Lamb's Gate Preschool & Kindergarten

AAC R9-5-516.J. J. A staff member’s or enrolled child’s prescription medication necessary to treat life-threatening symptoms: 1. May be kept in the activity area where the staff member or enrolled child is present; and 2. Except when the prescription medication is administered to treat life-threatening symptoms, is inaccessible to an enrolled child.

“Findings: Based on a conversation with the staff member in room D3, the Compliance Officer and Director were told that the parent of Child 5 left a prescription medication in the child’s backpack that was accessible to the children in the room. The staff member retrieved the medication from the backpack during the inspection and put it in a cabinet out of reach of the 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 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: Compliance Officer 2 reviewed 20 children’s emergency cards and observed the following: * Child 1 missing the name and phone number to one additional emergency contact (parent cannot be listed). * Child 2 was missing the date of enrollment and the phone number to one of the two required emergency contacts.”

AAC R9-5-306.A. A. A licensee shall: 1. Maintain a dated attendance form containing an enrolled child’s name with the time of each admission and release, and the parent or staff member's signature or other unique identifier. 2. If an electronic signature is used to admit or release the enrolled child, 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; 3. 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. 4. 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. 5. 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. 6. Maintain the attendance form on facility premises for 12 months after the date of attendance.

“Findings: During the inspection of room F8, the Compliance Officer counted five children physically present in the room. The Director pulled up the roster on Procare which reflected there were only four children signed-in and marked present. It was found that Child 3 was not signed-in.”

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: * During the inspection of the diaper changing area in room D2, the Compliance Officer observed that there was a toy ice cream cone in the sink and a sponge and cup on the counter next to the sink. * During the inspection of the diaper changing area in room E3, the Compliance Officer observed that there was a rag, a dirty toy bin, and a wooden tray under the soap and lotion bottles all on the counter next to the sink.”

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: The Compliance Officer observed that the non-prescription medication for Child 4 was missing written authorization from the child’s health care provider to administer the medication.”

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.

“Compliance Officer 2 reviewed the fire inspection report dated 02/01/2023 and observed that it was not current as it was over 12 months old.”

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.

“Compliance Officer 2 reviewed the children’s emergency cards and observed the following: * Child 1 was missing a phone number to one emergency contact. * Child 2 was missing the name and phone number for a health care provider, and the name and phone number for two emergency contacts.”

AAC R9-5-303.B. B. A licensee shall ensure that the licensed capacity of each indoor activity area or room is posted in that activity area or room.

“During the inspection of room F8, Compliance Officer 1 was unable to find the licensed capacity posted in the room.”

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

“Compliance Officer 1 reviewed the medication form for Child 3 and observed that there was not a start or end date listed on the form.”

AAC R9-5-605.B.8. B. A licensee shall ensure that: 8. Heating and cooling equipment is inaccessible to an enrolled child;

“During the inspection of room F8, Compliance Officer 1 observed that there was a standing floor fan that was accessible to children.”

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).

“Compliance Officer 2 reviewed two personnel files and observed the following: * Staff 1 was missing documentation of one additional professional reference.”

AAC R9-5-309.B. B. If there are gas pipes that run from a gas meter to an appliance or location on the facility premises, a licensee shall ensure that a licensed plumber or individual authorized by the local jurisdiction conducts a gas inspection that verifies there are no gas leaks in the gas pipes that run from the gas meter to any appliance or location on facility premises at least once every 12 months after the issue date of the license.

“Compliance Officer 2 reviewed the facility's required inspection reports and noted that the most current documentation for a gas inspection was dated 1/10/2023 and therefore had expired on 1/10/2024. Facility staff reported that they had scheduled a gas inspection for 1/18/2024.”

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

“Compliance Officer 1 reviewed the medications belonging to enrolled children at the facility and noted the following: Child 1’s authorization form did not list the start nor end dates for administration of the medication, nor the time and frequency. They also did not have an authorization form for their over the counter medication. Child 2’s authorization form did not list their prescription number nor the end date for administration of the medication.”

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.

“Compliance Officer 1 measured the depth of the wood chips in the fall zones of the playground equipment as follows: 3.5" in the fall zone of the blue Little Tykes slide on the "Swing Side" Playground; 4" in the fall zone of the wood log climber on the Sensory Playground.”

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;

“Compliance Officer 1 noted an uncovered outlet below the backpacks in the E 3/18 months old activity area”

AAC R9-5-305.B. B. A licensee shall attach an enrolled child’s written immunization record or exemption affidavit, required in subsection(A), to the enrolled child’s Emergency, Information, and Immunization Record card, required in R9-5 304(B).

“Compliance Officer 1 noted that enrolled children's vaccination records were not attached to their emergency records. Immunization records are all online.”

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.

“Compliance Officer 1 counted 13 children present in the F 6 activity area. The facility director confirmed the presence of the 13 children, however the classroom roster documented 12 children as being present.”