Pequenas Manitas/ Luisa F. Grijalva

AAC R9-3-403.A.3.b. A. A certificate holder shall ensure that: 3. When feeding an enrolled infant, a staff member: b. Feeds formula, breast milk, or other food to the enrolled infant according to current written instructions from the enrolled infant’s parent; and

“FINDINGS: Based on the Compliance Officer’s observations, review of documentation, and provider’s statement, it was determined that the feeding written instructions for Child 1 were not obtained from the parent or guardian.”

AAC R9-3-302.A. A. Within 10 calendar days after the starting date of employment or volunteer service, a certificate holder shall provide, and each staff member shall complete, training for new staff members that includes all of the following: 1. Names, ages, and developmental stages of enrolled children; 2. Health needs, nutritional requirements, any known allergies, and information about adaptive devices of enrolled children; 3. Guiding and disciplining children; 4. Hand washing techniques; 5. Diapering techniques and toileting, if any enrolled children are in diapers or require assistance in using the toilet; 6. Sudden infant death syndrome awareness, if child care services are provided to an infant or a one year-old child; 7. Preparing, serving, and storing food; 8. Preparing, handling, and storing infant formula and breast milk, if any enrolled children are fed infant formula or breast milk; 9. Recognizing signs of illness and infestation; 10. Detecting, preventing, and reporting child abuse or neglect; 11. Responding to accidents and emergencies; 12. Sun safety; 13. Procedures for trips away from the child care group home, if applicable; and 14. Staff responsibilities as required by A.R.S. Title 36, Chapter 7.1, Article 4 and this Chapter.

“Based on review of two staff files the Compliance Officers noted that neither Staff 1 or Staff 2 had completed the New Staff Training document as required. The training documents were signed and dated, but there was no indication that the training items on the form were completed.”

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.

“Based on review of Emergency, Information and Immunization Record (EIIR) cards the Compliance Officers noted the following: -Child 1 and Child 2's cards did not document the name and contact telephone number of each child’s physician, the cards said "N/A".”

AAC R9-3-304.A.2. 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: 2. An exemption affidavit for the enrolled child provided by the enrolled child’s parent that contains: a. A statement, signed by the enrolled child’s physician, physician assistant, or registered nurse practitioner, that the immunizations required by 9 A.A.C. 6, Article 7 would endanger the enrolled child’s health or medical condition; or b. A statement, signed by the enrolled child’s parent, that the enrolled child is being raised in a religion whose teachings are in opposition to immunization.

“Based on review of Emergency, Information and Immunization Record (EIIR) cards the Compliance Officers noted that Child 1 and Child 2 did not have immunization records or an immunization exemption affidavit as required.”

AAC R9-3-403.A.1.d. A certificate holder shall ensure that: 1. A staff member: d. Checks the diaper of each enrolled infant or one- or two-year-old child throughout the day and changes a diaper as soon as it is wet or soiled;

“THE FOLLOWING WAS SUBSTANTIATED Based on staff interviews, as well as diaper log documents, it was determined that Child 1 did not receive a diaper change while at the small group home on 03/07/2025. Child 1 was present from 11:45 AM to 5:00 PM.”

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.

“Based on review of March 2025 menus, as well as staff statements, the Compliance Officers noted that food substitutions were not being consistently documented as required.”

AAC R9-3-407.A.12. A. A certificate holder shall ensure that: 12. The food served to an enrolled child is consistent with a modified diet prescribed for the child by the child’s parent, physician, physician assistant, or registered nurse, as specified in R9-3-303(B)(8), and is written and posted in the kitchen;

“The Compliance Officers noted that Child 1 and Child 2's modified diets were not posted in the kitchen as required.”

AAC R9-3-301.N. When the premises of a child care group home are left unoccupied during hours of operation or the child care group home is temporarily closed due to an unexpected event, a certificate holder shall ensure that a staff member notifies the Department before leaving the child care group home unoccupied or closing the child care group home, stating the period of time during which the child care group home will be unoccupied or closed.

“The Provider did not inform the Department that the Small Group Home would be unoccupied on August 21, 2024. Compliance Officers arrived to conduct a Mid-Year inspection at 11:11 AM on 08/21/24, but there was no answer at the front door of the home. Compliance Officer 1 also attempted to call the Provider twice via phone while onsite, but was unsuccessful reaching her. The Compliance Officers left a business card in the door frame and left the property at 11:15 AM. The Provider emailed Compliance Officer 1 at 2:39 PM that same day to explain that no children were scheduled for the day, so the Provider had gone to the grocery store.”