K.E.S.D.#28 - Mirada Elementary

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 Officer's observation and staff statement, enrolled children eat lunch in a classroom that is not licensed for use. Per staff statement, the children eat lunch in the room every day.”

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 observation, the facility lacked a violation-free fire inspection.”

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, the medication authorization form for Child #5 lacked the start and end date of authorization.”

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 the Compliance Officer's observations, 4 of 20 Emergency, Information, Immunization, Records cards lacked the following: Child #1:. Child #2, and Child #3: The home address, city, state, and zip code of each parent of the child; and Child #4: The home address, city, state, and zip code of the second parent of the child.”

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 a review of the medication permission form for Child #4 and the Compliance Officer's observations, the form lacked the prescription number and the start and end dates (instructions for administration) for the medication.”

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

“Findings: Based on the Compliance Officer’s observation and review of 4 staff files, there was 1 of 4 staff files that lacked documentation verifying that results of a negative Mantoux skin test given to a staff member was on or before 12 months before the starting date of employment. * Staff #1-starting date of employment-11/8/2023. The file had documentation indicating that a negative Mantoux skin test was read on 2/13/2024.”

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, 3 out of 12 enrolled Children's Emergency, Information and Immunization Record cards reviewed lacked the following required information: 1) Child #1: The name and contact telephone number of the child's health care provider; 2) Child #2: The name and contact telephone number of the child's health care provider and the date of enrollment; 3) Child #3:The date of enrollment.”

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 observations, a copy of the current Certificate of Liability Insurance was unavailable for review so compliance could not be determined. The most recent Certificate of Liability Insurance expired on 7/1/2024.”

AAC R9-5-603.E. E. A licensee shall ensure that the following is provided and maintained within the fall zones of swings and climbing equipment in an outdoor activity area:1. A shock-absorbing unitary surfacing material manufactured for such use in outdoor activity areas; or 2. A minimum depth of 6 inches of a non-hazardous, resilient material such as fine loose sand or wood chips.

“Findings: Based on the Compliance Officer’s observations, the outdoor activity area lacked the following resilient surfacing: *3 of the required 6 inches of sand in the fall zone of the double slide.”

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 observation and a review of facility documentation, a current violation-free fire inspection from a local fire department was not available for the facility.”

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 review of facility records and Compliance Officer's observations, Child #4's prescription medication was dispensed as a two-pack, but only one was present at the facility and a physician’s authorization to separate them was not present.”