Immanuel Care For Children

AAC R9-5-503.E. E. A licensee shall ensure that the written diaper changing procedure in subsection (D) states that an enrolled child’s diaper is changed as soon as it is soiled, and that a staff member, when diapering:1. Uses a separate washcloth and towel only once for each enrolled child; 2. Washes and dries the enrolled child using the enrolled child’s individual personal products labeled with the enrolled child’s name; 3. Uses single-use non-porous gloves; 4. Washes the staff member’s own hands with soap and running water between 86° F and 110° F before and after each diaper change; 5. Washes each enrolled child’s hands with soap and running water between 86° F and 110° F after each diaper change; 6. Cleans, sanitizes, and dries the diaper changing surface following each diaper change; and 7. Uses single-use paper towels from a dispenser to dry the diaper changing surface or the hands of the enrolled child or staff member.

“Findings: Based on the Compliance Officer's observation, the following personal products lacked a label with the child's first and last name as required: Two's Room: 2 wipes were labeled with the child's first name only and 1 wipe was labeled with the child's first name and last initial only; and Infant Room: 3 wipes were labeled with the child's first name only.”

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 observation, the following hazards were accessible to enrolled children on the Preschool/School Age Playground: *The handle to the oven on the plastic play kitchen was broken exposing sharp plastic edging; and *There was a wire looped between the weaving on the long bench along the East playground wall.”

AAC R9-5-502.C.1.d. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: d. Keeps dated, daily, documentation of each infant including: i. A description of any activities the infant participated in, ii. The infant’s food consumption, iii. Diaper changes, and iv. Tummy time;

“Findings: Based on the Compliance Officer's observation, the facility lacked dated, daily, documentation of tummy time.”

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 Officer's observation, the following was observed: Hallway Bathroom: *1 of 3 stalls lacked mounted toilet paper; *1 stall was closed for repair; and SA Bathroom: *The bathroom stall lacked mounted toilet paper.”

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 Officer's observation and staff interview, it was determined that the health and safety of an enrolled infant was placed at risk of harm when a staff member fell asleep while holding an infant.”

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 of facility staff, it was determined that on 9/3/2024 around 9:00am, the ratio of 1-year-old and 2-year-old children while transitioning to the playground from the 2's classroom was 1:8 instead of the required ratio of 2:8.”

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 the Compliance Officer's observation, review of facility documentation and interview with facility staff, it was determined that Staff #1 (start date: 6/3/2024) was not qualified to be a teacher-caregiver and was not supervised by a teacher-caregiver.”

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 infant classroom. There were 7 children present in the classroom but the roster reflected the presence of 8 children.”

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 the Compliance Officer's observation and review of facility documentation, it was determined that the file for Staff #1 (start date: 6/3/2024) lacked documentation of experience to qualify the staff as a teacher-caregiver.”

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-5's classroom. There were 15 children present in the classroom but the roster reflected the presence of 9 children.”

AAC R9-5-404.E. E. In addition to maintaining the required staff-to-children ratios, a licensee shall ensure that:1. Staff members are present on facility premises to perform facility administration, food preparation, food service, and maintenance responsibilities; and 2. Facility maintenance does not depend on the work of enrolled children.

“Findings: Based on the Compliance Officers' observations, it was determined that the assistant director left the facility in the presence of the Compliance Officers with the designee in ratio. There was no staff available to perform facility administration. The Compliance Officers communicated this information to the Licensee who was on the telephone with the Compliance Officers, and thereafter a designee came up to the front lobby to perform facility administration duties.”

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

“Findings: Based on Compliance Officer #2's observation, it was determined that the following areas of the playground were not maintained free from hazards that were accessible to the enrolled children: *There was chipped paint exposing rust on the fencing on the east side. *The shed door had deteriorating and splintering wood.”

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 Compliance Officer #2's observation, it was determined that there were 4 uncovered outlets on a power strip by the door in the Infant classroom. There was also an uncovered outlet on the playground.”

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 Compliance Officer #2's observation, it was determined that the white freezer in the kitchen that is used to store the children's food lacked a thermometer.”

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

“Findings: Based on Compliance Officer #2's observation, it was determined that there was a plastic toy on the diaper changing surface in the 2's classroom. Also there was a gap along the edge of the diaper changing surface in the 1's and 2's classroom.”

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 Compliance Officer #2's observation, it was determined that 2 bottles lacked the infant's last name in the Infant classroom.”

AAC R9-5-516.I. I. Except as specified in A.R.S. § 36-2229(B) through (D), a licensee shall ensure that a facility does not stock a supply of medications for administration to enrolled children, including:1. Any prescription medication; or 2. A nonprescription medication such as aspirin, acetaminophen, ibuprofen, or cough syrup.

“Findings: Based on Compliance Officer #1's observation, it was determined that there were 8 packets of sting relief ointment medication in the facility's first aid kit.”

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 in the 3's/4's classroom was not accurate. There were 12 children present in the classroom but the roster indicated the presence of 13 children.”

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 Officers' observations, it was determined that there was an iPad playing a video in the infant classroom.”