Out Of This World Christian Child Care

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 the Compliance Officer's observations and on a discussion with staff, the staff acknolwedged that 2 packages of breast milk were not labeled with the infant’s first and last name.”

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 Officer's review of the infant written feeding instructions and on a discussion with staff, staff stated Child #3 staff was fed both formula and purée but the feeding instructions lacked the amount of puree to be fed and the frequency of puree feedings.”

AAC R9-5-516.B.3. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 3. A facility director, or a staff member designated in writing by the facility director, does not administer a medication to an enrolled child unless the facility receives written authorization signed by the enrolled child’s parent or health care provider that includes the: a. Name of the enrolled child; b. Type of the medication; c. Prescription number, if any; d. Instructions for administration specifying the: i. Dosage and route of administration; ii. If indicated, starting and ending dates of the dosage period; and iii. Times and frequency of administration; e. Reason for the medication; and f. Date of authorization; and

“Findings: Based on the Compliance Officer's review of the children's medications, the medication permission form for Child#1’s medication lacked the reason for medication.”

AAC R9-5-516.B.1. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 1. A facility director, or a staff member designated in writing by the facility director, is responsible for the administration of all medications in the facility, including storing, supervising an enrolled child’s ingestion of a medication, and documenting all medications administered to an enrolled child;

“Findings: Based on the Compliance Officer's review of the medication forms and on a discussion with the Director, the Director acknowledged there was not a written medical chain of command that designated a staff to be responsible for the administration of all medications in the facility, including storing, supervising a child’s ingesting a medication, and documenting all medications administered to an enrolled child. Instead the medication administion form for Child #1 indicated various staff on different days gave the child the medication.”

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, In Room 5, our personal products lacked a label of the child's first and last name.”

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 the Compliance Officer's review of Staff #2's file (DOE 2/19/25), the file contained documentation indicating that the new staff orientation training was completed on 3/3/2025, rather than within 10 calendar days of the staff's date of employment.”

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 the Compliance Officer's review of Staff #2's file (DOE 2/19/25), the file lacked documentation that the licensee had verified the validity of the staff's fingerprint clearance card through DPS, prior to the staff’s date of employment.”

AAC R9-5-203.D. D. A licensee shall ensure that each staff member submits to the licensee a copy of the staff member’s valid fingerprint clearance card each time the fingerprint clearance card is issued or renewed every six years.

“Findings: Based on the Compliance Officer's review of Staff #4's file (DOE 9/20/22), the staff's file contained documentation that Staff #4's fingerprint clearance card had expired 10/31/2024 and the staff's new fingerprint clearance card was not issued until 1/6/25.”

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 the Compliance Officer's observation, numerous packets of stock medication, including burn cream, antibiotic cream and sting relief cream were stored in the first aid kit.”

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 the Compliance Officer's observation and on a discussion with the infant room staff, 2 push walkers were observed in the infant room. The Staff acknowledged that the infants use the walkers.”

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 the Compliance Officer's review of the infant feeding instructions and on a discussion with the infant room staff, the following was noted regarding the written infant feeding instructions; *Child 1-The staff stated the infant was eating purée foods but the feeding instructions did not state the types of food, the amount of food and frequency of the feedings; *Child 2- The staff stated the infant was on formula but the feeding instructions did not state the amount of formula and the frequency of the feedings; *Child 3-The staff stated the infant was eating solid foods but the feeding instructions did not state the type of foods, the amount of food and the frequency of the feeding. The form indicated it was last updated in 6/2024; *Child 4-The staff stated the infant was on formula but the feeding instructions did not state the amount of formula and the frequency of the feedings; and *Child 5 The staff stated the infant was no longer drinking breast milk and the amount of formula had increased. Staff acknowledged the new amount of formula had not been updated on the form. In addition, the staff stated the child was also eating purée foods but the type of food, the amount of food and the frequency of feedings was not stated on the feeding instructions.”

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 Compliance Officer #2's observation, it was determined that the Mantoux skin test (TB test) for Staff #1 (date of employment-12/13/2023, date of TB test- 12/14/2023) and Staff #2 (date of employment- 5/3/2024, no documentation) was not administered on or before the start date of employment. *previously cited 5/11/2023”

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' observation, it was determined that Staff #2 was the assistant teacher-caregiver in room #6. Staff #2 lacked documentation of an evaluated diploma issued in a foreign country that is equivalent to a high school diploma in the United States.”

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 #1's observation, in classroom #2, there was 1 enrolled child with their face covered during nap time.”

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 #3 lacked documentation of a current lesson plan. The lesson plan was dated for the week of April 22, 2024.”

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 #1's observation, in classroom #5, there was a tube of A&D Ointment and 2 diaper creams that lacked the enrolled children's first and last names. *previously cited 5/11/2023”

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 facility documentation and Compliance Officer #1's observation, the infant feeding instructions lacked the following information: Child #1, Child #2, Child #4, and Child #6: amount and times the children were to be fed. Child #3 and Child #5: the types of food the children were to be fed. Child #7 and Child #8: the type of formula & the amount and times the children were to be fed.”

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 Officer #1's observation, in the Infant room, the diaper changing area lacked soap. The dispenser was empty.”

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#1's observation, in classroom #5, the soiled clothing container lacked a tight-fitting lid.”

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 #1's observation, in the bathroom used by classroom #5, there was a soiled diaper in the trashcan accessible to enrolled children.”

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 #2, the temperature in the refrigerator was at 54° F rather than 41° F or below as required.”

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 Officer #1's observation, in the Men's outdoor bathroom, there was peeling paint with exposed drywall on the right side of the sink.”

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

“Findings: Based on Compliance Officer #1's observation, in the outdoor activity area, there was a 16 x 3-inch gap located on the red surface with exposed foam.”

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 facility documentation and Compliance Officer #2's observation, it was determined that Staff #1 lacked a completed Criminal History Affidavit.”

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

“Findings: Based on Compliance Officer #2s observation, the 1st aid kit contained a stocked supply of medication (Burn cream and Triple Antibiotic packets).”