ElevateChild

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 review of facility documentation, it was determined that the medication form for Child #5 lacked the prescription number and the starting and ending dates of the dosage period. Additionally, Child #6 lacked a medication consent form for the child's medication.”

AAC R9-5-602.A. A. A licensee shall ensure that the facility meets the following square footage requirements for indoor activity areas based on the child care services classifications: 1. At least 35 square feet of indoor activity space for each infant and 1-year-old child; 2. At least 25 square feet of indoor activity space for each child who is not an infant or 1-year-old child; and 3. When 1-year-old children are grouped together with children older than 1-year-old children in the same activity area, at least 35 square feet of indoor activity space for each child.

“Findings: Based on the Compliance Officer's observation, it was determined that upon the Compliance Officer's arrival at the facility, there were 6 enrolled children in the office. The office is not a licensed space. The owner stated that a staff member was running late and that was the reason the children were in the office.”

AAC R9-5-203.D. D. A licensee shall ensure that each staff member submits to the licensee a copy of the staff member’s valid fingerprint clearance card each time the fingerprint clearance card is issued or renewed every five years.

“Findings: Based on the Compliance Officer's observation and review of facility documentation, it was determined that Staff #1 lacked a valid fingerprint clearance card. The fingerprint clearance card expired on 2/6/2026.”

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 the Compliance Officer's observation and review of facility documentation, it was determined that 4 out of 12 Emergency, Information, and Immunization Record cards reviewed were incomplete and lacked the following required information: Child #1, Child #2 and Child #3: The name and phone number of a second emergency contact. Child #4: The name and phone number of the child's second parent and the name and contact telephone number of the child’s health care provider.”

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

“Findings: Based on the Compliance Officer's observation, it was determined that there was a yellow plastic toy on the diaper changing surface in the 2's classroom.”

AAC R9-5-503.A.2. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 2. A hand-washing sink next to the diaper changing surface for staff use when changing diapers and for washing an enrolled child during or after diapering that provides: a. Running water between 86° F and 110° F, b. Soap from a dispenser, and c. Single-use paper hand towels from a dispenser;

“Findings: Based on the Compliance Officer's observation, it was determined that the water temperature in the diaper handwashing sinks in all the diapering rooms was 80° F.”

AAC R9-5-502.C.1.g. C. A licensee shall ensure that: 1. A staff member providing child care services in an infant room: g. Does not allow bumper pads, pillows, comforters, sheepskins, stuffed toys, or other soft products in a crib when an infant is in the crib;

“Findings: Based on the Compliance Officer's observation and information provided by the staff at the time of the inspection, it was determined there was a bunny and a giraffe in 2 cribs in the Infant classroom. Staff stated that "The babies like to sleep with them in their cribs."”

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;

“Per Allegation Findings: Based on the Compliance Officer's observation, it was determined that there were 4 unlabeled bottles in the Infant classroom.”

AAC R9-5-502.B.4. B. A licensee providing child care services for infants shall not: 4. Allow screen time in an infant room.

“Findings: Based on the Compliance Officer's observation, it was determined that screen time was observed on an iPad in the infant classroom.”

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 and review of facility documentation, it was determined that the lesson plan posted in the 1's/2's classroom was dated for the week of 5/5/2025.”

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 and review of facility documentation, it was determined that the roster was not accurate in the 3's/4's classroom. There were 7 children present in the classroom but the roster reflected the presence of 8 children.”

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 Officers' observations, and review of facility documentation, it was determined that 5 out of 20 enrolled children's Emergency, Information, and Immunization Record cards reviewed were incomplete and lacked the following required information: Child #1, Child #2, Child #3 and Child #4: The name, address and phone number of the child's second parent. Child #5: The name and phone number of a second emergency contact and the phone number of the child's health care provider.”

AAC R9-5-303.A. A. A licensee shall post in a place that can be conspicuously viewed by individuals entering or leaving the facility or activity area, the:1. Facility’s license; 2. Name of the facility director; 3. Name of the individual designated to act on behalf of the facility director when the facility director is not present in the facility, as prescribed by R9-5-301(B)(1); 4. Schedule of child care services fees and policy for refunding fees as prescribed by A.R.S. § 36-882(P); 5. Breakfast, lunch, dinner, and snack menus for each calendar week at the beginning of the calendar week; 6. Notice of the presence of any communicable disease or infestation listed in 9 A.A.C. 6, Article 2, Table 2, from the date of discovery through the incubation period of the communicable disease or infestation; 7. Notice of the Department’s intent to deny, revoke, or suspend as prescribed by A.R.S. § 36-888 at the expiration of time in the notice for the licensee to respond; 8. Notice of an intermediate sanction imposed as prescribed by A.R.S. § 36-891.01 within 10 calendar days after the licensee received notice of the intermediate sanction; 9. Notice of a legal injunction imposed as prescribed by A.R.S. § 36-886.01 when the licensee receives the legal injunction; and 10. Notice of the availability of facility inspection reports for public viewing at the facility premises.

“Findings: Based on the Compliance Officers' observations and review of facility documentation, it was determined that the menu posted on the posting board was dated for the week of 5/5/2025.”

AAC R9-5-517.A.9. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall:9. Ensure that the motor vehicle has: a. A working mechanical heating system capable of maintaining a temperature throughout the motor vehicle of at least 60° F when outside air temperatures are below 60° F; b. Except as provided in subsection (E), a working air-conditioning system capable of maintaining a temperature throughout the motor vehicle at or below 86° F when outside air temperatures are above 86° F; c. Except as provided in subsection (F), a first aid kit that meets the requirements of R9-5-514(A); d. Two large, clean towels or blankets; and e. Sufficient drinking water available to meet the needs of each enrolled child in the motor vehicle and sufficient cups or other drinking receptacles so that each enrolled child can drink from a different cup or receptacle;

“Findings: Based on the Compliance Officers' observations, it was determined that the facility vehicle lacked a first-aid kit.”

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, it was determined that the diaper changing area in the Infant classroom lacked single-use paper hand towels from a dispenser.”

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, it was determined that there was an iPad on the diaper changing surface in the 1's/2's classroom.”

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, it was determined that the children's pull-ups were being changed in the 1's/2's restroom. The restroom is not approved for diaper changing.”

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, it was determined that 2 bottles were not labeled in the Infant classroom.”

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 Officers' observations, it was determined that the crib sheets in the Infant classroom did not fit on the mattress. The sheet was loose and bunched up in the middle of the mattress.”

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, it was determined that 2 pacifiers in the infant classroom lacked an identifier.”

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 and review of facility documentation, it was determined that the roster was not accurate in the 2’s classroom. There were 5 children in the classroom but the roster reflected the presence of 6 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.

“Per allegation findings: Based on Compliance Officer #1's observation and review of facility documentation, it was determined that the negative Mantoux TB test for Staff #1 (start date: 10/7/2024) was not read until 10/8/2024.”

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 Compliance Officer #1's observation, it was determined that Staff #1 (start date: 10/7/2024) lacked a valid fingerprint clearance card.”

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

“Per allegation findings: Based on the Compliance Officers' observations, it was determined that a 4 year-old child was not supervised by a staff member when the child left the play room and went into the adjacent 4's classroom via the restroom that connects the 2 classrooms. The staff member observed the child leaving the play room and entering the classroom, but was unable to leave the play room to retrieve the child. The child was in sight during the incident, however the staff member was unable to be accountable for the child's actions and whereabouts.”

AAC R9-5-502.C.4.h. C. A licensee shall ensure that:4. When feeding an infant, a staff member: h. If an infant is no longer being held for feeding, seats the infant in a feeding chair or at a table with a chair that allows the infant to reach the food while sitting.

“Findings: Based on the Compliance Officers' observations and review of video footage from 10/1/2024, it was determined that an infant was given a bottle in the crib by a staff member in the Infant classroom.”

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

“Per allegation findings: Based on the Compliance Officers' observations, and review of video footage from 10/1/2024, it was determined that a staff member in the Infant classroom used a form of discipline that could cause harm to the health, safety, and welfare of an infant when the staff member pulled an infant by one arm aggressively and forced the infant to lay down in a crib. The infant cried out in distress after the staff member pulled the child down to the crib surface.”

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;

“Per allegation findings: Based on Compliance Officer #1's observation and review of facility documentation, it was determined that the file for Staff #1 (start date: 5/1/2024) lacked documentation of experience to qualify the staff as a teacher-caregiver.”

AAC R9-5-510.A.1. A. A licensee shall ensure that a staff member: 1. Defines and maintains consistent and reasonable guidelines and limitations for an enrolled child’s behavior;

“Findings: Based on the Compliance Officers' observations, and review of video footage from 10/1/2024, it was determined that a staff member in the Infant classroom did not maintain consistent and reasonable guidelines for an infant's behavior in the Infant classroom. The staff was heard saying "Shhhh" and "Stop it" in a harsh manner to the infant who was fussing in a crib.”

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;

“Per allegation findings: Based on the Compliance Officers' observations, and review of video footage from 10/1/2024, it was determined that the health, safety, and welfare of enrolled infants were placed at risk of harm in the following instances: A staff member aggressively pulled a fussy infant down by one arm in the crib, causing the child to cry in distress. A staff member was seen holding an infant whose face was covered with a blanket.”

AAC R9-5-307.2. A licensee shall ensure that the licensee or a staff member documents and reports all suspected or alleged cases of child abuse or neglect.2. The licensee or staff member shall report the suspected or alleged child abuse by a staff member to the Department and to a local law enforcement agency as prescribed in A.R.S. § 13-3620. A licensee or staff member shall also send documentation to the Department and to any law enforcement agency previously notified within three calendar days of the initial report, and maintain documentation of a child abuse report on facility premises for 12 months after the date of a report.

“Per allegation findings: Based on the Compliance Officers' observations and interview of facility staff, it was determined that the Licensee and facility director failed to immediately report suspected child abuse by a staff member on 10/1/2024 when they became aware of a staff member pulling an infant aggressively by the arm.”

AAC R9-5-404.C.3. C. A licensee shall ensure that:3. When six or more enrolled children are present in a facility, an infant is not placed for supervision with a child who is not an infant.

“Findings: Based on the Compliance Officers' observations, it was determined that there was a 1 year-old child in the Infant classroom when more than 5 children were present at the facility.”

AAC R9-5-511.A. A. A licensee shall provide each enrolled child who naps or sleeps at the facility with a separate cot or mat or a crib that meets the requirements of R9-5-502(A)(8) and ensure that:1. A cot, mat, or crib used by the enrolled child accommodates the enrolled child’s height and weight; 2. A staff member covers each cot, crib mattress, or mat with a clean sheet that is laundered when soiled, or at least once every seven days and before use by a different enrolled child; 3. A clean blanket or sheet is available for each enrolled child; 4. A rug, carpet, blanket, or towel is not used as a mat; and 5. Each cot, mat, or crib is maintained in a clean and repaired condition.

“Findings: Based on the Compliance Officer's observation, it was determined a child was asleep on the carpet in the One's classroom.”

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

“Per allegation findings: Based on the Compliance Officer's observation and interview with the facility staff, it was determined that enrolled children in diapers are placed in the Three's/Four's classroom. The classroom is not approved by the Department for diapering.”

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

“Findings: Based on the Compliance Officer's observation and review of facility documentation, it was determined that the roster was not accurate in the Two's/Three's classroom. There were 6 children present in the classroom but the roster reflected the presence of 9 children.”

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

“Per allegation findings: Based on the Compliance Officer's observation and interview with the facility staff it was determined that the ratio is not maintained at all times. Staff stated that sometimes the ratio is 1:10 instead of the required ratio of 2:10 when the two-year-old children are in the Three's/Four's classroom.”

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 Officer's observation and interview with the facility staff it was determined that the container for soiled diapers is accessible to the enrolled children in the Two's/Three's classroom.”

AAC R9-5-502.C.4.h. C. A licensee shall ensure that:4. When feeding an infant, a staff member: h. If an infant is no longer being held for feeding, seats the infant in a feeding chair or at a table with a chair that allows the infant to reach the food while sitting.

“Findings: Based on the Compliance Officers' observations, it was determined that there was an infant drinking from a bottle in a bouncy seat in the younger Infant classroom.”

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' observations and review of video footage, it was determined that on 5/15/2024, the children in the 3's/4's classroom were not supervised when they came back inside the classroom from the playground. Per the video footage, at 8:56am, the children in 3's/4's classroom were seen coming inside the classroom from the playground but there was no staff member supervising them in the classroom.”

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 and review of video footage, it was determined that the ratio in the 3's/4's classroom on 5/15/2024 at 8:57am was 1:17 instead of the required ratio of 2:17.”

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 and review of facility documentation it was determined that the rosters were not accurate in the Infant classrooms. Both Infant classrooms had 5 children present in the classroom but the rosters reflected the presence of 10 children. Additionally there was no roster on the playground to reflect the presence of 8 one-year-old children.”