Little Giants Spanish Immersion Preschool at Midtown

AAC R9-5-501.B.9. B. 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 Officer’s observations, the following personal products were not labeled with the child’s first and also name, as required: *1s Room 1 pack of wipes labeled with only the child’s last name. 1 diaper cream cream labeled with the child’s first initial and last name. *2s Room 4 packs of wipes and 1 diaper cream labeled with only the children’s first name. 1 unlabeled diaper cream.”

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, 3 out of 15 enrolled children’s Emergency, Information, and Immunization Records lacked the following documentation: *Child #1: The name, home address, email address, and telephone number for 1 of 2 of the child’s parents. *Child #2: The name of the individual to be contacted first in case of injury or illness. *Child #3: The email address for 1 of 2 of the child’s parents.”

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: Based on facility documentation, staff statements, and the Compliance Officer's observations, it was determined that staff are signing the enrolled children in or out. The facility lacks written permission from parents to sign the enrolled children in or out. Staff stated the following: *When children are not signed out by parents or staff, the ProCare system automatically signs them out as "admin" at 7:00 PM, which doesn't require a manual release time or signature. *When staff manually sign children in, the system doesn't require a signature, but does document the time. ***Previously cited 8/18/2025, 11/22/2024, and 8/22/2024.”

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 observations, the following attendance rosters did not accurately reflect the number of children in the room: Room103 (3s): There were 10 enrolled children present and 9 marked on the roster. Room 106 (1s): There were 8 enrolled children present and 7 marked on the roster. ***Previously cited 8/18/2025, 8/22/2024, 5/14/2024, 1/22/2024, and 10/19/2023.”

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 and staff statement, in Room 101 (2s), there were 2 uncovered outlets on the West wall near a shelf. Staff stated the shelf was moved during nap time for children to lay down. ***Previously cited 8/18/2025, 5/14/2024, and 8/15/2023.”

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 observations, Child #4's medication was stored in a red zipper container, and not in the original container dispensed by the pharmacy. ***Previously cited 8/18/2025.”

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 and the Compliance Officer's observations, in the Infant room, Child #5, Child #6, Child #7, Child #11, and Child #12's infant feeding plans lacked the frequencies and amounts the infants eat. ***Previously cited 8/18/2025, 11/22/2024, and 8/22/2024.”

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 (CO) observations, in Room 103 (3s), there were 2 cots with napping children on them spaced 4” apart, rather than 18" as required.”

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, in the Infant room, the water temperature of the diaper changing sink measured 68.7 degrees F, rather than between 86 - 110 degrees F, as required. ***Previously cited 8/18/2025, 8/22/2024, 5/31/2024, 1/22/2023, 8/15/2023, and 10/19/2023.”

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, in the Infant room, there was a loose crib sheet in an occupied crib, rather than a tight-fitted sheet as required. ***Previously cited 8/22/2024.”

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 observation and staff statement, the health, safety and welfare of enrolled children was placed at risk of harm. The fire alarm panel was flashing “monitor” and was beeping. In the Infant room, there was a boppy on an adult chair. Staff stated it was used for the teachers back when feeding infants. ***Previously cited 8/18/2025.”

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 child educator 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 and the Compliance Officer's observations, Staff #1 lacked departure times on 11/3, 11/12, 11/18, 11/19, & 11/20/2025 ***Technical Assistance given on 8/18/2025 and discussed on 8/15/2023.”

AAC R9-5-502.A.5.c. A. A licensee providing child care services for infants shall: 5. Develop, document, and implement tummy time policies and procedures that: c. Require continuous interaction between a non-crawling infant and the staff member who is supervising the non-crawling infant during tummy time;

“Findings: Based on staff statement, tummy time was not being documented for infants. ***Technical assistance was given 8/22/2024.”

AAC R9-5-502.A.4. A. A licensee providing child care services for infants shall: 4. Permit an infant to maintain the infant's pattern of sleeping and waking;

“Findings: Based on the Compliance Officers' (CO) observations and staff statement, upon entering Room 14 (infants), 7 of 7 infants were in their cribs with the lights turned off, and some of the infants were crying. When the CO asked why all of the infants were in cribs at the same time, staff stated “it's nap time”.”

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 the Compliance Officers' observations and staff statement, in Room 104 (infants), 7 of 7 infants (Child #5, #6, #7, #8, #9, #10, and #11) lacked written infant feeding instructions. Staff stated they did not know they needed them. ***Previously cited 8/22/2024 & 11/22/2024”

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, in Room 104 (infants), there were 2 ceramic planters on the right side of the diaper changing sink. ***Previously cited 10/19/2023, 1/22/2024, 5/14/2024, 8/22/2024, & 11/22/2024. ***Technical assistance was given 8/22/2024.”

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, there were uncovered outlets, accessible to enrolled children, in the following rooms: Infant room: 1 outlet near a crib Room 101 (2s): 1 outlet to the left of the books. ***Previously cited 8/15/2023 & 5/14/2024”

AAC R9-5-501.B.9. B. 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' observation, in Room 101 (2s), the following personal products lacked the child's first and last name, as required: *1 unlabeled diaper cream; *1 unlabeled Destin and Antibiotic ointment and; *1 Aquaphor labeled with only a child’s first name and last initial only. ***Previously cited 10/19/2023 & 8/22/2024”

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 103 (3-4s): There were sharp edges on the bottom of the counter where the formica laminate was missing from the edge. *Room 104 (infants): *There were 2 exposed screws at the South end of a long gate that was separating the room, and the gate was not secured to the wall. *There was an outlet cover broken off and small remnants were stuck in an electrical outlet within reach of an infant crib. *Room 106 (1s): There was an exposed nail on a toddler chair where the safety strap was missing. Room 201 (4-5s): There was an unsecured black cord hanging on the North wall near an artificial tree. Boys’ toilet room: There were two 4” holes, missing the metal caps on each side of the water station sink. ***Previously cited 8/15/2023, 10/19/2023, & 1/22/2024”

AAC R9-5-203.G. G. As 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 10 staff files, Staff #1 (DOE: 8/5/24) and Staff #2's (DOE: 2/27/24) files lacked documentation of the Central Background Check results before their start date. ***Previously cited 8/22/2024”

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: Based on facility documentation and the Compliance Officers' observations, 2 of 10 children's attendance forms lacked the following information: *Child #1: Release times and signatures on 8/5, 8/6, 8/11, 8/12, 8/13, & 8/15/2025. *Child #2: Arrival signature and release time and signature on 8/4/2025, and release times and signatures on 8/6, 8/7, 8/8, & 8/14/2025. ***Previously cited 8/22/24 and 11/22/24”

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, the following rosters were incomplete: *Playground (1-5s): There were 6 children present and 3 children were marked on the roster. *Room 101 (infants): There was 1 child present and no children were marked on the roster. ***Previously cited 10/19/2023, 1/22/2024, 5/14/2024, & 8/22/2024. ***Discussed at the Initial inspection 8/15/2023.”

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 Room 104 (infants), the diapering area lacked single-use paper towels, and the diaper area hand washing sink water temperature measured at 82° F, rather than between 86 - 110 degrees F as required. ***Previously cited 8/15/2023, 10/19/2023, 1/22/2024, 5/14/2024, 5/31/2024, & 8/22/2024”

AAC R9-5-401.4. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 4. An assistant child educator is 16 years of age or older and provides the licensee with documentation of one of the following: a. Current and continuous enrollment in high school or a high school equivalency class; b. High school or high school equivalency diploma; c. Enrollment in vocational rehabilitation, as defined in A.R.S. § 23-501; or d. Employment or service as a volunteer in a licensed child care facility for 12 months;

“Findings: Based on facility documentation and the Compliance Officers' observations of 10 staff files, it was determined that Staff #3 (DOE 1/6/25), Staff #4 (DOE 4/7/24), Staff #5 (DOE 7/25/25) and Staff #6 (DOE 10/30/24) were assistant child educators. The files lacked documentation of a high school or high school equivalency diploma, current and continuous enrollment in high school or a high school equivalency class, enrollment in vocational rehabilitation, or employment or service as a volunteer in a licensed child care facility for 12 months. The documents in the files were not translated or evaluated to be equivalent to a high school diploma or high school equivalency diploma from the United States. ***Previously cited 10/19/2023 & 8/22/2024”

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 positive discipline, including separation; 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; 17. Field trip procedures, if applicable; 18. Infant tummy time, if applicable; 19. Prevention of sudden infant death syndrome and use of safe sleeping practices, if applicable; and 20. Prevention of shaken baby syndrome, pediatric abusive head trauma, and child maltreatment.

“Findings: Based on facility documentation and the Compliance Officers' observations, Staff #3's file (DOE 1/6/25) lacked documentation of new staff training within 10 calendar days of the starting date of employment. ***Previously cited 8/22/2024”

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, the health, safety or welfare or enrolled children was placed at risk of harm. *In Room 101 (infants) a child was in a crib wearing a bib with a pacifier attached to a long, stretchy lanyard that was also attached to the child's wrist. *The Fire alarm panel was in trouble mode. ***Previously cited 10/19/2023”

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 Officers' observations, in Room 106 (1-2s), Child #1 and Child #2's prescription medication lacked the original container dispensed by the pharmacy. Both medications were in a clear ziplock baggie.”

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 Officers' observations, Child #3 and Child #4's prescription medications lacked written authorization documentation. ***Discussed at the Initial inspection 8/15/2023 ***Technical assistance was given 8/22/2024.”

AAC R9-5-504.A.9.a. A. A licensee providing child care services for 1-year-old and 2-year-old children shall: 9. 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 106 (1s), enrolled children were eating orange segments and whole raspberries. The food was not of a size to prevent a choking hazard.”

AAC R9-5-509.C.13. C. A licensee shall ensure that: 13. Each staff member is informed of a modified diet prescribed for an enrolled child by the child’s parent or health care provider, and the modified diet is posted in the kitchen and in the child’s activity area;

“Findings: Based on the Compliance Officers' observations, Room 106 (1s) lacked a posted allergy chart, and there was a child with a known nut allergy enrolled in the room.”

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 2 of 2 Boys’ toilet rooms, there was a yellow substance on the base of a toilet.”

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 106 (1s), 3 children were seated at the table and were not strapped in the chairs with the safety straps, and 1 chair was missing a safety strap.”

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

“Finidngs: Based on the Compliance Officer's observations, in the Girls’ toilet room, the wall to the right of the exit door was dirty and there were discolored orange smears on the wall.”

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, in the Girls’ toilet room, the middle toilet leaked water from the pipe when the toilet was flushed.”

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 CO's observations and a review of facility documentation, all enrolled infants lacked infant feeding instructions from the parent or health care provider.”

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 Compliance Officer's (CO) observations and a review of facility documentation, 4 of 10 children's attendance records reviewed lacked the following required information: **Child #1 - Arrival signature signed with initials on 11/01/2024; arrival and departure signatures signed with initials on 11/04/2024, 11/05/2024, 11/07/2024, and 11/13/2024; arrival signature signed with initials and departure signature on 11/06/2024; departure signature signed with initials on 11/08/2024 and 11/12/2024 **Child #2 - Departure signature signed with initials on 11/04/2024; arrival and departure signatures signed with initials on 11/05/2024, 11/07/2024, 11/08/2024, and 11/13/2024; arrival signature signed with initials and departure signature on 11/06/2024 **Child #3 - Arrival and departure signatures signed with initials on 11/04/2024 and 11/08/2024; arrival signature signed with initials and departure signature on 11/06/2024 and 11/20/2024; arrival and departure signatures on 11/13/2024 and 11/18/2024 **Child #4 - Departure signature on 11/06/2024, 11/07/2024, 11/15/2024, and 11/19/2024; arrival signatures on 11/08/2024, 11/12/2024 and 11/13/2024”

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 CO's observations, the soiled clothing container in Room 104 lacked a waterproof liner.”

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 CO's observations, diaper changing areas in the following areas were not seamless and smooth: **Room 104 (Infants) - Sticker on the inside panel of the diaper changing surface **Room 105 (2's) - Unsealed gaps on the side rail of the diaper changing area **Room 106 (1's/2's) - Unsealed gaps at the back of the diaper sink and along the edges of the plexiglass divider”

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 CO's observations, containers of peaches, muscle relief cream and whiteboard dry-erase spray were stored together in a cabinet above the diaper changing sink.”

AAC R9-5-403.C. C. A licensee shall ensure that documentation of a staff member's completion of training required by subsection (A) is signed by the facility director and dated.

“Findings: Based on CO's observations and a review of 11 staff files, Staff #10's (DOE 08/05/2024) 10-day new employee training lacked the Facility Director's signature and date.”

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 CO's observations, 8 of 9 cribs had sheets that were not fitted to the size of the mattresses.”

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 CO's observations, 2 containers of infant food were not labeled with a child's name.”

AAC R9-5-502.B.3. B. A licensee providing child care services for infants shall not: 3. Permit an infant to use a walker; or

“Findings: Based on CO's observations, a shopping cart walker was in the infant room.”

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 CO's observations, 9 of 9 enrolled infants lacked written dietary instructions from a parent or 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 CO's observations, the following diaper changing areas were not seamless/smooth and/or not kept clear of items: **Room 101 - Additional water spout at the front right corner of the sink. **Room 104 - Debris on the surface and unsealed gaps at the 2 strap holes, the sides and corners of the surface. **Room 105 - Small mirror, plastic bottles, a paper cup, and a sponge at the sink; unsealed gaps at the plexiglass side rail and the corners of the changing table. **Room 106 - 1-1/2 inch hole in the stainless steel at the front, right corner of the sink; 1/2-inch gap at the backsplash of the sink; bottle of hand sanitizer at the sink”

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 CO's observations, the diaper-changing table in Room 105 was 8-feet away from the diaper-changing sink.”

AAC R9-5-503.A.3. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains:3. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled diapers; and

“Findings: Based on CO's observations: **Room 104 - The soiled diaper container lacked a waterproof liner. **Room 106 - The cabinet-type container used for soiled diapers was not a waterproof container. The liner hung loosely inside the cabinet below the tight-fitting lid.”

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 CO's observations, the soiled containers in Rooms 104 and 106 lacked waterproof liners.”

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 CO's observations, Room 106 lacked a disinfectant to sanitize the diaper-changing surface.”

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 CO's observations, Rooms 105 and 106's activity areas lacked musical instruments for the enrolled children.”

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 CO's observations, napping children in Rooms 101 (3 children), 103 (2 children), and 201 (1 child) lacked sheets on their mats.”

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 CO's observations, 1 of 2 toilets in the Girls' restroom was not operational. An "out-of-order" sign was placed on the door.”

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 CO's observations, the facility's first aid kit lacked gauze rolls and antiseptic wipes.”

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 CO's observations, the facility's first aid kit continued packets of burn cream, insect protection cream, insect sting relief, wound dressing gel, and sunscreen lotion.”

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 CO's observations, the siding on the storage shed in Playground #3 was crumbling and peeling paint, and a slat was detached from the side, accessible to enrolled children.”

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 CO's observations and a review of 11 staff files, Staff #10's (DOE 08/05/2024) 10-day new employee training was incomplete. The dates of completion for all topics were blank.”

AAC R9-5-401.4. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:4. An assistant teacher-caregiver is 16 years of age or older and provides the licensee with documentation of one of the following: a. Current and continuous enrollment in high school or a high school equivalency class; b. High school or high school equivalency diploma; c. Enrollment in vocational rehabilitation, as defined in A.R.S. § 23-501; d. Employment as a teacher-caregiver aide for 12 months; or e. Service as a volunteer in a child care facility for 12 months;

“Findings: Based on CO's observations and a review of 11 staff files, 5 of 11 staff were acting in the capacity of assistant teacher-caregivers and lacked the following required information: **Staff #3 (DOE 02/27/2024), Staff #5 (DOE 05/09/2024), Staff #8 (DOE 08/06/2024), Staff #10 (DOE 08/05/2024) - Evaluation of international education of equivalency in the United States or documentation of related early childhood experience. **Staff #11 (DOE 07/30/2024) - Educational documentation and related early childhood experience documentation.”

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 CO's observations and a review of 11 staff files, Staff #4 (DOE 07/30/2024) was acting in the capacity of a teacher-caregiver and lacked an evaluation of their international education of equivalency in the United States and lacked documentation of related early childhood experience.”

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 CO's observations and a review of facility documentation, current, violation-free fire and gas inspections were not available for review.”

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 CO's observations, a napping child was blocking an exit in Room 101.”

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 CO's observations and a review of 11 staff files, Staff #4 (DOE 07/30/2024) lacked documentation of a completed 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 CO's observations and a review of facility documentation, 13 children were present in Room 103, and 15 children were noted on the roster as in attendance.”

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 CO's observations and a review of facility documentation, enrolled children's attendance records were not available for review.”

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 CO's observations and a review of 11 staff files, the following staff lacked documentation of freedom from tuberculosis on or before the starting date of employment: **Staff #3 (DOE 02/27/2024) - Negative results dated 06/17/2024 **Staff #4 (DOE 07/30/2024) - Negative results dated 08/03/2024 **Staff #9 (DOE 07/30/2024) - Negative results dated 08/01/2024 **Staff #11 (DOE 07/30/2024) - Negative results dated 08/05/2024”

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 CO's observations and a review of 11 staff files, Staff #7 (DOE 10/16/2023) and Staff #11 (DOE 07/30/2024) lacked documentation of submission to DCS to complete a background check.”

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 CO's observations and a review of 11 staff files, fingerprint clearance cards for the following staff lacked documentation of contact with DPS to verify their cards as valid before their starting date of employment: **Staff #1 (DOE 10/16/2023) - Verified 10/23/2023 **Staff #4 (DOE 07/30/2024) - Verified 08/05/2024 **Staff #7 (DOE 10/16/2023) - Verified 10/20/2023 **Staff #6 (DOE 08/12/2024), Staff #8 (DOE 08/06/2024), Staff #10 (DOE 08/05/2024), Staff #11 (DOE 07/30/2024) - Lacked dated verification”

AAC R9-5-203.A. A. A licensee shall ensure that a staff member completes, signs, dates, and submits to the licensee, before the staff member’s starting date of employment or volunteer service:1. The form required in A.R.S. § 36-883.02(C); and 2. If required by A.R.S. § 8-804, the form in A.R.S. § 8-804(I).

“Findings: Based on Compliance Officer's (CO) observations and a review of 11 staff files: **Staff #1 (DOE10/16/2023) - Criminal history affidavit was dated 10/26/2023; Direct Service affidavit was dated 11/26/2023. **Staff #2 (DOE 04/07/2024) - Criminal history affidavit was dated 04/08/2024; Direct Service affidavit was dated 04/23/2024. **Staff #3 (DOE 02/27/2024) - Direct Service affidavit was dated 04/10/2024. **Staff #4 (DOE 07/30/2024), Staff #5 (DOE 05/09/2024), Staff #6 (DOE 08/12/2024), Staff #8 (DOE 08/06/2024), Staff #9 (DOE 07/30/2024) - Lacked documentation of a completed Direct Service affidavit (REFERENCE: R9-5-203.G). **Staff #7 (DOE 10/16/2023) - Direct Service affidavit was dated 10/19/2023. **Staff #10 (DOE 08/05/2024) - Criminal history affidavit lacked a date.”

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 CO's observations, children's personal products in the following activity areas lacked a first and last name: **Room 101 - Diaper ointment labeled with a first name only. **Room 104 - Diaper ointment and wipes labeled with a first name and last initial. **Room 105 - Wipes labeled with a first name only or not labeled with a name.”

AAC R9-5-404.C.1. C. A licensee shall ensure that:1. When there are six or more enrolled children present in a facility, the following individuals are present in the facility: a. A facility director or a director’s designee who meets the requirements in R9-5-401 for a director’s designee; and b. One additional staff member;

“Findings: Based on Compliance Officers' observations, neither the facility director nor the director's designee were present at the facility.”

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 Officers' observations, upon arrival to the facility the Compliance Officers' noted that the ratio of the 2/3's room was operating at a staff-to-child ratio of 1:12 instead of the state mandated ratio of 2:12.”

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 Compliance Officers' observations and review of facility documentation, there were 9 children present on the facility playground however a roster was not present to account for the children's presence on the playground.”

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 Compliance Officers' observations and review of facility documentation, the facility lacked documentation of the names of the individual designated to act on behalf of the facility director when the facility director is not present at the facility.”

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 Officers' observations, the diapering sink in the 2/3's classroom had a bin of paint brushes and smocks sitting in the basin, and the surface surrounding the sink had a bubble machine with bubble solution laying atop the surface. Additionally, the diapering surface of the 1/2's classroom was not able to be sanitized due to the seams along the surface of the table and the brackets on the surface.”

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 Compliance Officers’ observations, there was a large play mat leaning against the door and obstructing the exit for Room 106.”

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 Officers’ observations, there was one outlet along the wall of the 2/3's classroom and 3 outlets along the power strip in the 1/2's classroom that all lacked safety covers.”

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 Compliance Officers’ observations, there was a trash receptacle containing food waste that lacked a cover in the 1/2’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 Compliance Officers' observations, the paper towel dispenser in the 1/2's diaper changing area lacked singly dispensed paper towels.”

AAC R9-5-504.5.c. A licensee providing child care services for 1-year-old and 2-year-old children shall: 5. Ensure that: c. If a child is fed with a bottle, a staff member complies with the requirements in R9-5-502(C)(3); and

“Findings: Based on the Compliance Officers' observations, in Room 106 (1's), there was an enrolled child drinking a bottle on the cot and not in a chair as required.”

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 Compliance Officer #2's observations, in Room 106 (1's), the refrigerator lacked a thermometer. Previously cited on 10/19/23.”

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, in Room 103 (2's/3's), there was 5 enrolled children present however, 6 were marked on the roster.”

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 Compliance Officer #2's observations, in Room 103 (2's/3's), there were 6, 1-inch holes in the north wall exposing drywall. Previously cited on 10/19/23 and 8/15/23.”

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, in Room 101 (3's), there was a clipboard on the diaper changing table. In Room 106 (1’s), there was a roll of paper towels, shelf with color paper, stacks of computer paper, a microwave, basket of books, box of tissue and a plant on the diaper changing table. Previously cited on 10/19/23”

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 Room 106 (1's), the diaper changing hand washing lacked single-use paper towels from a dispenser.”

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 and the Compliance Officers' observations, it was determined that Staff #2 and Staff #4 were teacher-caregivers in the classroom at the time of the inspection. Staff #2 and Staff # 4 were not qualified as a teacher-caregiver and were not supervised by a qualified staff member.”

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, it was determined that the Mantoux skin test for Staff #1 (DOE 10/16/23) and Staff #2 (DOE 8/28/23) was not administered on or before the starting date of employment.”

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 Officers' observations, in classroom 106, there was a jug of water next to the diaper-changing sink.”

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 Compliance Officer #2's observation, in classroom 106, the soiled diaper container lacked a waterproof liner as required.”

AAC R9-5-503.A.3. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 3. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled diapers; and

“Findings: Based on Compliance Officer #2’s observation, in classroom 106, the soiled diaper container lacked a tight-fitting lid.”

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 observations, in classroom 106, there were wooden shelves with papers, a bell, a black marker, scissors, an orange metal water bottle, a lunchbox, a purse, a ceramic pencil decoration, a ceramic apple decoration, a plastic spoon, pink coffee cup, roll of tape, coffee tin, 6 paint dobbers, paper towel roll, wipes, a single diaper, diaper cream, wooden basket, spray bottle with yellow substance, hand sanitizer, yellow paper muffin cup, paper plate, a clipboard with paper and a green washcloth on the diaper changing surface.”

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 Compliance Officer #2's observations, in classroom 101, there were 4 diaper creams and 4 wipes that lacked the enrolled child's last name. In classroom 106, there were 4 diaper creams, 2 wipes, 1 bottle of lotion and 1 baby spray that lacked the enrolled child's first and last name, and 1 diaper cream and 1 wipe that lacked the enrolled child's last name.”

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 Officers' observations, it was determined that 8 out of 15 enrolled children's Emergency, Information and Immunization Record cards reviewed lacked the following required information: Child #1 and Child #2: Parent signature on the back of the card. Child #3: The date of enrollment. Child #4: The date of enrollment, the name, home address, city, state, zip code, and contact telephone number of each parent of the child, 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. Child #5 and Child #6: The date of enrollment, the child’s home telephone number. Child #7: The date of enrollment, The name and contact telephone number of the child’s health care provider, the name of the individual to be contacted in case of injury or sudden illness of the child and a parent's signature on the back of the card. Child #8: 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 and the name of the individual to be contacted in case of injury or sudden illness of the child.”

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 Compliance Officer #2’s observation, the health, safety and welfare of enrolled children was placed at risk of harm when there were 2 non-enrolled school-age (8-years-old) children present in classroom 101 with 5 one-year-olds.”

AAC R9-5-401.4. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 4. An assistant teacher-caregiver is 16 years of age or older and provides the licensee with documentation of one of the following: a. Current and continuous enrollment in high school or a high school equivalency class; b. High school or high school equivalency diploma; c. Enrollment in vocational rehabilitation, as defined in A.R.S. § 23-501; d. Employment as a teacher-caregiver aide for 12 months; or e. Service as a volunteer in a child care facility for 12 months;

“Findings: Based on facility documentation and the Compliance Officers' observations, it was determined that Staff #1 and Staff #4 were teacher-caregivers in classrooms 101 and 106 . Staff #1 and Staff #4 were not qualified as teacher-caregivers, the files for Staff #1 and Staff #4 lacked documentation of a high school diploma or high school equivalency diploma.”

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 and the Compliance Officers' observations, it was determined that Staff #3 was a teacher-caregiver in classroom 101 . Staff #3 could not be qualified as a teacher-caregiver, the staff lacked a file on facility premises during the inspection.”

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, it was determined that the file for Staff #1 (DOE 10/16/2023), Staff #2 (DOE 8/28/23), and Staff #3 (DOE* No file to review dates ) lacked documentation of a valid fingerprint clearance card.”

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 Compliance Officer #1’s observation, in classroom 106, the refrigerator lacked a thermometer as required.”

AAC R9-5-401.2. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 2. A facility director’s designee is 21 years of age or older and provides the licensee with documentation of one of the following: a. At least 12 months of child care experience, a high school or high school equivalency diploma, and: i. Three credit hours or more in early childhood, child development, or a closely-related field from an accredited college or university, or ii. At least 30 actual hours of instruction, provided in conferences, seminars, lectures, or workshops in early childhood, child development, or a closely-related field; b. At least 12 months of child care experience and: i. An N.A.C., C.D.A., or C.C.P. credential; or ii At least 24 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; c. At least six months of child care experience and an associate degree from an accredited college or university in early childhood, child development, or a closely-related field; or d. At least three months of child care experience and a bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field;

“Findings: Based on facility documentation and the Compliance Officers' observations, it was determined that Staff #3 was the director designee. Staff #3 could not be qualified as the director designee, the staff lacked a file on facility premises during the inspection.”

AAC R9-5-204. A. The Department licenses child care facilities using the following service classifications: 1. Full-day care; 2. Part-day care; 3. Evening and nighttime care; 4. Infant care; 5. One-year-old child care; 6. Two-year-old child care; 7. Three-year-old, four-year-old, and five-year-old child care; 8. School-age child care; and 9. Weekend care. B. The Department shall designate on a facility’s license each service classification that the facility is licensed to provide. C. A licensee shall not provide child care services in a service classification for which the licensee is not licensed.

“Findings: Based on facility documentation and Compliance Officer #2’s observation, it was determined that the licensee had 2 School-age children (8-years-old) present in room 101. The license does not service School-age children.”

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 Compliance Officer #2's observation, in classroom 106, there was a diaper in the trash can that lacked a lid next to the table and was accessible to enrolled children.”

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 Compliance Officer #2’s observation, it was determined that the roster in classroom 101 did not reflect the number of children present (5 children present, 8 children listed on the roster).”

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, classroom 101 had 12- 1-inch holes and classroom 103 had 8 holes 1/2 inch holes on the north wall exposing drywall with sharp edges to enrolled children.”

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 facility documentation and Compliance Officer #1’s observation, it was determined that Classroom 106 lacked documentation of a current lesson plan. The lesson plan was dated for the week of October 2-6th, 2023.”

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, it was determined that Staff #3 and Staff #4 lacked a file. The following information could not be reviewed for Staff #3 and Staff #4: *Staff member’s name, date of birth, home address, and telephone number. *Staff member's starting date of employment. *The name and telephone number of an individual to be notified in case of an emergency. *Staff member's written statement attesting to current immunity against measles, rubella, diphtheria, mumps, and pertussis. *Documentation of 2 good faith effort professional references. *Documentation for the 10-day training for new staff members.”