Phoenix Rescue Mission Changing Lives Center

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 Officer's observations, the following diaper changing areas were not maintained in a sanitizable condition: *Infant Room: The diapering sink lacked caulking where the surface meets the backsplash. *Infant, 1's, 2's, and 3' Room: The shield divider on the diapering surfaces lacked caulking.”

AAC R9-5-501.A.18. A. A licensee shall ensure that: 18. 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 the Compliance Officer's observations, in the School-Age restrooms, there was a plunger in the right restroom and a toilet brush in both the left and right restrooms.”

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 Officer's observations, the South wall in the 3's/4's room had multiple scuffs of peeling paint, exposing the drywall.”

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 Officer's observations, the diaper table in the Infant room lacked caulking along the backsplash.”

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 observations, in the 4's/5's restroom, the caulking between the sink and the wall was cracked, making the sink detached from the wall.”

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 the Compliance Officer's observations and a review of 4 staff files, the following staff files lacked documentation of freedom from infectious active tuberculosis before their date of employment: *Staff #1: DOE: 7/23/24 TB test read: 7/27/24 *Staff #2: DOE: 9/3/24, TB test in staff file lacked the date read by a health care provider”

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 Officer's observations, the following hazards were accessible to enrolled children: *4's/5's room: There was peeling paint towards the bottom of the entry/exit door. *3's room: There was peeling paint on the wall next to the handwashing sink.”

AAC R9-5-502.A.8.b. A. A licensee providing child care services for infants shall: 8. Provide a crib for each infant that: b. Has a commercially waterproofed mattress; and

“Findings: Based on the Compliance Officer's observations, 3 of 8 mattresses reviewed in the Infant room were ripped at the corners, making them no longer commercially waterproof.”

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 observations and facility documentation, in the Infant room, 5 of 6 feeding instructions reviewed were incomplete.”

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

“Findings: Based on the Compliance Officer and Deputy Bureau Chief's observations, in the School Age 5-7 classroom, the following facility furnishings were not maintained in a clean condition: *A yellow stool used for hand washing was covered in dirt and black smudges. *A pillow with brown smudges on it was located on a chair.”

AAC R9-5-502.A.5.b. A. A licensee providing child care services for infants shall:5. Develop, document, and implement tummy time policies and procedures that: b. Ensure a staff member who is supervising a non-crawling infant while the infant is flat on their stomach and on the floor: i. Is within reach of the infant; ii. Does not perform any other duties while supervising the infant; iii. Does not allow the use of pillows, comforters, sheepskins, stuffed toys, or other soft products in the same floor space as the infant; and iv. Does not allow any product specified in subsection (A)(5)(b)(iii) to be within reach of the infant;

“Findings: Based on the Compliance Officer and Deputy Bureau Chief's observations, in the Infant classroom, staff was not within reach of a non-crawling infant while they were flat on their stomach on the floor for tummy time.”

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 facility documentation and the Compliance Officer and Deputy Bureau Chief's observation, it was determined that 3 out of 15 reviewed sign in and out records lacked the following information: *Child #1: A release signature for 5/10/2024 and 5/24/2024. *Child #2 and Child #3: A release signature for 5/23/2024 and 5/29/2024.”

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 facility documentation and the Compliance Officer and Deputy Bureau Chief's observations, it was determined that the file for Staff #1 (date of employment 1/2/2024) lacked documentation that DPS was contacted for validation of the fingerprint clearance card.”

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 the Compliance Officer and Deputy Bureau Chief's observations, in the School Aged 8-12 classroom, 5 out of 5 nap mats lacked a sheet.”

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 and the Deputy Bureau Chief's observations, in the School Age 5-7 classroom, food waste from snack (grapes and boiled eggs) was stored in an uncovered container that lack a plastic bag. In the bathroom located near the School Age classrooms, the toilet was missing a bolt cover which exposed the screw, there was urine located at the bottom of the toilet around the bolt cover, and there was a plunger and a toilet bowl brush located to the left of the toilet.”

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 Officer and the Deputy Bureau Chief's observations, in the Preschool classroom, the diaper changing area was not kept clear of the following items not required for diaper changing: *A plastic toy cat *A charging cord”

AAC R9-5-305.A. A. A licensee shall not permit an enrolled child to attend a facility until the facility receives: 1. An immunization record for the enrolled child with the information required in 9 A.A.C. 6, Article 7, documenting that the enrolled child has received all current, age-appropriate immunizations required under 9 A.A.C. 6, Article 7: a. Provided by a healthcare provider, 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 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 health care provider, 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.

“Findings: Based on facility documentation and the Compliance Officer and Deputy Bureau Chief's observations, it was determined that the files for 5 out of 10 children reviewed lacked documentation of an immunization record.”

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 Officer and Deputy Bureau Chief's observations, in the Infant classroom, 3 crib sheets were loose and not tight-fitted to the mattress.”

AAC R9-5-502.C.3.a. C. A licensee shall ensure that: 3. When preparing, using, or caring for an infant's feeding bottles, a staff member: a. Labels each bottle received from the parent with the infant's name;

“Findings: Based on the Compliance Officer and the Deputy Bureau Chief's observations, in the Infant classroom, there were 4 bottles labeled with only the child's first name.”

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 the Compliance Officer and the Deputy Bureau Chief's observations, the following outdoor activity areas were not maintained free from hazards: *A ripped chair with foam exposed was propped up against a storage container accessible to enrolled children. *On the main play structure, the plastic had split and had exposed the rusty metal beneath it. *A cotton play tunnel was ripped on the edge with sharp plastic exposed.”

AAC R9-5-403.B. B. A licensee shall ensure that:1. Each staff member who provides child care services completes 18 or more actual hours of training every 12 months after the effective date of this Chapter or the staff member’s starting date of employment or volunteer service in at least two topics listed in this subsection: a. Child growth and development, including: i. Infant growth and development, which may include sudden infant death syndrome prevention; ii. Developmental psychology; iii. Language development; iv. Observation and child assessment; v. Developmentally-appropriate activities; vi. Child guidance and methods of discipline which may include training on the appropriate techniques to prevent a child from harm or to prevent the child from harming others; and vii. Developmentally-appropriate activity areas; b. Health and safety issues, including: i. Accident and emergency procedures, including CPR and first aid for infants and children; ii. Recognition of signs of illness and infestation; iii. Nutrition and developmentally-appropriate eating habits; iv. Child abuse detection, reporting, and prevention; v. Safety of indoor and outdoor activity areas; and vi. Sun safety policies and procedures; c. Program administration, planning, development, or management; and d. Availability of community services and resources, including those available to children with special needs; and 2. As part of the required 18 hours of training in subsection (B)(1): a. A staff member who has less than 12 months of child care experience before the staff member’s starting date, completes at least 12 hours in one or more of the topics in subsection (B)(1)(a) in the staff member’s first 12 months at the facility; b. A staff member who has 12 months or more of child care experience, completes at least 6 hours in one or more of the topics in subsection (B)(1)(a) every 12 months after the staff member’s starting date; c. A staff member who provides child care services to an infant completes at least 6 hours in subsection (B)(1)(a)(i) every 12 months after the staff member’s starting date; and d. A facility director completes at least 6 hours in subsection (B)(1)(c) every 12 months after the facility director’s starting date.

“Findings: Based on facility documentation and the Compliance officer and Deputy Bureau Chief's observations, it was determined that 1 out of 5 staff files reviewed lacked the required training requirements: *Staff #2: An additional 18 hours of annual training for the time period of 11/15/2022-11/15/2023.”

AAC R9-5-501.A.13. A. A licensee shall ensure that:13. Toys and play equipment, required in this Article, are maintained: a. Free from hazards, and b. In a condition that allows the toy or play equipment to be used for the original purpose of the toy or play equipment;

“Findings: Based on the Compliance Officer and the Deputy Bureau Chief's observations, the following activity areas were not maintained free of hazards: *Preschool classroom: A 1 inch by 1.5 inch hole, which was .5 inches deep, was located on the wall above the red chair. *School Age 8-12 classroom: A laminator was on the counter accessible to children, a torn pillow with black smudges was located on a chair, and there were exposed wires and an extension cord on the floor accessible to children under the keyboard piano. *School Age 5-7 classroom: A corner cubby was not anchored down and was wobbly when touched.”