Childtime Learning Centers

AAC R9-501.A.9. A. A licensee shall ensure that: 9. Clean clothing is available to an enrolled child when the enrolled child needs a change of clothing;

“Findings: Based on staff statements and the Compliance Officers' observations, the facility lacked spare clothing to meet the needs of enrolled children. In the Preschool room (3s), a child was observed wearing a pull-up and no pants. Staff stated spare clothing is not available on site.”

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: Per allegation, and based on documentation, staff statements, and the Compliance Officers' observations, the staff-to-child ratios are not maintained at all times. On the Preschool Playground, the staff-to-child ratio was 2:28, rather than the required ratio of 3:28, with 3-year-olds present. Staff stated the following: "We were out of ratio yesterday morning." "Sometimes we are out of ratio with 2:28 with 2-year-olds present." "Quality First had to leave due to being out of ratio." "We are out of ratio at least 4 times a week." "We have been out of ratio, usually in the mornings, for a long time now."”

AAC R9-5-601.4. A licensee shall comply with the following physical plant requirements, as applicable: 4. Except as provided in subsection (5), when providing child care services for infants or children who require diapering, a diaper changing area that meets the requirements in R9-5-503 is available in each infant room or indoor activity area used by an enrolled infant or child who wears diapers or disposable training pants;

“Findings: Based on staff statements and the Compliance Officers' observations, in the Preschool room (3s), children's diapers were being changed in the restrooms. Staff stated there are 5 children in the Preschool room who are not potty trained, and their soiled diapers are regularly changed standing up in the restrooms. The Preschool room is not a diapering-approved room.”

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, staff statement, and the Compliance Officer's observations, Staff #1 (DOH: 11/17/2025), Staff #2 (DOH: 11/3/2025), and Staff #3's (DOH: 9/29/2025) files lacked documentation of six months of child care experience and a high school diploma or high school equivalency diploma to qualify them as child educators. Staff stated they work alone in classrooms occasionally.”

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 staff statements and the Compliance Officer's observations, in the Infant room, there was a walking 15-month-old child, with 4 other infants present, and 57 total children present at the facility. Staff stated the child had been walking for a couple of weeks.”

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: Based on the Compliance Officer's observations, in the PreK room (4-5s), two vinyl couches had large patches of torn vinyl and exposed foam throughout the surface of the cushions and armrests.”

AAC R9-5-501.A.17. A. A licensee shall ensure that: 17. 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 the Compliance Officer's observations, in the Infant room, 6 of 6 pacifiers lacked a label.”

AAC R9-5-501.B.6. B. A licensee shall ensure that a staff member: 6. For enrolled children five-years or younger, and except as provided in subsection (C), prepares, posts, and implements 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 facility documentation and the Compliance Officer's observations, in the 2B (2s), Preschool (3s), and PreK (4-5s) rooms, the posted lesson plans were not current. The posted lesson plans were for the week of 3/9-3/13.”

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, in the 2B (2s) room, there were 3 plastic corkscrew toys in the diaper changing sink and a plastic bag of clothes to the right of the sink.”

AAC R9-5-503.A.3.4. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 3. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled diapers; and 4. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled clothing.

“Findings: Based on the staff statement and the Compliance Officer's observations, the 2B (2s) room, the diaper changing container lacked a lid, and a soiled clothing container. Staff stated they did not know they needed a soiled clothing container, and put the soiled clothing into a bag and into the children's cubbies.”

AAC R9-5-503.E.1. E. A licensee shall ensure that in an activity area with a diaper changing area: 1. The container required in subsection (A)(3) and (4) are inaccessible, and

“Findings: Based on the Compliance Officer's observations, in the 2A (2s) restroom, there was an open bag of soiled diapers on the floor, accessible to enrolled children.”

AAC R9-5-504.A.3. A. A licensee providing child care services for 1-year-old and 2-year-old children shall: 3. Ensure that each activity area has a supply of age-appropriate toys, materials, and equipment that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Art supplies; b. Books; c. Rubber or soft plastic balls; d. Puzzles and toys to enhance manipulative skills; e. Blocks; f. Washable soft toys and dolls; g. Musical instruments; and h. Indoor and outdoor equipment to enhance large muscle development;

“Findings: Based on the Compliance Officer's observations, the Toddler 1 (1s) room lacked a sufficient number of books for the 13 enrolled children present.”

AAC R9-5-509.C.13. C. A licensee shall ensure that: 13. Each staff member is informed of a modified diet prescribed for an enrolled child by the child’s parent or health care provider, and the modified diet is posted in the kitchen and in the child’s activity area;

“Findings: Based on facility documentation and the Compliance Officer's observations, the Infant Feeding Plans posted in the kitchen were not current.”

AAC R9-5-516.B.3. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 3. A facility director, or a staff member designated in writing by the facility director, does not administer a medication to an enrolled child unless the facility receives written authorization signed by the enrolled child’s parent or health care provider that includes the: a. Name of the enrolled child; b. Type of the medication; c. Prescription number, if any; d. Instructions for administration specifying the: i. Dosage and route of administration; ii. If indicated, starting and ending dates of the dosage period; and iii. Times and frequency of administration; e. Reason for the medication; and f. Date of authorization; and

“Findings: Based on facility documentation and the Compliance Officer's observations, Child #1's prescription medication lacked a medication authorization form. Child #2's prescription medication authorization form lacked a prescription number and the starting and ending dates of the dosage period.”

AAC R9-5-516.B.4. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 4. A staff member: a. Administers a prescription medication provided by a parent only from a container dispensed by a pharmacy; b. Administers a nonprescription medication provided by a parent for an enrolled child only from a container prepackaged and labeled for use by the manufacturer and labeled with the enrolled child’s name; c. Does not administer any medication that has been transferred from one container to another; and d. Does not administer a nonprescription medication to an enrolled child inconsistent with the instructions on the nonprescription medication’s label, unless the facility receives written authorization from the enrolled child’s health care provider.

“Findings: Based on the Compliance Officer's observations, Child #1 and Child #2's prescription medications lacked the original container dispensed by a pharmacy.”

AAC R9-5-601.4. A licensee shall comply with the following physical plant requirements, as applicable: 4. Except as provided in subsection (5), when providing child care services for infants or children who require diapering, a diaper changing area that meets the requirements in R9-5-503 is available in each infant room or indoor activity area used by an enrolled infant or child who wears diapers or disposable training pants;

“Findings: Based on the Compliance Officer's observations, in the 2A (2s) room, enrolled children's soiled diapers were being changed in the restroom, rather than in the approved diaper changing area located in the classroom.”

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 observations, the following restrooms were not maintained in a clean and sanitized condition: 2A (2s) room: *The caulking around the left and right toilets was discolored and had a buildup of a brown substance. *The top of the baseboards had a buildup of dirt and debris. *The caulking around the handwashing sink was discolored, had a buildup of a brown substance, and had a gap separating from the wall and was not sanitizable. Preschool (3s) *The caulking around the left and right toilets was discolored and had a buildup of a brown substance. *The top of the baseboards had a buildup of dirt and debris. *In the right toilet, there was a brown substance. *In the left toilet, there was a yellow substance. PreK (4-5s) rooms: *The caulking around the left and right toilets was discolored and had a buildup of a brown substance. *The top of the baseboards had a buildup of dirt and debris.”

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 Compliance Officer's observation and review of facility documentation, the classroom roster in the 4's classroom reflected the presence of 25 children, however only 24 children were actually present.”

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 findings: Based on Compliance Officer's observation and information provided by the staff, Staff #1 (start date 1/8/24) did not teach, model, or encourage orderly conduct or personal control. Per staff, Staff #1 has been heard "swearing in the classroom" and had "yelled at" a child in the classroom when the child was misbehaving at lunch time.”

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 findings: Based on Compliance Officer's observation and information provided by the staff, Staff #1 (start date 1/8/24) used a method of discipline that could cause harm to the health, safety, or welfare of children, when Staff #1 was observed by multiple staff members to have "flicked (child) in the left ear" when the child was misbehaving during lunch time.”

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 facility documentation and the Compliance Officers' observations, the Infant feeding instructions were not posted in the infant room and kitchen. In the Infant room, the feeding instructions were in a binder in a cabinet on a high shelf, and the kitchen did not have feeding instructions.”

AAC R9-5-501.C.4. C. A licensee shall ensure that a staff member:4. Except as provided in subsection (D), prepares and posts in each indoor activity area, a current schedule of children’s age-appropriate activities, including the times the following are provided: a. Meals and snacks; b. Naps; c. Indoor activities; d. Outdoor or large muscle development activities; e. Quiet and active activities; f. Teacher-directed activities; g. Self-directed activities; h. Activities for individuals, groups of five or fewer children, and groups of six or more children; and i. Activities that develop small muscles;

“Findings: Based on the Compliance Officers' observations, the activity schedule in the 3’s and 4's Room lacked the times when each activity occurs.”

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 Officers' observations, the 3's and 4's Room lacked a current Lesson plan. The Lesson plan posted was dated March 10 -14.”

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 Officers' observation, the enrolled children's personal products were not labeled with the child’s first and last name in the following Rooms: Two's A: Two packages of wipes were not labeled, one package had the child's first name only; Twos B: Several diaper rash ointments were not labeled.”

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 review of the facility documentation and the Compliance Officers' observations, the Infant feeding instructions lacked feeding times, solid food instructions, parent signatures, and date of completion by parent.”

AAC R9-5-502.C.1.i. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: i. Changes each crib sheet and blanket before use by another enrolled child, when soiled, or at least once every 24 hours;

“Findings: Based on the Compliance Officers' observations and Staff statement, in the Infant room, 1 child's crib sheet had a buildup of a dried green substance at a corner; Staff stated the child was not present.”

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

“Findings: Based on the review of the facility documentation and the Compliance Officers' observations, the files for Staff #1 (DOE 01.15.25), Staff # 2 (DOE 12.16.24), and Staff #4 (DOE 03.03.25) lacked a copy of the back of their fingerprint clearance card.”

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

“Findings: Based on the review of the facility documentation and the Compliance Officers' observations, the file for Staff #4 (DOE 03.05.25) lacked documentation of a negative Mantoux skin test before the starting date of employment. The negative result was dated 03.06.25. *Previously cited: 04.23.24”

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 Officers' observations, the facility documentation and Staff interview, 9 of 15 children's attendance records reviewed lacked the following: *Child #1: Arrival and departure time and signatures for the month, staff stated the child had been present; *Child #2: Arrival and departure signatures from 03.10.25 to 03.21.25; *Child #3: Arrival and departure times and signatures for March, staff stated the child had been present; *Child #4: Arrival time and signature on 03.05.25, arrival times and signature from 03.10-14.25, and was signed with a squiggly line on 03.07.25 and 03.17.25; *Child #5: Departure time and signature on 03.13.25; *Child #6: Arrival time and signature on 03.20.25; *Child #7: Child's name, departure time, and signature on 03.20.25; *Child #8: Signed with squiggly lines; Child #9: Departure time and signature on 03.11,12.25.”

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 facility documentation at the Compliance Officers' observations, the facility lacked a current, violation-free fire inspection. The fire inspection reviewed had expired on 10/31/2024.”

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

“Findings: Based on the Compliance Officers' observations, exit doors to the outside, throughout the facility, were locked. There was an Allen wrench in the push bar, preventing the doors from being opened.”

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 Officers' observations, the outdoor activity area was not maintained free from hazards, and accessible to the enrolled children: *There was exposed weed fabric liner protruding from the woodchips and the landscape edging was exposed in both outdoor areas; *There was a detached bottom fence rail at the middle fence between both outdoor areas. *South Playground: 4 trikes with broken seats. *Previously cited: 04.23.24.”

AAC R9-5-516.G. G. A licensee shall return all unused prescription and nonprescription medications to a parent when the medication prescription date has expired or the medication is no longer being administered to the enrolled child or dispose of the medication if unable to locate the enrolled child's parent after the child's disenrollment

“Findings: Based on the review of the facility documentation and the Compliance Officers' observations, the end date on the medication authorization had passed for an enrolled child, and the medication had not been returned to the parent.”

AAC R9-5-516.B.4. B. If prescription or nonprescription medications are administered, a licensee shall ensure that:4. A staff member : a. Administers a prescription medication provided by a parent only from a container dispensed by a pharmacy; b. Administers a nonprescription medication provided by a parent for an enrolled child only from a container prepackaged and labeled for use by the manufacturer and labeled with the enrolled child’s name; c. Does not administer any medication that has been transferred from one container to another; and d. Does not administer a nonprescription medication to an enrolled child inconsistent with the instructions on the nonprescription medication’s label, unless the facility receives written authorization from the enrolled child’s health care provider.

“Findings: Based on the Compliance Officers' observations, an enrolled child's medication lacked the prescription box dispensed by the pharmacy.”

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: Based on the Compliance Officers' observations, the following toys/ play materials were not maintained free from hazards: *Toddlers, Two's A and B, Three's and Four's Room: Blue vinyl children's sofa torn and exposed foam; *Pre-K Room: The rail on the back of a wooden chair was detached from the side support and a blue vinyl sofa tape with dirt build-up and torn and exposed foam; *Previously sited: 04.23.24.”

AAC R9-5-514. C. C. A licensee shall:1. Prepare and date a written fire and emergency plan that contains: a. The location of the first aid kit; b. The names of staff members who have the first aid training required by R9-5-403(E); c. The names of staff members who have the CPR training required by R9-5-403(E); d. The directions for: i. Initiating verbal notification of an enrolled child’s parent by telephone or other equally expeditious means within 30 minutes of a fire or emergency; and ii. Providing written notification to the enrolled child’s parent within 24 hours; and e. The facility’s street address and the emergency telephone numbers for the local fire department, police department, ambulance service, and poison control center; 2. Maintain the plan required in subsection (C)(1) in a location on facility premises that has an operable telephone service or two-way voice communication system that connects the facility with an individual who has direct access to an in-and-out operable telephone service; 3. Post the plan required in subsection (C)(1) in any indoor activity area that does not have an operable telephone service or two-way voice communication system that connects the indoor activity area with an individual who has direct access to an in-and-out operable telephone services; and 4. Update the plan in subsection (C)(1) every 12 months after the date of initial preparation of the plan or when any information changes.

“Findings: Based on the facility documentation and the Compliance Officers' observations, the Fire and Emergency plans in all rooms were dated 11.25.2023.”

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 Officers' observations, on the south playground, the garbage can with food waste was overflowing onto the ground.”

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 Officers' observations, the following restrooms were not maintained in a clean and sanitized condition: *Toddler A Restroom: Brown dirt build-up and pieces of toilet paper on the floor; *Toddler B Restroom: Brown dirt build-up and cracked caulking at the base of the toilet; *Three's Restroom: Calcium build-up around the sink faucet; unflushed toilet w/ brown dirt build-up in the basin; cracked caulking at the toilet's base; and pieces of toilet paper behind the toilet and around the floor; *Pre-K Restroom: Brown dirt build-up at the base of the toilet and baseboard and calcium build-up in the sink faucet.”

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 Officers' observations, the health, safety, and welfare of an enrolled child was placed at risk of harm, in the Pre-K Room, when a child's head was covered with a blanket while sleeping.”

AAC R9-5-501.A.2. A. A licensee shall ensure that: 2. Except for an enrolled school-age child, drinking water is provided sufficient for the needs of and accessible to each enrolled child in both indoor and outdoor activity areas;

“Finding: Based on the Compliance Officers' observations, water was not accessible to the enrolled children in the 2’s B Room; the water pitcher was empty and located on a high counter, and the cups were in a high cabinet out of children's reach.”

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 Officers' observations, the infant feeding chairs in the Infant Room were not maintained free from hazards, in the Infants Room, 3 of the 4 feeding chairs' backs had peeling vinyl.”

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 Officers' observations, the following activity areas were not maintained in a clean condition: *Dirt build-up in the AC vents and sprinklers in several classrooms; *Pre-K Room: Dark grime buildup on chair backs; *Infants: Food and other debris in infant feeding chairs; buildup on the back infant feeding chairs; *Toddler Room: Play mat with dark stains. *Outdoor Area: Brown dirt build-up in both multicolored climbing structures.”

AAC R9-5-504.5.d. A licensee providing child care services for 1-year-old and 2-year-old children shall:5. Ensure that: d. If a parent brings a sippy cup for the parent’s enrolled child, the sippy cup is labeled with the enrolled child’s name.

“Findings: Based on the Compliance Officers' observations, in the 2’s A Room, the sippy cups were not labeled with the child’s first and last name.”

AAC R9-5-503.F.1. F. A licensee shall ensure that in an activity area with a diaper changing area: 1. The containers required in subsections (A)(3) and (4) are inaccessible, and

“Findings: Based on the Compliance Officers' observations, soiled Pull-ups/diapers were accessible to the enrolled children in the 2’s A and Pre-K Rooms' garbage cans.”

AAC R9-5-503.A.3. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:3. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled diapers; and

“Findings: Based on the Compliance Officers' observations, the soiled diaper container in the 2’s B room lacked a waterproof liner.”

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 Officers' observations: *Two’s B Room: The diaper changing surface was not next to the sink. The diaper changing table was located approximately 5 feet away from the sink, and when changing the staff member had to walk around the diaper changing table to get to the diaper changing sink. *Two A and B Rooms: The water temperature was 126 °F; *Two B Room: There were no paper towels in the dispenser in the diaper changing area.”

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 Officers' observations, the following diaper-changing areas were not seamless/smooth or not kept clear of items: *Toddler Room: Wipes and a cardboard box of gloves on top of the diaper changing area. *Infant Room: Food preparation sink with heavy calcium and thick brown buildup around the joints of the faucet causing it to separate from the sink basin; there was a buildup of calcium and dirt around the nozzle of the diaper changing sink;”

AAC R9-5-516.B.1. B. If prescription or nonprescription medications are administered, a licensee shall ensure that:1. A facility director, or a staff member designated in writing by the facility director, is responsible for the administration of all medications in the facility, including storing, supervising an enrolled child’s ingestion of a medication, and documenting all medications administered to an enrolled child;

“Findings: Based on the Compliance Officers' observations and the facility review, the facility lacked documentation of a Person responsible for administering medications.”

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: Per allegation, based on Compliance Officers' (CO) observations and staff interview, the ratio for (2) 2-year-old children was 0:2, with a required ratio of 1:2, when the 2 children were left alone outside on the playground. Staff stated that when one of the parents arrived to pick up their child at the end of the day, the child was not in the classroom. The Director immediately checked outside and found the 2 children at the back corner of the west playground near the playhouse. There were no other staff in the outdoor area. The facility's review of the video footage revealed that the 2 children were on the playground alone for 31 minutes. Based on CO #2's observations at the time of inspection, the ratio in 3’s classroom was 1:16, with a required ratio of 2:16.”

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: Per allegation and based on staff interview, the health, safety, and welfare of enrolled children were placed at risk of harm when (2) 2-year-olds were left on the west playground alone for 31 minutes. Staff stated that the facility review of the video footage revealed the time frame for those children being alone on the playground. The rest of the 2's classroom had gone inside, and the 2 staff did not follow the facility's face-to-name protocol to ensure all children were present as the group transitioned inside and once inside the classroom. The children were discovered missing from the classroom when one of the children's parents arrived to pick up the child at the end of the day. The Director immediately checked the west playground area and found the 2 children at the back corner near the playhouse.”

AAC R9-5-501.C.1. C. A licensee shall ensure that a staff member: 1. Supervises each enrolled child at all times;

“Findings: Per allegation and based on staff interview, (2) 2-year-old children were left unsupervised on the west playground. Staff stated that a facility review of video footage showed the children were unsupervised for 31 minutes. The rest of the group had transitioned inside the classroom, and staff did not follow the facility's face-to-name protocol to ensure all children were present when transitioning into the classroom, and once inside the classroom.”

AAC R9-5-502.A.5.b. A. A licensee providing child care services for infants shall:5. Develop, document, and implement tummy time policies and procedures that: b. Ensure a staff member who is supervising a non-crawling infant while the infant is flat on their stomach and on the floor: i. Is within reach of the infant; ii. Does not perform any other duties while supervising the infant; iii. Does not allow the use of pillows, comforters, sheepskins, stuffed toys, or other soft products in the same floor space as the infant; and iv. Does not allow any product specified in subsection (A)(5)(b)(iii) to be within reach of the infant;

“Findings: Based on Compliance Officer #2's observation, an Infant classroom staff member placed a distressed infant on their stomach on top of a soft quilted activity gym on the floor, and then walked away from the infant. The infant continued to cry while face down on the gym surface. The Compliance Officer had to redirect the staff member from conducting other duties to attend to the infant.”

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 Compliance Officer #2's observation, there was green, yellow, and blue paint, and a white, grimy, oily substance in the sink basin, on the side of the sink, and around the faucet of the sink by the Two's diaper changing area.”

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 Compliance Officer #2’s observation, In the Infant classroom there were 9 crib mattresses with rips and holes exposing foam, and 8 sheets that were loose and not tight fitting to the mattresses.”

AAC R9-5-502.C.1.c. C. A licensee shall ensure that: 1. A staff member providing child care services in an infant room: c. Responds immediately to each infant's distress signals;

“Findings: Based on Compliance Officer #2's observations, in the Infant classroom staff did not respond immediately to each infant's distress signals when an infant was crying in a crib for more than 2 minutes, while lifting their head up and down to the mattress.”

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

“Findings: Based on facility documentation and Compliance Officer #1s observations, 2 of the 6 staff files reviewed lacked a negative TB test before their start date of employment. Staff #1’s (start date 1/2/2024) negative TB was dated 8/9/2022, outside of the required time frame. Staff #2’s (start date 1/2/2024) negative TB test was dated 1/8/2024, outside the required time frame.”

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 discipline; 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; and 17. Field trip procedures, if applicable.

“Findings: Based on facility documentation and Compliance Officer #1’s observations, 1 of the 6 staff files lacked a complete 10-day new staff training: Staff #1 (start date 1/2/2024)”

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 Compliance Officer #2's observation, 2 one-year-old children were placed in the Infant classroom for supervision while 10 infants were present in the classroom.”

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 Compliance Officer #2's observations, the health, safety, and welfare of children in the Two's classroom was placed at risk of harm in the following situations: *Six of 14 children were screaming and crying and the 2 staff in the room were not attending to the children. 1 staff member was sitting on the floor looking down, and the other staff member was standing at the back of the room and had their back to the children. *A child was sitting in the corner up against a shelf, screaming and crying. The staff member in the back of the room told the child to stop crying. Later during the inspection, a child was heard crying loudly from the Two's classroom from another activity area. The Compliance Office entered the classroom and the same child was in the same area as previously observed. When the Compliance Officer attended to the child, the staff member came over, looked at the child, and told the child to stop crying.”

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 Compliance Officer #2’s observation, the following hazards were found accessible to children: Preschool Classroom: *There was a white box exposing a heavy build up of rough rust, dirt, and mold on the wall and baseboard in the Preschool's second bathroom. *The baseboard by the exit door was separated from the wall. *There was a roll of plastic trash bags on the paper towel dispenser in both bathrooms. Pre-K Classroom: *There was a laminator that was powered on, hot to the touch, and unused, sitting on top of the light table accessible to children. *There were 3 power cords hanging from the shelf onto the light table and accessible to children. *There was a separation from the window and window sill on the South wall leaving a 1/4in gap. *There was a separating baseboard exposing sharp edges at the South exit door. *There were areas of peeling vinyl with exposed foam located on the blue couch, accessible to children. 2A Classroom: *The baseboards throughout the classroom were separated from the wall. *There were broken latches on the sliding doors in the diaper changing area. Infant Classroom: *The locks on the 2 evacuation cribs did not lock when put in locking position. The staff stated that the cribs have not locked for a while and the front management was notified multiple times.”

AAC R9-5-501.C.1. C. A licensee shall ensure that a staff member: 1. Supervises each enrolled child at all times;

“Findings: Based on Compliance Officer #2's observation, staff did not supervise children at all times as required: *In the Infant classroom, 2 infants were pushing 2 cribs around the classroom while staff in the classroom were doing other duties. *In the Two's classroom, a child was climbing on top of a stack of 10 cots. One staff member was sitting on the floor looking down while the other staff was by the diaper changing area with their back turned to the child. *In the Preschool classroom, a child was rolling their body across 2 blue child-size chairs while the 3 staff members were sitting with the rest of the class on the carpet during circle time. The child rolled 3 times across the chairs, then laid across the chairs for more than 7 minutes. When the Compliance Officer asked the child why they were lying on the chairs, the child stated they were in time out. *A child was sitting on the floor behind a shelf in the dramatic play area, while kicking the back of the shelf repeatedly. The 3 staff members were sitting with the rest of the class on the carpet during circle time. The child sat behind the shelf for more than 6 minutes. *A child was sitting in the sand table, throwing toys at the other children.”

ARS § 36-882.C. C. An application for an initial license shall include:1. The form that is required pursuant to section 36-883.02, subsection C and that is completed by the applicant. 2. A copy of a valid fingerprint clearance card issued to the applicant pursuant to section 41-1758.07. 3. If the applicant's facility is located within one-fourth mile of any agricultural land, the names and addresses of the owners and lessees of the agricultural land and a copy of the agreement required pursuant to subsection D of this section.

“Findings: Based on facility documentation and Compliance Officer #1’s observation, 1 of the 6 staff files lacked the following: Staff #2’s (start date 1/2/2024) criminal history affidavit was signed on 1/3/24, outside of the required time frame.”

AAC R9-5-203.E. E. If a staff member possesses a fingerprint clearance card that was issued before the staff member became a staff member at the facility, a licensee shall:1. Contact the Department of Public Safety before the individual becomes a staff member to determine whether the fingerprint clearance card is valid; and 2. Document this determination, including the name of the staff member, the date of contact with the Department of Public Safety, and whether the fingerprint clearance card is valid.

“Findings: Based on facility documentation and Compliance Officer #1’s observations, 2 of the 6 files reviewed lacked the following: Staff #1’s (start date 1/2/24) fingerprint clearance card was verified after the starting date of employment on 1/3/24.”

AAC R9-5-504.3. A licensee providing child care services for 1-year-old and 2-year-old children shall:3. Ensure that each activity area has a supply of age-appropriate toys, materials, and equipment that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Art supplies; b. Books; c. Rubber or soft plastic balls; d. Puzzles and toys to enhance manipulative skills; e. Blocks; f. Washable soft toys and dolls; g. Musical instruments; and h. Indoor and outdoor equipment to enhance large muscle development;

“Findings: Based on Compliance Officer #2's observation and staff interview, the 2A classroom lacked enough books for the 14 children present in the room. There were a total of 2 books, and staff stated there were not any other books for the children in the classroom, and "The front knows we need more".”

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 Compliance Officer #2's observation, the following activity areas were not maintained in a clean condition: Preschool Classroom: *There were 3 trashcans with a dried, unknown substance on the lid, sides, and front. *There was a thick, black debris on the back exit threshold door plate. *There was a build-up of dirt and debris along the baseboards of the classroom. 2A Classroom: *There was a thick build-up of dirt and debris in the corners and on the threshold door plate of the West exit door. *The top of the fire extinguisher box on the West wall had a thick, gray, fuzzy dust buildup. *The wooden step stool in the diaper changing area had a black tar-like substance on the steps. Pre-K Classroom: *There was a thick, sticky, brown substance in the Northeast corner of the entrance area. *There was a thick build-up of dirt and debris in the corners and on the threshold door plate of the South exit door. *There were thick black smudges on the on the South exit door and handle. *The top of the fire alarm/extinguisher box on the South wall, had a thick, gray, fuzzy dust buildup.”

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 Compliance Officer #2's observation, the following restrooms were not maintained in a clean and sanitized condition: 2A Classroom: *There was a thick brown substance on the floor and around the base of the toilet. *There was a thick layer of dirt behind the toilet and on the baseboards. *There was dirt and a black substance on and around the floor drain. *There were black smudges on the wall under and next to the paper towel dispenser. *There was dirt buildup on top of the brown crown molding along the wall. *There was a thick green build up along the top of the backsplash at the sink. Preschool Classroom: Bathroom 1: *There was dirt and black smudges on the handle, outside and inside of the bathroom door, and the door frame. *There was dirt and black smudges on the light switch and wall under the light switch. *There was a green and brown build up behind and around the sink faucet. *There was a yellow and brown substance in the corner on the floor, on the wall, and the baseboard to the right of the toilet. *There was a brown build up around the caulking and the base of the toilet. *There was a thick build of dust on the baseboards. Bathroom 2: *There was a brown substance on the stool for the toilet. *There was a black build up around the caulking at the base of the toilet. *There were black and brown smudges on the wall next to the toilet. *There were black sticky spots on the floor. Pre-K Classroom: *There was a thick layer of dirt on the top of the backsplash behind the sink. *There was a green dirt-like substance around the sink faucet. *There was dirt around the baseboards.”

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 Compliance Officer’#2”s observation, the following equipment was not maintained in a clean condition: Younger playground: *There was a thick build up of black tar-like substance on the climber's yellow dome, the entrance of the blue slide, the green viewing board and the red platform. Older Playground: *There was a thick black build up on the climber's slide entrance and the blue steering panel.”

AAC R9-5-516.B.3. B. If prescription or nonprescription medications are administered, a licensee shall ensure that:3. A facility director, or a staff member designated in writing by the facility director, does not administer a medication to an enrolled child unless the facility receives written authorization signed by the enrolled child’s parent or health care provider that includes the: a. Name of the enrolled child; b. Type of the medication; c. Prescription number, if any; d. Instructions for administration specifying the: i. Dosage and route of administration; ii. If indicated, starting and ending dates of the dosage period; and iii. Times and frequency of administration; e. Reason for the medication; and f. Date of authorization; and

“Findings: Based on facility documentation and Compliance Officer #1’s observation, 1 of 1 medication form lacked the following: The medication authorization form for Child #1’s medication lacked the end date of administration and the prescription number.”

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 Compliance Officer #2's observation, the following hazards were observed in the outdoor activity areas: Younger Playground: *There was peeling and flaking white paint exposing rough rust on the poles of the shade structure. *There was exposed weed plastic protruding from the ground. Older Playground: *There was exposed weed plastic protruding from the ground. *There were exposed rusty nails along the black curbing. *There was uneven ground around the climber, with the corners protruding upward. *There was separating and cracking rubber surface at the base of the red steps and the bottom of the blue slide of the climbing structure. *There was cracking and peeling rubber exposing rust on the handlebars of the tricycle. *There was a large crack with sharp edges on the door to the house in the climber.”