Congregation Beth Israel Chanen Preschool

AAC R9-5-511.C. C. A licensee shall provide an unobstructed passageway at least 18 inches wide between each row of cots or mats to allow a staff member access to each enrolled child.

“Findings: Based on the Compliance Officer's observations, in Room 6 (2s), a child was sleeping against the wall with another sleeping child directly next to them. There was a car table directly on one side of the child and the wall on the other side. The child was not accessible to staff.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on facility documentation and the Compliance Officer's observations, in the Room 10 (1s), there were 4 children present and 3 children were listed on the roster.”

AAC R9-5-501.A.10. A. A licensee shall ensure that: 10. If a staff member places an enrolled child in a feeding chair when feeding the enrolled child, the: a. Feeding chair is constructed to prevent toppling; b. Tray or feeding surface of the feeding chair is smooth and free of cracks; and c. Staff member: i. Cleans the feeding chair before and after each enrolled child's use; ii. Sanitizes the tray or feeding surface before and after each enrolled child's use; and iii. If the feeding chair was manufactured with a safety strap, fastens the feeding chair's safety strap while the enrolled child is in the feeding chair;

“Findings: Based on the Compliance Officer's observations, in Room 9 (1s), 6 children were seated in wooden feeding chairs and the safety straps were not fastened.”

AAC R9-5-603.B. B. Except as provided in subsection (D) a licensee shall ensure that an outdoor activity area: 1. Is enclosed by a fence: a. A minimum of 4 feet high; b. Secured to the ground; and c. With either vertical or horizontal open spaces on the fence or gate that do not exceed 4.0 inches; 2. Is maintained free from hazards, such as exposed concrete footings and broken toys; and 3. Has gates that are kept closed while an enrolled child is in the outdoor activity area

“Findings: Based on the Compliance Officers' observations, on the Infant playground, there were loose strings on the lower section of the security screen hanging off the bottom of the wrought-iron fence. On the 1’s playground, there were horizontal and vertical gaps greater than 4” at the bottom of the wrought-iron fence.”

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 an Emergency, Information, and Immunization Record that is no more than a two-page written notice, and is signed by the enrolled child’s parent containing: 1. The child’s name, home address, sex, and date of birth; 2. The date of the child’s enrollment; 3. The name, home address, email address, and 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 the nutritional and dietary needs of the child including, if applicable, the request in R9-5-509(C)(14); and 9. A written record completed by the child’s parent or health care provider noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance.

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that 2 out of 6 enrolled children's Emergency Information and Immunization Record Cards reviewed lacked the following required information: 2/6 Child #1: Second parent's name, address and phone number. Child #2: A second emergency contact name and phone number.”

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 facility documentation and the Compliance Officer's observations, the medication form for Child #4 lacked a doctor's note to administer the medication. The medication stated for children ages 6 years old and older.”

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 #4's medication form lacked the reason to administer the medication. The form stated "as needed" with no other details.”

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, in the toilet room in Rooms 2 (3s) and 6 (2s), there was a thick layer of dust on the ceiling vents.”

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

“Findings: Based on facility documentation, the Compliance Officers' observations and staff statement, in the Infant room, Child #3's feeding plan was not current. The plan was dated 8/14/2025. Staff stated Child #3 eats items that were not marked by the child's parent on the plan.”

AAC R9-5-501.A.1. A. A licensee shall ensure that: 1. In addition to complying with the requirements in this Chapter, the health, safety, or welfare of an enrolled child is not placed at risk of harm;

“Findings: Based on the Compliance Officer's observations, in Room 8 (1s), it was determined that a staff member failed to ensure that the health, safety and welfare of enrolled children was not placed at risk of harm during naptime, when an enrolled child was observed sleeping with a blanket covering their face. Staff were unable to observe the sleeping child's face.”

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

“Findings: Based on facility documentation, the Compliance Officer's observations and staff statement, it was determined that Staff #2 (DOE 10.18.2024) was a teacher caregiver alone with enrolled children in the Infant room at the time of the inspection. Staff #2 was not qualified as a teacher-caregiver and was not supervised by a qualified staff member. Staff #3 & Staff #4 were not recording times of arrival and times of departure. Staff stated they did not know they had to.”

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's observations of 7 staff files, the files for the following staff lacked a negative Mantoux skin test administered within 12 months before the starting date of employment: Staff #2 (DOE 10.18.2024): TB test read 2.19.2022. Staff #5 (DOE 1.27.2025): TB test read 1.29.2025. *** Previously cited 7.20.2022, 7.7.2023, & 4.25.2025”

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

“Findings: Based on facility documentation and the Compliance Officer's observations, the statement of services lacked the following information: 1.Field trip requirements and procedures, 2.Transportation procedures, 3.Child admission and release requirements, 4. A statement that a parent has access to the areas on facility premises where the parent's enrolled child is receiving child care services, and 5.Emergency medical procedures.”

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

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that 14 out of 25 Emergency, Information, and Immunization Record cards lacked: Child #1: Copy of the back of the Emergency Contact card. Child #2, Child #4, Child #5, Child #7, Child #8 and Child #14: Date of the child's enrollment. Child #3: The name and contact telephone number of the second authorized person to collect the child from the facility in case of emergency, or if the child’s parent cannot be contacted. (The parents were listed as the second emergency contact person.) Child #6 and Child #10: The name, home address, city, state, zip code, and contact telephone number of the second parent. Child #9: Date of the child’s enrollment and the name of the individual to be contacted in case of injury or sudden illness. Child #11: The name, home address, city, state, zip code, and contact telephone number of the second parent, the name of the individual to be contacted in case of injury or sudden illness, and the parent signature. Child #12: The date of the child’s enrollment and the home address, city, state, zip code, of the parent. Child #13: The name, home address, city, state, zip code, and contact telephone number of the second parent, the name and contact telephone number of the child’s health care provider, and the name of the individual to be contacted in case of injury or sudden illness of the child. *** Previously cited 10.28.2024”

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.

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that the Emergency, Information and Immunization Record Cards for Child #3, Child #4, Child #15, Child #16, Child #17 and Child #19 lacked a written immunization record or exemption affidavit. Child #6 and Child #8: The child's name was not listed on the immunization record. *** Previously cited 6.19.2024 & 10.28.2024”

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

“Findings: Based on facility documentation and the Compliance Officer's observations, 14 out of 14 children's admission and release forms lacked: Child #9, and Child #31: Admission and release signatures on 6.4.25. Child #20, Child #21, Child #22, Child #24, Child #25, Child #26, Child #27, Child #28, Child #29, Child #30, and Child #32: Admission and release signature on 6.3.25. Child #23: Admission and release signature on 4.29, 5.1, and 5.2.25.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on facility documentation and the Compliance Officer's observations, in Room 6 (2s), there were 8 children present and 3 children were marked on the roster. *** Previously cited 7.7.2023, 6.19.2024,10.28.2024, & 4.25.2025”

AAC R9-5-308.A. A. A licensee shall secure and maintain the following minimum insurance coverage: 1. General facility liability insurance of at least $300,000; and 2. Motor vehicle insurance coverage, required by A.R.S. Title 28, Chapter 9, Article 4, for each motor vehicle provided by a licensee to transport enrolled children.

“Findings: Based on the Compliance Officer's observation and staff statement, the Licensee had a waiver of liability included in the enrollment packet. Staff stated they thought that had been removed. *** Previously cited 10.28.2024”

AAC R9-5-402.A. A. A licensee shall maintain a file for each staff member containing:1. The staff member’s name, date of birth, home address, and telephone number; 2. The staff member’s starting date of employment or volunteer service; 3. The staff member’s ending date of employment or volunteer service, if applicable; 4. The name and telephone number of an individual to be notified in case of an emergency; 5. The staff member’s written statement attesting to current immunity against measles, rubella, diphtheria, mumps, and pertussis; 6. The form required in A.R.S. § 36-883.02(C); 7. Documents required by R9-5-203; 8. Documents required by R9-5-301; 9. Documents required by R9-5-401, if applicable; 10. If applicable: a. The form required in A.R.S. § 8-804(I), b. Documentation of the submission required in A.R.S. § 8-804 and the information received as a result of the submission, and c. Documentation of training provided by a licensee as required by R9-5-403, if applicable; 11. A copy of any current license or certification required by A.R.S. Title 36, Chapter 7.1, Article 1. or this Chapter; and 12. Documentation of the requirements in A.R.S. § 36-883.02(D).

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that Staff #6's (DOE 10.2.2024) file lacked 2 of the required 2 good faith effort professional references from previous employers. *** Previously cited 10.28.2024 & 4.25.2025”

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 the Compliance Officer's observations of 7 staff files, the following files lacked new staff training within 10 calendar days of the starting date of employment. Staff #1 (DOE 11.4.2024): The training in the file was dated 5.15.2025. Staff #2 (DOE 10.18.2024): The training in the file was dated 2.19.2022.  *** Previously cited 7.20.2022, 7.7.2023, 6.19.2024, 10.28.2024, & 4.25.2025”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on the Compliance Officers' observations, staff-to-child ratios were not maintained in the following rooms: *Room 11 (Infants): 1:6, rather than 2:6 as required. *Room 9 (1s): 1:11 at 11:20am when a staff member left the room to gather the buggies in the hallway, rather than 2:11 as required. *** Previously cited 7.7.2023, 6.19.2024, & 1.3.2025”

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 and staff statement, the health, safety and welfare of enrolled children was placed at risk of harm. In Room 4 (4s): *There was a sharp knife in the sink. Staff stated they used it for cutting cucumbers. *There was a black staff purse on the floor with cold medication inside and accessible to the children present in the room. In Room 2 (3s), there was a sharp knife and a vegetable peeler on a drying rack.”

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 following hazards were accessible to enrolled children: Room 1 toilet room (3-4s): The toilet seat was loose and not secured. Room 1 (3-4s): There were 2 cracked areas with sharp edges on the broken surface of a blue chair. Room 4 (4s): A wooden unit had a broken shelf that was not attached near the bottom left side, and there was a black pencil sharpener with a loose cord laying on top of the shelf. Room 5 (2s): There were loose and hanging cords dangling down from a wooden shelf. Room 7 (2s): There was a 4” x 3” area of peeling white paint below a white board. Room 9 toilet room (1s): The toilet seat was loose and not secured.”

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

“Findings: Based on the Compliance Officers' observations, pacifiers in the following rooms lacked an identifier specific to an enrolled child: Infant playground: There was an unlabeled pacifier on the ground. 1's playground: There were 2 unlabeled pacifiers in children's mouths. Room 8 (1s): There were 3 unlabeled pacifiers. Nest 2 (Infants): There was 1 unlabeled pacifier. Nest 1 (Infants): There were 2 unlabeled pacifiers. Room 9 (1s): There was 1 unlabeled pacifier. Room 10 (1s): There were 3 unlabeled pacifiers. Room 11 (Infants): There were 3 unlabeled pacifiers.”

AAC R9-5-501.A.19. A. A licensee shall ensure that:19. Except as provided in subsection (A)(20), the following are stored separate from food storage areas and are inaccessible to an enrolled child: a. All materials and chemicals labeled as a toxic or flammable substance; b. All substances that have a child warning label and may be a hazard to a child; and c. Lawn mowers, ladders, toilet brushes, plungers, and other facility equipment that may be a hazard to a child;

“Findings: Based on the Compliance Officer's observations, the following substances with a child warning label were accessible to enrolled children: Room 5 (2s): There was Febreze on a counter. Girls’ toilet room: There was Lysol spray on a 3-tiered white cabinet.”

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;

“Findings: Based on the Compliance Officer's observations and staff statement, there was no drinking water available for 3 of the 11 one-year-old children present on the playground. Staff stated they left the water bottles inside. In Room 10 (1s), the water was located on a 33" high shelf and was not accessible to the children present.”

AAC R9-5-501.A.21. A. A licensee shall ensure that:21. Except when used as part of an activity, the following are stored in an area inaccessible to an enrolled child: a. Garden tools, such as a rake, trowel, and shovel; and b. Cleaning equipment and supplies, such as a mop and mop bucket.

“Findings: Based on the Compliance Officer's observations, the following was accessible to enrolled children: Room 6 (2s) toilet room: There was a vacuum, dustpan, dust mot, mop and bucket on the floor. Room 5 (2s) room: There was a foldable step ladder on the floor.”

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 the Compliance Officers' (COs) observations, on the 2’s playground, a child was observed trying to drink water off a drum set table two different times. The second time, the CO had to inform a staff what the child was doing. Another child was observed standing on a tricycle that was on its side trying to reach something on the playground. The CO had to inform a staff of what the child was doing. *** Previously cited 4.25.2025”

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, activity schedules were not complete and/or posted in the following rooms: Room 1 (3 - 4s) & Room 4 (4s): Lacked a posted activity schedule. Room 8 (1s): Lacked the activities from 3:30 - 5:30pm. Room 10 (1s): Lacked the activities from 3:00 - 5:30pm.”

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, lesson plans were not posted in the following rooms: Room 1 (3 - 4s), Room 5 (2s), and Room 9 (1s). In Room 10 (1s), the lesson plan was dated 6/9 - 6/13/2025. *** Previously cited 7.20.2022, 7.7.2023, & 6.19.2024”

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' observations and staff statement, the following items lacked a label of the child's first and last name as required: Room 10 (1s): Aquaphor and 2 bottles of sunscreen labeled with a child's first name and last initial only. Room 2 (3s): 2 bottles of sunscreen labeled with a child's first name only, and the sunscreen was accessible to enrolled children. Room 7 (2s): There was a bottle of sunscreen on a low shelf, accessible to children. Room 11 (Infants): 1 diaper cream labeled with a child's first name and last initial. Staff stated the facility provides the wipes to use on enrolled children. The facility lacked written approval for use of the wipes from enrolled children's parents. *** Previously cited 7.7.2023”

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

“Findings: Based on the Compliance Officers' (COs) observations, in Room 11 (Infants), the infant room door was open when the COs arrived. *** Previously cited 7.20.2022”

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

“Findings: Based on staff statement, tummy time was not being documented for infants. *** Technical assistance 7.20.2022”

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

“Findings: Based on the Compliance Officer's observations, in Room 11 (Infants) there were 3 loose crib sheets, rather than tight-fitted sheets as required.”

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

“Findings: Based on facility documentation and the Compliance Officers' observations, the following written feeding instructions were not current: Child #33 & Child #35: The plans were dated 2.2025 and did not include the amount to be fed to each infant. Child #34: The plan did not include the amount of food to feed the infant. *** Previously cited 7.20.2022, 7.7.2023, 6.19.2024, & 4.25.2025”

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

“Findings: Based on the Compliance Officers' observations, in Room 11 (Infants), 6 out of 17 infant bottles lacked the child's first and last name. In Nest 1 (Infants), 2 containers of breastmilk were labeled with a child's last name only. *** Previously cited 7.7.2023 & 6.19.2024”

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 and smooth, and not clear of unrelated items not required for diaper changing: Room 8 (1s): There was a clear box containing diapers on the diaper changing sink. Room 5 (2s): There was a Swiffer mop and a bottle of Febreze on the diaper surface. Room 6 (2s): *There was a white mat with stitching on the diaper surface. *There were dirty smears in the diaper sink, and there was dirt and debris on the diapering surface. Room 9 (1s): There was a sticker on the diaper surface, and there were yellow rags and a white plastic hook to the right of the diaper sink. Room 10 (1s): There were 2 balls, a yellow rag, a drying rack, a paper, an orange bubble blower and Cinnamon leaf oil on the diaper sink surface, and there was a sticker on the diaper surface. Room 11 (Infants): There was a sticker on the diaper surface. *** Previously cited 7.20.2022, 7.7.2023, & 6.19.2024”

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

“Findings: Based on the Compliance Officers' observations and staff statement, the following rooms lacked a soiled clothing container: Nest 2 (Infants), Room 8 (1s), Room 10 (1s), Room 6 (2s), and Room 5 (2s). Staff stated they did not know they needed to have a soiled clothing container.”

AAC R9-5-503.B. B. A licensee shall ensure that a staff member does not:1. Permit a bottle, formula, food, eating utensil, or food preparation in a diaper changing area; 2. Draw water for human consumption from a diaper changing area sink; or 3. Except as provided in subsection (C), if responsible for food preparation, change diapers until food preparation duties have been completed for the day.

“Findings: Based on the Compliance Officer's observations, in Room 10 (1s), there was a cup and 2 spoons located to the right off the diaper sink.”

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, in Room 10 (1s), the soiled diaper and the soiled clothing containers were located on a low shelf between the diaper surface and the diaper sink, accessible to enrolled children.”

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.

“Findings: Based on staff statements, staff stated they place soiled clothing in a bag and place the bag in the child's bag or in the child's backpack, rather than in a soiled clothing container.”

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 the Compliance Officers' observations, the following classrooms lacked the following age-appropriate toys and materials: Room 6: (2s): Balls and musical instruments. Room 8 (1s): Books, rubber or soft plastic balls, puzzles and toys to enhance manipulative skills, blocks, washable soft toys and dolls, and musical instruments. There were 3 airplanes and plastic animals available for 13 children. Room 7 (1s): Rubber or soft plastic balls, washable soft toys and dolls, and musical instruments.”

AAC R9-5-504.5.a. A licensee providing child care services for 1-year-old and 2-year-old children shall: 5. Ensure that: a. If finger food is served, the food is of a size and texture that does not present a choking hazard;

“Findings: Based on the Compliance Officers' observations, in Room 9 (1s), hard, round granola bites were served to children, posing a choking hazard.”

AAC R9-5-509.C.18. C. A licensee shall ensure that:18. A staff member: a. Prepares a weekly menu at least one week in advance, b. Includes on the menu the specific foods to be served on each day, c. Dates each menu, d. Posts each menu at least one day before the first meal on the menu will be served, and e. Writes food substitutions on a posted menu no later than the morning of the day of meal service;

“Findings: Based on the Compliance Officers' observations, the posted menu stated applesauce and Belvita were to be served to enrolled children. In Room 10 (1s), children were observed eating applesauce and granola bites, and no food substitutions were written on the menu. *** Previously cited 6.19.2024”

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

“Findings: Based on the Compliance Officers' observations, the following refrigerators were not maintained at 41°F or below: Room 1 (Pre-K): 65° F. Room 7 (2s): 47° F. Room 8 (1s): 54° F. Room 10 (1s): Lacked a thermometer.”

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

“Findings: Based on the Compliance Officers’ observations, freezers in the following rooms were not maintained at a temperature of 0 degrees F or below, as required: Room 11 (Infants), Room 10 (1s), & Room 9 (1s): The freezers lacked a thermometer. Nest 2 (Infants): 8° F in a black freezer.”

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 the Compliance Officer's observations of 7 staff files, the Licensee failed to contact DPS to determine the validity of the staff member's fingerprint clearance card before the individual becomes a staff member for Staff #1 (DOE 11.4.2024). The fingerprint clearance card was verified as valid on 5.15.2025. *** Previously cited 7.20.2022, 10.28.2024, & 4.25.2025”

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 classrooms were not maintained in a clean condition: Room 10 (Infant) & Room 11 (Infants): There was a build-up of dust and debris in the folded creases of a soft blue mat. Room 1 (3 - 4s): *There was brown grime build-up in the sink. *There was brown grime build-up on the shelf labeled "water bottles". *There were brown smudges on the basket that holds the water bottles. *There were discolored smudges on an activity table. Room 4 toilet room (4s): There were discolored smears on the wall and dirty smudges on the white door frame. Room 8 toilet room (1s): There were paint smears on the wall. Room 7 (2s): *There were dirty smudges on the blue and white table and chair set. *There were dried paint smears and debris in the sink. Girls’ hall toilet room: *There were 4 rolls of toilet paper stacked on top of a toilet paper stand on the floor to the left of the right toilet. *There were 3 rolls of toilet paper stacked on top of a toilet paper stand on the floor to the left of the left toilet. 2’s playground: There were sticky handlebars on a dirty tricycle. *** Previously cited 7.20.2022, 7.7.2023, & 6.19.2024”

AAC R9-5-512.C. C. A licensee shall ensure that floor coverings are:1. Clean; and 2. Free from: a. Dampness, b. Odors, and c. Hazards.

“Findings: Based on the Compliance Officers' observations, the floors in the following rooms were not maintained in a clean condition: Room 11 (Infant): There was dirt and debris on the floor around the shelves. Room 2 (3 - 4s): There was a brown sticky tape residue and remnants of tape on the floor. Room 7 (2s): There was a brown grime build-up on the emergency exit threshold. Room 9 (1s): There was an orange substance on the floor behind the white refrigerator, and a red and black substance on the floor to the right of the refrigerator. Room 10 (1s): There were sticky white and brown smudges on the gray floor cushion.”

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 was not maintained in a clean condition: Room 6 toilet room (2s): There was a thick layer of dust on the ceiling vent, and there was an unsecured potty seat on one of the toilets that wobbled easily when touched. Room 2 toilet room (3s): There was a thick layer of dust on the ceiling vent.”

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, the toys, materials, and equipment were not maintained in a clean condition in the following classrooms: Room 1 (3 - 4s): The activity table and the water shelf had a brown buildup. Room 2 (3 - 4s): The blocks had a brown sticky grime build-up, and there was a dusty stuffed octopus. Room 5 (2s): The play kitchen had dust and debris inside the compartments. Room 9 (1s): There were discolored smears on the black garbage can lid. Room 7 (2s), Room 6 (2s), & Room 4 (4s): There was uncovered food waste in the containers.”

AAC R9-5-514. A. A. A licensee shall ensure that there is a first aid kit on facility premises that contains first aid supplies in a quantity sufficient to meet the needs of the enrolled children including the following:1. Sterile bandages including: a. Adhesive bandages of assorted sizes, b. Sterile gauze pads, and c. Sterile gauze rolls; 2. Antiseptic solution or sealed antiseptic wipes; 3. A pair of scissors; 4. Adhesive tape; 5. Single-use, non-porous gloves; and 6. Reclosable plastic bags of at least one-gallon size.

“Findings: Based on the Compliance Officer's observations, the First Aid kit lacked adhesive tape and a second gauze roll.”

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, it was determined that 12 out of 14 medication consent forms lacked: Child #18: Starting and ending dates of the dosage period. Child #30: Ending dates of the dosage period. Child #36: Prescription number, times, and frequency of administration. Child #37: Times and frequency of administration. Child #38: Prescription number. Child #39: Name of the enrolled child and prescription number. Child #40: Prescription number, times and frequency of administration, dosage period, route of administration, and ending dates of the dosage period. Child #41, and Child #45: Prescription number, starting and ending dates of the dosage period, and times and frequency of administration. Child #42: Prescription number, times and frequency of administration, dosage, starting and ending dates of the dosage period. Child #43: Ending year of the dosage period. Child #44: Prescription number on the container did not match the prescription number on the form. *** Previously cited 6.19.2024”

AAC R9-5-516.F. F. A licensee shall maintain documentation of all medications administered to an enrolled child.1. Documentation shall contain: a. The name of the enrolled child; b. The name and amount of medication administered and the prescription number, if any; c. The date and time the medication was administered; and d. The signature of the staff member who administered the medication to the enrolled child; and 2. A licensee shall maintain the documentation on facility premises for 12 months after the date the medication is administered.

“Findings: Based on facility documentation, the Compliance Officer's observations, and staff statement, it was determined that Child #23, Child #40, Child #41, and Child #42's medication forms lacked documentation of the administration of the prescription medication. Staff stated the medication had been administered.”

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 Compliance Officer's observations, Child #44 and Child #46's medications were no longer being administered. The medication for Child #44 expired June 2025, and Child #46's medication expired May 2025.”

AAC R9-5-516.H. H. Except as provided in subsection (J), a licensee shall ensure that prescription and nonprescription medications are stored as follows:1. An enrolled child’s medication is kept in a locked, leak-proof storage cabinet or container that is used only for storing enrolled children’s medications and is located out of reach of children; 2. Medication for a staff member is kept in a locked, leak-proof storage cabinet or container that is separate from the storage container for enrolled children’s medications and is located out of reach of children; and 3. Medications requiring refrigeration are kept in a locked leak-proof container in a refrigerator.

“Findings: Based on the Compliance Officers' observations, the following stock medications were observed in the first aid kit: 2 pain relieving sprays and Bleed stop.”

AAC R9-5-518.A.1. A. A licensee providing a field trip for an enrolled child shall:1. Obtain written permission from a parent before the enrolled child participates in a field trip including: a. The date and description of the field trip; b. The times of departure from and return to the facility; and c. The name, street address, and telephone number, if any, of the field trip destination;

“Findings: Based on facility documentation and the Compliance Officers’ observations, the facility lacked written permission from a parent before an enrolled child participates in a field trip. Field trips were listed without dates and times on a form that lacked a parent signature.”

AAC R9-5-518.A.2. A. A licensee providing a field trip for an enrolled child shall:2. Prepare a written field trip plan including: a. The name of each participating enrolled child, staff member, and other individuals on the field trip; b. The times of departure from and return to the facility; c. If applicable, license plate number of any motor vehicle used on the field trip; and d. The name, street address, and telephone number, if any, of the field trip destination; and

“Findings: Based on facility documentation and the Compliance Officer’s observations, a field trip form to the Ballroom lacked the dates, and departure and return times of the trip.”

AAC R9-5-518.C. C. A staff member shall verify the presence of each enrolled child and place a checkmark next to the enrolled child’s name on the list required in subsection (B)(3) for each enrolled child who is present at the following times:1. At the beginning of the field trip or when boarding the motor vehicle, 2. Upon arrival and each hour while at the field trip destination, 3. When preparing to leave the field trip destination or when boarding the motor vehicle to return to the facility, and 4. When reentering the facility at the conclusion of the field trip.

“Findings: Based on facility documentation and the Compliance Officer’s observations, the field trip form to the Ballroom lacked checkmarks to each child’s name at the start of the field trip, at the arrival at the location, when leaving the location and when returning to the facility. (There was time written by the first child’s name and an arrow down to the 3rd or 4th child.) The field trip to the Ballroom on 6.17.2025 lacked documentation of the enrolled children present on the trip during the required times. (There was a time listed for the first child and arrows downward for all of the children.)”

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, in the outdoor activity areas, the following was observed: Infant playground: There were loose strings hanging from the security screen on the fence. 1’s playground: There was a 1/2" x 10” gap under the base of the West Fence. *There was a 5 1/2” gap under the base of the North fence. *There was a 4 1/2" x 13” gap under the base of the North fence. 2’s playground: *There were 4.5” gaps between the wrought-iron fence slats near the posts. 3 & 4’s playground: *There was an unraveled black hose on the ground. *There was thick, broken plastic with sharp edges on a black storage container. *There was rust on a shade post, and on the lower sections of the wrought-iron fence. *** Previously cited 7.7.2023, 6.19.2024, & 4.25.2025”

AAC R9-5-208.B. B. At least 30 calendar days before the date of an intended change in a facility’s service classification, space utilization, or licensed capacity, a licensee shall submit a written request for approval of the intended change to the Department that includes:1. The licensee’s name; 2. The facility’s name, street address, city, state, zip code, mailing address, and telephone number; 3. The name, telephone number, and fax number of a point of contact for the request; 4. The facility’s license number; 5. The type of change intended: a. Service classification, b. Space utilization, or c. Licensed capacity; 6. A narrative description of the intended change; and 7. The following additional information, as applicable: a. If the intended change affects individual rooms, the following information about each affected activity area, as applicable: i. Identification of the activity area, ii. Current and intended square footage, iii. Current and intended operating hours, iv. Current and intended service classification, v. Current and intended licensed capacity, and vi. Whether the activity area has or will have a diaper changing area; b. If the intended change is to increase licensed capacity, the square footage of the outdoor activity area; and c. If the intended change includes an alteration or addition to the physical plant of a licensed facility, the following, as applicable: i. If the facility is not located in a public school or if providing child care services to infants, one-year-old children, or two-year-old children in a facility located in a public school, the information required in R9-5-201(A)(5)(g) and (A)(5)(h) showing the intended change; or ii. If the facility is located in a public school and provides child care only for three-year-old, four-year-old, or five-year-old, or school-age children, a set of final construction drawings or a school map, including the information required in R9-5-201(5)(j) showing the intended change.

“Findings: Based on the Compliance Officers' observations and staff statement, the Licensee failed to submit a written request for approval of an intended change to the Department prior to the change in space utilization. Staff stated they use the art room during the school year. The art room is not a Department-approved activity area.”

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, the following designated exits were blocked: Room 1 (3 - 4s), there was a black refrigerator blocking the emergency exit. In Nest 1 (Infants), there was an adult chair and a bouncy seat blocking the designated exit door. *** Previously cited 7.20.2022”

AAC R9-5-605.B.10. B. A licensee shall ensure that:10. Toilet rooms are ventilated to the outside of the building, either by a screened window open to the outside air or by an exhaust fan and duct system that is operated when the toilet room is in use;

“Findings: Based on the Compliance Officer's observations, both the Girls’ and the Boys’ toilet room vents were inoperable.”

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: Based on the Compliance Officers' observations, outlets in the following classrooms were not covered with a safety plug cover or insert: Room 11 (Infant): 1 near a crib. Room 1 (3 - 4s): 3 outlets. Room 2 (3 - 4s): 1 outlet. Room 6 (2s): 2 outlets. Room 4 (4s): 2 outlets.”

ARS § 36-883.02.A. A. Except as provided in subsection B of this section, child care personnel, including volunteers, shall submit the form prescribed in subsection C of this section to the employer and shall have valid fingerprint clearance cards issued pursuant to section 41-1758.07 before starting employment or volunteer work.

“Findings: Based on facility documentation and the Compliance Officer's observations of 7 staff files, Staff #1's (DOE11.4.2025) and Staff #2's (DOE 10.18.2024) file lacked a completed Criminal History Affidavit prior to starting employment. Staff #2's Affidavit was dated 12.23.2024. *** Previously cited 6.19.2024, 10.28.2024, & 4.25.2025”

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

“Findings: Based on facility documentation, the Compliance Officer's observation, and staff statement, Staff #2's (DOE 10.18.2024) file lacked documentation of the original foreign education document that had been translated, and Staff #2 was a teacher-caregiver in the Infant room at the time of the inspection. Staff stated they thought that had the document but were unable to locate it. *** Previously cited 7.20.2022, 7.7.2023, & 4.25.2025”

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 facility documentation and the Compliance Officers’ observations, Staff #2’s (D.O.H 1-6-25) file lacked documentation of the front and back side of the staff member’s valid fingerprint clearance card.”

AAC R9-5-402.A. A. A licensee shall maintain a file for each staff member containing:1. The staff member’s name, date of birth, home address, and telephone number; 2. The staff member’s starting date of employment or volunteer service; 3. The staff member’s ending date of employment or volunteer service, if applicable; 4. The name and telephone number of an individual to be notified in case of an emergency; 5. The staff member’s written statement attesting to current immunity against measles, rubella, diphtheria, mumps, and pertussis; 6. The form required in A.R.S. § 36-883.02(C); 7. Documents required by R9-5-203; 8. Documents required by R9-5-301; 9. Documents required by R9-5-401, if applicable; 10. If applicable: a. The form required in A.R.S. § 8-804(I), b. Documentation of the submission required in A.R.S. § 8-804 and the information received as a result of the submission, and c. Documentation of training provided by a licensee as required by R9-5-403, if applicable; 11. A copy of any current license or certification required by A.R.S. Title 36, Chapter 7.1, Article 1. or this Chapter; and 12. Documentation of the requirements in A.R.S. § 36-883.02(D).

“Findings: Based on facility documentation and the Compliance Officers' observations of 5 staff files, the following files lacked: Staff #1 (DOH 11-1-24), Staff #2 (DOH 1-6-25), Staff #3 (DOH 8-6-24), and Staff #5 (10-2-24): 2 of the 2 required good faith effort references. Staff #4 (DOH unknown): Date of hire and 2 of the 2 required good faith effort references.”

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

“Findings: Based on facility documentation and the Compliance Officers' observations of 5 staff files, Staff #4 (DOH unknown) and Staff #5's (DOH 10-2-24) files lacked the DCS submittal requirements.”

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

“Findings: Based on facility documentation, the Compliance Officers' observations, and staff statements, the following teacher caregiver files lacked: *Staff 1 (DOH 11-1-24): Documentation of education. *Staff 2 (DOH 1-6-25): Documentation of 3 of the required 6 months of previous childcare experience. *Staff 3 (DOH 8-6-24): Documentation of education. *Staff 4 (DOH unknown): Documentation of education and 3 of the required 6 months of previous childcare experience. *Staff 5 (DOH 10-2-24): Documentation of education. Staff stated these teachers work alone with children.”

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 the Compliance Officers' observations, the following staff's files lacked documentation of a negative TB test administered within 12 months before the starting date of employment: *Staff 3 (DOH 8-6-24): TB test was read 8-11-24, and *Staff 5 (DOH 10-2-24): TB test was read 10-25-24.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on facility documentation and the Compliance Officers' observations, on the 1's Playground, 18 children were present and there were 22 children marked on the roster.”

ARS § 36-883.02.A. A. Except as provided in subsection B of this section, child care personnel, including volunteers, shall submit the form prescribed in subsection C of this section to the employer and shall have valid fingerprint clearance cards issued pursuant to section 41-1758.07 before starting employment or volunteer work.

“Findings: Based on facility documentation and the Compliance Officers' observations, Staff #1's (DOH 11-12-24) file lacked documentation of a Criminal History Affidavit.”

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 the Compliance Officers’ observations of 5 staff files, the following files lacked verification of a valid fingerprint clearance card: Staff #1 (DOH 11-1-24), Staff #3 (DOH 8-6-24), Staff #4 (DOH unknown), and Staff #5 (DOH 10-2-24).”

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 the Compliance Officers' observations, the following staff files lacked documentation of the 10-day new staff training: Staff 1 (DOH 11-1-24), Staff 2 (DOH 1-6-25), Staff 3 (DOH 8-6-24), Staff 4 (DOH unknown), and Staff 5 (DOH 10-2-24).”

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 statements and the Compliance Officers' observations, enrolled children were not supervised at all times. Staff stated the following: *Sometimes, the staff are standing in groups near the ladder. *Sometimes, kids put rocks in their mouths. *Kids frequently (daily) put rocks in their mouths, and *Children get rocks from under the fence and put them in their mouths.”

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: Per allegation and based on the Compliance Officers' observations, on the 1's Playground, the following gaps greater than 4" were observed: *There was a 1/2" x 10” gap under the base of the West Fence. *There was a 5 1/2” gap under the base of the North fence. *There was a 4 1/2" x 13” gap under the base of the North fence.”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on Compliance Officer (CO) #1's observation and staff statement, in Room 6 (2s), the staff to child ratio was 1:11, with two-year-old children present in the room, and a required ratio of 2:11. A staff was observed leaving the room prior to the CO entering the room. Staff stated the other staff had just left the room.”

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, in Nest 1 and Nest 2 (Infant rooms), the diaper changing areas were lacking single dispensed paper towels. The paper towels were stacked on top of each other on the diaper sink.”

AAC R9-5-402.A. A. A licensee shall maintain a file for each staff member containing:1. The staff member’s name, date of birth, home address, and telephone number; 2. The staff member’s starting date of employment or volunteer service; 3. The staff member’s ending date of employment or volunteer service, if applicable; 4. The name and telephone number of an individual to be notified in case of an emergency; 5. The staff member’s written statement attesting to current immunity against measles, rubella, diphtheria, mumps, and pertussis; 6. The form required in A.R.S. § 36-883.02(C); 7. Documents required by R9-5-203; 8. Documents required by R9-5-301; 9. Documents required by R9-5-401, if applicable; 10. If applicable: a. The form required in A.R.S. § 8-804(I), b. Documentation of the submission required in A.R.S. § 8-804 and the information received as a result of the submission, and c. Documentation of training provided by a licensee as required by R9-5-403, if applicable; 11. A copy of any current license or certification required by A.R.S. Title 36, Chapter 7.1, Article 1. or this Chapter; and 12. Documentation of the requirements in A.R.S. § 36-883.02(D).

“Findings: Based on the Compliance Officers' observations and facility documentation, the following staff files lacked: Staff #1 (DOE 8/14/2024): 2 of the 2 required good faith references; Staff #2 (DOE unknown): The staff member's starting date of employment; and Staff #4 (DOE 7/1/2024): The staff member's ending date of employment and 2 of the 2 required good faith references.”

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 the Compliance Officers' observations and facility documentation, the files for Staff #1 (DOE 8/14/2024), Staff #2 (DOE Unknown), Staff #3 (DOE 8/26/2024), and Staff #4 (7/1/2024) lacked documentation of the staff's 10-day training”

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

“Findings: Based on the Compliance Officers' observations, the files for Staff #1 (DOE 8/14/2024), Staff #2 (DOE Unknown), and Staff #3 (DOE 8/26/2024) lacked documentation of a Criminal History Affidavit.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on the Compliance Officers' observations, the following areas lacked accurate documentation of the presence of enrolled children in an activity area: Room 8 (1's/2's): There were 12 children present in the outdoor activity area and no roster documenting the children present; and Room 3 (Pre-K): There were 2 children present and no roster documenting the children present.”

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.

“Findings: Based on Compliance Officer #1's observations and facility documentation, the Emergency, Information, and Immunization Record cards for Child #1 and Child #2 lacked immunization records.”

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

“Findings: Based on Compliance Officer #1's observations and facility documentation, 2 of 4 Emergency, Information, and Immunization Record cards lacked the following: Child #1 and Child #2: The Emergency, Information, and Immunization Record card; and Child #3: The date of the child's enrollment.”

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

“Findings: Based on the Compliance Officers' observations and facility documentation, the files for Staff #1 (DOE 8/14/2024), Staff #3 (DOE 8/26/2024), and Staff #4 (DOE 7/1/2024) lacked documentation of the DCS Central Registry submittal.”

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 the Compliance Officers' observations and facility documentation, the staff files for Staff #1 (DOE 8/14/2024), Staff #2 (DOE Unknown), Staff #3 (DOE 8/26/2024), and Staff #4 (DOE 7/1/2024) lacked documentation determining the validity of the staff's fingerprint clearance card.”

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 Compliance Officers' observations and facility documentation, the file for Staff #1 (DOE 8/14/2024) lacked a copy of the staff member's valid fingerprint clearance card.”

AAC R9-5-308.A. A. A licensee shall secure and maintain the following minimum insurance coverage: 1. General facility liability insurance of at least $300,000; and 2. Motor vehicle insurance coverage, required by A.R.S. Title 28, Chapter 9, Article 4, for each motor vehicle provided by a licensee to transport enrolled children.

“Findings: Based on the Compliance Officers' observations and facility documentation, there was a waiver in the parent handbook waiving the facility's liability.”

AAC R9-5-603.C. C. Except as provided in subsection (D), a licensee shall ensure that an outdoor activity area:1. Is enclosed by a fence: a. A minimum of 4 feet high; b. Secured to the ground; and c. With either vertical or horizontal open spaces on the fence or gate that do not exceed 4.0 inches; 2. Is maintained free from hazards, such as exposed concrete footings and broken toys; and 3. Has gates that are kept closed while an enrolled child is in the outdoor activity area

“Findings: Based on the Compliance Officer's observations, the following areas of the fence had openings exceeding 4 inches at the bottom of the fence: Preschool playground: *Northeast side of fence-various areas that had 6-inch vertical and horizontal openings; *East side fence- 7 panels had various areas of both 6-inch vertical and horizontal openings; and Toddler playground: *Southwest corner- various areas had 6-inch horizontal openings; and *Northwest side of the fence near the shed- various areas had 6-inch horizontal openings. Note: This is a repeat deficiency that was also cited at the time of the July 2023 inspection.”

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

“Findings: Based on the Compliance Officer's observations, the lesson plans that were posted in rooms 1, 2 and 9 were not dated and it could not be verified that the lesson plans were current.”

AAC R9-5-502.A.11. A. A licensee providing child care services for infants shall: 11. Label each food container received from the parent with the infant's name.

“Findings: Based on the Compliance Officer's observations, 3 infant food containers that were received from the infant's parent in the older infant room were not labeled with the infant's first and last name.”

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 observation and on a discussion with the Director, a child's twin pack of Epipens contained only 1 of the 2 prescribed injectors. The Director acknowledged that written permission from the child's health care provider that allowed the EpiPens to be separated had not been obtained.”

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

“Findings: Based on the Compliance Officer's observations 4 bottles of formula/ breast milk were not labeled with the infant's first and last name.”

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

“Findings: Based on the Compliance Officer's observations and on a discussion with staff, it was determined that 6 of the infant's written feeding instructions lacked the following required information: *Child #1- the staff stated the infant was eating food but the form did not state the type of foods the child eats and the frequency and amount of food to be fed; *Children #2 and #6- the staff stated both infants were eating food but the forms did not state the frequency and amount of food to be fed; Child #3- the staff stated the infant was eating food but the form was not dated and it could not be determined if it was current. The form also did not state the frequency and amount of food to be fed; *Child #4- the staff stated the infant was eating food but the form did not state the frequency of the feeding; and *Child #5-the staff stated the infant was eating both formula and food but the form did not state the frequency and amount of formula and food to be fed. Note: This is a repeat deficiency that was also cited at the time of the July 2023 inspection.”

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

“Findings: Based on the Compliance Officer's observations, the following items were stored in the bathrooms: *Room 5 bathroom- a mop was stored on the floor; and *Room 7 bathroom- a wicker basket and a poster were on the floor.”

AAC R9-5-509.C.18. C. A licensee shall ensure that:18. A staff member: a. Prepares a weekly menu at least one week in advance, b. Includes on the menu the specific foods to be served on each day, c. Dates each menu, d. Posts each menu at least one day before the first meal on the menu will be served, and e. Writes food substitutions on a posted menu no later than the morning of the day of meal service;

“Findings: Based on the Compliance Officer's review of the posted Snack menu and on a discussion with the Director, the menu listed "yogurt" and "fig bars" but did not list the various flavors served. The Director acknowledged that various flavors were served for both food items.”

AAC R9-5-503.A.1. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:1. A nonabsorbent, sanitizable diaper changing surface that is: a. Seamless and smooth, and b. Kept clear of items not required for diaper changing;

“Findings: Based on the Compliance Officer's observations the following items were stored in the diapering areas: *A roll of trash bags were stored on the diapering counter near the sinks in Room 6, 8 and 9; and *A bottle of disinfectant spray was stored on the diapering counter near the sink in room 5.”

AAC R9-5-502.A.10. A. A licensee providing child care services for infants shall: 10. Ensure that an occupied crib with a crib side that does not have a non-porous barrier is placed at least 2 feet from another occupied crib side that does not have a non porous barrier; and

“Findings: Based on the Compliance Officer's observations, 3 occupied cribs in the older infant room were spaced only 18 inches apart on the sides of the cribs that did not have the plexiglass barrier.”

AAC R9-5-501.A.9. A. A licensee shall ensure that:9. If a staff member places an enrolled child in a feeding chair when feeding the enrolled child: a. The feeding chair is constructed to prevent toppling; b. The tray or feeding surface of the feeding chair is smooth and free of cracks; and c. The staff member: i Cleans the feeding chair before and after each enrolled child’s use; ii. Sanitizes the tray or feeding surface before and after each enrolled child’s use; and iii. If the feeding chair was manufactured with a safety strap, fastens the feeding chair’s safety strap while the enrolled child is in the feeding chair;

“Findings: Based on the Compliance Officer's observation and on a discussion with the Director, 4 of the feeding chairs lacked the manufacturer's safety straps in the older infant room. Eight of the feeding chairs lacked the manufacture's safety straps in the younger infant room. The Director stated the straps had been removed to be washed and had not been replaced. *Note: This is a repeat deficiency that was also cited at the time of the July 2023 inspection.”

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

“Findings: Based on the Compliance Officer's review of Staff #4's and Staff #5's files, the files lacked documentation of the staff's completion of the required criminal history affidavit form.”

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 the Compliance Officer's observation and on a discussion with the Director, the Director acknowledged that the parental medication permission form for a child's EpiPen had not been obtained.”

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

“Findings: Based on the Compliance Officer's review of Staff #2's file (DOE 8/1/2016) the file contained documentation of only 11 hours of the required 18 hours of annual training for the period of 8/1/22 through 8/1/23; and The file for Staff #3 (DOE 8/5/14), the files lacked documentation of the staff's completion of any of the 18 hours of required annual training for the period of 8/5/22 through 8/5/23.”

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 (Ratios) Based on the Compliance Officer's observation and on a discussion with the Director, a ratio of 2:14 was observed on the outside playground. The youngest children in the group were 1-2 year olds. The Director stated 2 staff who were scheduled were running late.”

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 the Compliance Officer's review of staff files, it was determined that the files for Staff #1 (DOE 5/1/22), Staff #4 (DOE 12/18/23) and Staff #5 (DOE 9/5/23) lacked documentation of the staff's completion of the required new staff training.”

AAC R9-5-309.C. C. A licensee shall maintain on facility premises: 1. A current fire inspection report including documentation of any repairs or corrections required by the fire inspection report; and 2. If there are gas pipes that run from a gas meter to an appliance or location on the facility premises, a current gas inspection report including documentation of any repairs or corrections required by the gas inspection report.

“Findings: Based on the Compliance Officer's review of the City of Phoenix fire permit and on a discussion with the Director, it was determined the fire permit expired on 5.31.2024. The Director acknowledged the renewal permit fee had not been paid and the fire inspection was not scheduled.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on the Compliance Officer's observation, 4 children were present in Room 5 but the roster had only 2 children listed as present; and *Six children were present in Room 8 but the roster had only 2 children listed as 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 Compliance Officer's review of Staff #4's file, the file lacked a copy of the front and back of the staff's fingerprint clearance card. Note: Per the DPS website, Staff #4 does have a valid fingerprint clearance card that expires in 12/2029.”

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.

“Findings: Based on the Compliance Officer's review of 20 children's files, the files for children #7, #8 and #9 lacked a copy of either the child’s immunization record or a religious or medical exemption.”