC R9-3-504.E.1. E. A certificate holder shall: 1. Prepare a fire and emergency plan, consisting of: a. The child care group home’s address and telephone number; b. A list of emergency telephone numbers, including 9-1-1 and a poison control center; c. A document or documents that include the contact telephone number for a parent of each enrolled child; and d. An evacuation plan for the child care group home, including a floor plan of the child care group home’s residence on which lines have been drawn showing the evacuation path from each area of the child care group home approved for providing child care services;

“Senior Compliance Officer observed that an evacuation map not posted in new addition.”

AAC R9-3-506.5. A certificate holder shall ensure that: 5. Each bathroom used by an enrolled child at the child care group home has the following within the reach of enrolled children: a. Mounted toilet tissue, b. Soap contained in a dispenser, and c. Singly dispensed paper towels;

“Senior Compliance Officer observed that the toilet paper was not mounted; it was sitting on top of a trash can.”

AAC R9-3-507.B.1. B. A certificate holder shall ensure that: 1. A staff member: a. Cleans, sanitizes, and dries a diaper-changing surface using a single-use paper towel before and after each diaper change; b. Washes the staff member’s hands with soap and running water before and after each diaper change; c. Wears single-use non-porous gloves during each diaper change; d. Washes an enrolled child’s hands with soap and running water or with a washcloth or disposable wipe after the enrolled child’s diaper is changed and uses each washcloth or disposable wipe on only one child and only one time before it is laundered or discarded; and e. Documents the daily diaper changes for each enrolled child in a dated diaper-changing log after changing the enrolled child’s diaper;

“Senior Compliance Officer observed that the diaper changing log is not being maintained.”

AAC R9-3-403.A.3.a. A. A certificate holder shall ensure that: 3. When feeding an enrolled infant, a staff member: a. Prepares and stores the enrolled infant’s formula, breast milk, or other food according to written instructions from the enrolled infant’s parent;

“Senior Compliance Officer observed that there were no infant feeding instructions for Infant 1.”

AAC R9-3-205.B. B. At least 30 calendar days before the date of an intended change in a child care group home’s space utilization or capacity, a certificate holder shall submit to the Department a written request for approval of the intended change that includes: 1. The certificate holder’s name; 2. The child care group home’s name, if applicable; 3. The name, telephone number, e-mail address, and fax number of a point of contact for the request; 4. The child care group home’s certificate number; 5. The type of change intended: a. Space utilization, or b. Capacity; 6. A narrative description of the intended change; and 7. The following additional information, as applicable: a. If requesting a change in capacity, the square footage of the outdoor activity area and the square footage of the indoor areas where child care services will be provided; b. If requesting a change that involves a modification of the residence that requires a building permit, a copy of the building permit; c. If requesting a change in space utilization that affects individual rooms: i. A floor plan of the residence that complies with R9-3-201(2)(g) and shows the intended changes, and ii. The square footage of each affected room; and d. If requesting a change in space utilization that affects the outdoor activity area: i. A site plan of the premises that complies with R9-3-201(2)(h) and shows the intended changes, and ii. The square footage of the intended outdoor activity area.

“Senior Compliance Officer and Compliance Officer observed that the porch was enclosed without a permit from the local jurisdiction or approval from the Department. The area was set up with childcare equipment, and is being utilized by the enrolled children. The addition did not have heating or cooling equipment. According to the Provider, the door between the main house and the addition is left open in order to let the heat and/or cold enter the room. The required temperatures is required to be maintained at all times. The area cannot be utilized by the enrolled children at any time until it has been approved by your local jurisdiction, and by the Department.”

AAC R9-3-401.C.4. A certificate holder shall ensure that a staff member: 4. Except as specified in subsection (C)(5), labels the personal items of an enrolled child with an identifier that is specific to the enrolled child and stores the personal items separately from the personal items of other enrolled children and residents;

“Senior Compliance Officer observed diaper wipes not labeled.”

AAC R9-3-401.A. In addition to complying with the requirements in this Chapter, a certificate holder shall ensure that the health, safety, or welfare of an enrolled child is not placed at risk of harm.

“Upon entering the home, Compliance Officers observed a young infant (infant 1), laying in a bouncy seat. The infant was strapped in the bouncy seat, and was wrapped in thick blankets. Senior Compliance Officer requested that the blankets be removed from the infant. The infant was moved to the crib with one thick blanket still wrapped around them. The infant also had a pacifier and pacifier keeper while in the crib. The pacifier keeper was laying across the infants neck area, and requested that the Provider remove the pacifier and keeper.”

AAC R9-3-301.N. When the premises of a child care group home are left unoccupied during hours of operation or the child care group home is temporarily closed due to an unexpected event, a certificate holder shall ensure that a staff member notifies the Department before leaving the child care group home unoccupied or closing the child care group home, stating the period of time during which the child care group home will be unoccupied or closed.

“Compliance Officers attempted to conduct a monitoring inspection on November 9, 2023. Upon arriving to the child care group home, CO rang the ring doorbell. The Provider answered from another location. She stated that she had left the home five minutes prior due to an emergency. She stated that she could return to the group home in order to complete the inspection, but would take her at least a 1/2 hour to return to the home. The CO's could not wait and stated that another inspection would have to be conducted. Previously cited on 9/12/23.”