Little Learning Lambs Daycare

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“Findings: While onsite the Compliance Officers observed that the lunch served to the children did not match the posted weekly menu, as the substitutions were not noted. -The menu specified: Mozzarella cheese, multi-grain bread, lettuce, applesauce, and milk. -The lunch served included: Spaghetti w/meat sauce, multi-grain bread, green beans, diced apples, and milk.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“Findings: Based on review of ten Emergency, Information and Immunization Record (EIIR) cards, Compliance Officer 2 noted the following: -Child 1's card did not document the name and contact telephone number of the child’s physician nor did it include the name of the person to contact first in an emergency. -Child 2's card did not document the name and contact telephone number of the child’s physician as required. -Child 3's card did not document their date of enrollment as required.”

AAC R9-3-502.A. A. Except as provided in subsection (B), a certificate holder shall ensure that the child care group home has an outdoor activity area that: 1. Is on the premises; 2. Is at least 500 square feet in size; 3. Is adjacent to the residence; 4. Includes shaded areas large enough to accommodate all enrolled children occupying the outdoor activity area at any time; and 5. Except as provided in subsection (D), is enclosed by a fence that: a. Is at least 4 feet high; b. Is secured to the ground; c. Does not have any vertical or horizontal open space that exceeds 4 inches at any point, including any space on a gate; and d. Has a gate from which an individual may exit the outdoor activity area.

“Findings: While inspecting the outdoor activity area Compliance Officer 1 noted that sections of the wire fencing have pulled away from their support posts, and there are several areas along the bottom of the fencing where the dirt has been dug out, leaving gaps of more than 4 inches.”

AAC R9-3-502.A. A. Except as provided in subsection (B), a certificate holder shall ensure that the child care group home has an outdoor activity area that: 1. Is on the premises; 2. Is at least 500 square feet in size; 3. Is adjacent to the residence; 4. Includes shaded areas large enough to accommodate all enrolled children occupying the outdoor activity area at any time; and 5. Except as provided in subsection (D), is enclosed by a fence that: a. Is at least 4 feet high; b. Is secured to the ground; c. Does not have any vertical or horizontal open space that exceeds 4 inches at any point, including any space on a gate; and d. Has a gate from which an individual may exit the outdoor activity area.

“The Compliance Officer noted that a shade apparatus was not available in the outdoor activity area, as the previous cover was damaged due to wind.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“Findings: Based on review of Emergency, Information and Immunization Record (EIIR) cards Compliance Officer 2 noted the following: -Child 1, Child 3, and Child 6's cards did not document their dates of enrollment as required. -Child 2's card did not document the name and contact telephone number of the child’s physician, nor did it include the name and number for a second emergency contact. -Child 4's card did not document the person to call first in an emergency. -Child 5's card did not document the name and contact telephone number of the child’s physician, the name and number for a second emergency contact, their date of enrollment, or the person to call first in an emergency.”

AAC R9-3-304.A.1. A. A certificate holder shall not permit an enrolled child to receive child care services at a child care group home until the child care group home receives: 1. An immunization record for the enrolled child with the information required in 9 A.A.C. 6, Article 7, stating that the enrolled child has received all current, age-appropriate immunizations required under 9 A.A.C. 6, Article 7, that is: a. Provided by a physician, physician assistant, registered nurse practitioner, or another individual authorized by state law to administer immunizations; or b. Generated from the Arizona State Immunization Information System, which is the Department’s child immunization reporting system established in A.R.S. § 36-135; or

“Findings: Based on review of Emergency, Information and Immunization Record (EIIR) cards Compliance Officer 2 noted that an immunization record or exemption affidavit was not available for Child 5.”

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“Findings: Compliance Officer 1 noted that the posted menu was not current, it was dated for the week of August 12 - August 16, 2024.”

AAC R9-3-502.A. A. Except as provided in subsection (B), a certificate holder shall ensure that the child care group home has an outdoor activity area that: 1. Is on the premises; 2. Is at least 500 square feet in size; 3. Is adjacent to the residence; 4. Includes shaded areas large enough to accommodate all enrolled children occupying the outdoor activity area at any time; and 5. Except as provided in subsection (D), is enclosed by a fence that: a. Is at least 4 feet high; b. Is secured to the ground; c. Does not have any vertical or horizontal open space that exceeds 4 inches at any point, including any space on a gate; and d. Has a gate from which an individual may exit the outdoor activity area.

“Findings: Compliance Officer 1 noted the following while inspecting the playground: -A shaded area was not available in the fenced outdoor activity area, as the shade structure was damaged by wind. -There is a rectangular gap larger than 4 inches at the bottom-left portion of the mesh gate located near the house.”

AAC R9-3-507.A.1. A. A certificate holder shall ensure that a staff member changes diapers only on a nonabsorbent, sanitizable diaper changing surface that: 1. Is kept clear of items not required for diaper changing;

“Findings: Compliance Officer 1 observed the following items on the diaper-changing table: -A cardboard box of toys -Two dry erase markers and an eraser -A pen holder”

AAC R9-3-507.B.1. B. A certificate holder shall ensure that: 1. A staff member: a. Cleans, sanitizes, and dries a diaper-changing surface using a single-use paper towel before and after each diaper change; b. Washes the staff member’s hands with soap and running water before and after each diaper change; c. Wears single-use non-porous gloves during each diaper change; d. Washes an enrolled child’s hands with soap and running water or with a washcloth or disposable wipe after the enrolled child’s diaper is changed and uses each washcloth or disposable wipe on only one child and only one time before it is laundered or discarded; and e. Documents the daily diaper changes for each enrolled child in a dated diaper-changing log after changing the enrolled child’s diaper;

“Findings: Based on review of required documents Compliance Officer 1 noted as of 1:10 PM a diaper-changing log had not been started for two diapered children that were present during the inspection.”

AAC R9-3-401.B.2. B. A certificate holder shall ensure that: 2. The areas of the child care group home approved for providing child care services are maintained free from hazards;

“Findings: Compliance Officer 1 noted that a tree in the outdoor activity area has thorns that are accessible to enrolled children.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“FINDINGS: The Compliance Officer reviewed the children’s emergency cards and observed the following: -the card for Child 1 lacked their doctor’s name and telephone number. -the card for Child 2 lacked the name of the person to call first. -the card for Child 3 lacked their doctor’s telephone number.”

AAC R9-3-407.A.11. A. A certificate holder shall ensure that: 11. Each staff member is informed of a modified diet prescribed for an enrolled child by the child’s parent, physician, physician assistant, or registered nurse practitioner, as specified in R9-3-303(B)(8), and is written and posted in the kitchen;

“FINDINGS: The Compliance Officer reviewed the postings and observed that the food restrictions for Child 2 were not posted in the kitchen.”