Primrose Of West Gilbert

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 the Compliance Officers' observations, the ratio in the Preschool 2 classroom was 2:17 instead of 3:17, with two-year-old children present.”

AAC R9-5-510.A.1. A. A staff member shall provide guidance to help children respond to difficult situations. To develop self-regulation, children should receive adult support that is individual to the child and adapts as the child develops internal controls. This process should include: 1. Forming a positive relationship with the child, which occurs when the adult spends time talking to the child, listening to the child, following the child’s lead, playing with the child, and responding to the child’s needs; 2. Base expectations on the child’s developmental level; 3. Establishing and being proactive in teaching and supporting children in learning simple rules; 4. Modifying the learning/play environment to support the child’s appropriate behavior; 5. Creating a predictable daily routine and schedule; 6. Modeling desired behavior; 7. Showing children positive alternatives; 8.Using deliberate redirection, the staff member should encourage the child to use appropriate behavior, and provide positive feedback when the child exhibits the behavior; 9. Individualized positive discipline strategies based on the individual needs of children, such as using a buddy system, individualized schedule, special break, or another applicable positive discipline strategy; and 10. If applicable, a licensee shall develop a written plan with the enrolled child's parent to provide individualized social and emotional intervention supports for the enrolled child that includes methods for understanding the enrolled child's behavior, and developing, adopting, and implementing a team-based positive behavior support plan.

“Findings: Based on the staff statements and the Compliance Officers' observations, it was determined that staff failed to model desired behavior. Staff Stated: "(Staff Name) was observed yelling a few times". "(Staff Name) was short-tempered; you could tell when they were done." "We had a specific teacher yelling"”

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 rooms had personal items that lacked the required labeling: *Toddler 1: 7 out of 10 wipes lacked the enrolled child's last name. *Pathways: 3 out of 5 wipes lacked the enrolled child's last name.”

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 the Pathways and Toddler 2 rooms, there were eight cots with sheets stacked next to the diaper changing table and the hand-washing sink. *Previously cited on 02/12/2024 and 02/04/2025”

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, the following rooms had water temperatures that were not in the required range: *Toddler 1 - 121° F *Toddler 2 - 115° F”

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, Child #1's medication was not in the original container dispensed by a pharmacy.”

AAC R9-5-603.B. B. 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 Officers' observations, on the Pre-K and Preschool playground, there was rust and chipped paint on the fencing accessible to children.”

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 the Compliance Officers' observation, in Infant Room 2, the designated exit was blocked with an adult rocking chair.”

AAC R9-5-208.D. D. If requesting a diaper changing area outside an infant room or indoor activity area to allow privacy for diapering an enrolled child with a special health care need or a disability, submit a written request for an approval; and 1. For a license application, submit physical plant documents required by R9-5-201(A)(5)(h) that designate the location of the proposed diaper changing area; 2. For a licensed facility, submit a drawing of the proposed diaper changing area to the Department before installing the diaper changing area. Within 30 calendar days after the date of the receipt of the request, the Department shall send written notice to the licensee of approval or disapproval. If the proposed diaper changing area: a. Complies with A.R.S. Title 36, Chapter 7.1, Article 1 and this Chapter and provides privacy for the enrolled child with a special health care need or a disability, the Department shall approve the proposed diaper changing area; or b. Does not comply with A.R.S. Title 36, Chapter 7.1, Article 1 or this Chapter or provide privacy for the enrolled child with a special health care need or a disability, the Department shall provide the licensee with the requirements necessary for the Department to approve the requested change; and 3. Not use a diaper changing area located outside of an activity area until the Department approves the use of the diaper changing area;

“Findings: Based on the Compliance Officer's observation, in Preschool 1 (Rm 4), the facility had made changes to the diaper changing area without approval from the Department.”

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 observation, it was determined that 5 out of 25 enrolled children's Emergency, Information, and Immunization Records reviewed lacked the following required information: Child #1: The date of enrollment Child #2: The date of enrollment, the name and contact telephone number of the child's healthcare provider, and the name of the individual to be contacted in case of injury or sudden illness of the child. Child #3 and Child #4: Written instructions of a 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. Child #5: The name and contact telephone number of a 2nd individual 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. ***Previously Cited: 02/04/2025”

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 facility documentation and the Compliance Officer's observation, the Licensee lacked documentation of a current violation-free fire inspection report as required.”

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 Officer's observation, it was determined that Staff #2 (DOE-01/26/26) and Staff #7 (DOE-9/17/25) were acting as Assistant Child Educators. Staff #2 and Staff #7 were not qualified as Assistant Child Educators because the staff files lacked documentation of a high school diploma or high school equivalency. ***Previously Cited 02/04/2025 and 02/13/2023”

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, the health, safety, and welfare of enrolled children were placed at risk of harm. In the 2/3's Classroom, 2 enrolled children were sleeping with blankets covering their heads. ***Previously Cited 01/29/2025”

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 observation, in the following classrooms, enrolled children's personal products lacked the required label: Pathways (Rm 5) *There was 1 wipe that lacked the enrolled child's first and last name. *There were 2 wipes that lacked the enrolled child's last name. *There was 1 diaper cream that lacked the enrolled child's last name. Preschool (Rm 4) *There were 2 wipes that lacked the enrolled child's last name. *There was 1 diaper cream that lacked the enrolled child's first and last name. Toddler 2 *There was 1 diaper cream that lacked the enrolled child's last name. *There was 1 diaper cream that lacked the enrolled child's first and last name. Infant 1 *There were 3 wipes that lacked the enrolled child's last name. Infant 2 *There were 3 wipes that lacked the enrolled child's last name. EPS 1 *There was 1 wipe that lacked the enrolled child's last name. *There were 3 diaper creams and 1 wipe that lacked the enrolled child's first and last name. EPS 2 *There were 3 wipes that lacked the enrolled child's last name. *There was 1 wipe that lacked the enrolled child's first and last name. ***Previously Cited 2/12/2024 and 02/04/2025”

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 the facility documentation and the Compliance Officer's observation, it was determined that the Licensee lacked tummy time documentation as required.”

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 observation, in the Infant 1 and the Kitchen, the Infant feeding instructions lacked the following: Child #7: Lacked the amount in ounces of milk to be fed to the infant. Child #8 and Child #9: Lacked the feeding schedule for the infants.”

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's observation, in the Infant 2 classroom, there was 1 container of food and 3 bottles that lacked the enrolled child's last name as required.”

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 observation, the surface of the diaper changing table in the following areas was not kept clear of items not required for diaper changing: EPS 2 *There was a green dry-erase marker next to the sink in the diaper changing area. Toddler 1 *There were 2 cots with sheets stacked next to the diaper changing area. Toddler 2 *There were 3 wooden chairs, a cloth floor seat, and a sweeper next to the diaper changing area. ***Previously Cited 02/12/2024 and 02/04/2025”

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 following classrooms, the temperature of the diaper changing sink was: Infant 2 *The diaper changing sink was 82° F. rather than 86° F to 110° F. as required. Toddler 1 and Preschool 1 *The diaper changing sink was 112° F. rather than 86° F to 110° F. as required. Toddler 2 *The diaper changing sink was 117° F. rather than 86° F to 110° F. as required. Pathways *The diaper changing sink was 118° F. rather than 86° F to 110° F. as required”

AAC R9-5-512.C. C. A licensee shall ensure that floor coverings are: 1. Clean; and 2. Free from: a. Dampness, b. Odors, and c. Hazards.

“Findings: Based on the Compliance Officer's observation, in the Pathways Classroom, there was a Laundry basket filled with clothes and bibs in the bathroom next to the sink. In Classroom 10’s toilet rooms, there were paper towels on the floor of the girls and toilet paper on the floor of the boys. ***Previously cited 02/12/2024”

AAC R9-5-512.F.1. 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;

“Findings: Based on the Compliance Officer’s observation, in Classrooms 8, 9 and 10, the toilet rooms lacked paper towels in a mounted dispenser.”

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 facility documentation and the Compliance Officer’s observation, in the Preschool 1 Classroom, the medication form for Child #6 lacked end dates and side effects for both medications for the child.”

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 facility documentation and the Compliance Officer’s observation, it was determined that the facility maintained a medication for Child #6 in a container not prepackaged or labeled for use by the manufacturer.”

AAC R9-5-603.B. B. 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’s observations, in the Outdoor Activity areas the following hazards were observed: Preschool Playground: *There was actively chipping paint exposing rust colored disintegrating sharp metal pieces on the base of the north fence panels. *There was a red bench with exposed sharp holes at the back and areas on the corner lacking rubber exposing sharp plastic and rust colored metal. Pathways Playground: *There were 3 fence panels with chipping paint exposing disintegrating sharp metal pieces on the base.”

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 the Compliance Officer’s observations, in the Toddler 2 Classroom, there was an enrolled child on a cot blocking the designated exit door. In the Infant 2, the designated exit door was blocked by an adult rocking chair. In the Pathways Classroom, the designated exit door was blocked by a round child size table and vinyl and wooden chair.”

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 Officer's observation, the files for Staff #1(DOE-12/19/25), Staff #2 (DOE-01/26/26), Staff #3 (DOE-01/06/26), Staff #4 (DOE-07/07/25), Staff #5 (DOE-07/08/25), and Staff #6 (DOE-02/26/25) lacked documentation of a submitted DCS Registry background check before start date of employement.”

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 observations, the following rooms lacked labels on personal products; Pathways *There were 4 wipes that lacked the enrolled child's last name. *There was 1 diaper cream that lacked the enrolled child's first and last name. Early Preschool 1 *There were 5 wipes that lacked the enrolled child's last name. *There were 2 diaper creams that lacked the enrolled child's last name. Toddler 2 *There were 4 wipes that lacked the enrolled child's last name. *There were 3 diaper creams that lacked the enrolled child's last name. Early Preschool 3 *There were 4 wipes that lacked the enrolled child's last name. *There were 2 wipes that lacked the enrolled child's first and last name. Early Preschool 2 *There were 4 wipes that lacked the enrolled child's last name. *There were 2 wipes that lacked the enrolled child's first and last name. *There was 1 diaper cream that lacked the enrolled child's first and last name. Infant 2 *There were 3 wipes that lacked the enrolled child's last name. Infant 1 *There were 4 wipes that lacked the enrolled child's last name. Toddler 1 *There were 8 wipes that lacked the enrolled child's last name. *There were 3 diaper creams that lacked the enrolled child's last name.”

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 Officer #2’s observation, it was determined that Staff #2 and Staff #7 were assistant teacher-caregivers. Staff #1 and Staff #2 were not qualified as assistant teacher-caregivers because the staff file lacked documentation of enrollment in high school or high school equivalency class, high school or equivalent diploma, previous child care employment or volunteer service for 12 months.”

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 #1’s observation, it was determined that the roster in Preschool 2 Classroom did not reflect the number of children present (9 children present, 16 children listed on the roster).”

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 Compliance Officer #1's observations, the following feeding instructions lacked information; Infant 2 Child #1: lacked the times and amount of food to be fed. Child #2 lacked the amount of food to be fed.”

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 #2’s observation, it was determined that 15 out of 48 enrolled children's attendance forms lacked the following information: Child #2, Child #15, Child #16, Child #17, Child #18, Child #19, Child #20, Child #21, Child #22, Child #24, Child #25, Child #26 and Child #27 : An admission signature (initials only) 01/29/2025. Child #3 and Child #23: An admission signature 01/29/2025.”

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 Officer #2’s observation, it was determined that 14 out of 30 enrolled children's Emergency, Information, and Immunization Record cards reviewed lacked the following required information: Child #1,Child #2 and Child #8: A parent or guardian signature on the back of the card. Child #3 and Child #4: The child's city, state, and zip code. Child #5: The child's city, state, and zip code and the city, state, and zip code of parent/guardian #1. Child #6 and Child #7: The date of enrollment for the child. Child #8: The contact telephone number for the child. Child #9: The state for the child and the state for parent/guardian #1. Child #10: A written record completed by the child's parent or health care provider noting the child's physical condition of which a staff member should be aware. Child #11: The name and contact telephone number of the child's health care provider. Child #12: The name of the individual to be contacted in case of injury or sudden illness of the child. Child #13:The date of birth for the child. Child #14: The child's state, the name of the individual to be contacted in case of injury or sudden illness of the child and the written instructions of a child's parent or health care provider for nutritional and dietary needs of the child including susceptibility to illness and physical conditions, the parent or guardians signature on the back of the card.”

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 Compliance Officer #2’s observation, it was determined that the Mantoux skin tests for Staff #1(DOE-11/7/24, TB Completed 2/1/25), Staff #5 (DOE-8/23/24, TB Completed 9/1/24), Staff #6 (DOE-7/15/24, TB Completed 7/31/24) were not administered on or before the starting date of employment.”

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 #1's observations, the following diaper-changing areas and surfaces were not kept clear of items: Toddler 1 and Toddler 2 *There was a cardboard box of gloves on top of the diaper changing area. Early Preschool 3 *There was a magic eraser, tissue, and orange paint in the sink of the diaper changing area. Early Preschool 2 *There was a plastic container with orange rags, tissues, gloves, and wipes on the diaper changing area. *There was a plastic container labeled soap and pink paint in the diaper changing sink area.”

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 facility documentation and Compliance Officer #2’s observation, the medication for Child #29 lacked the container dispensed by a pharmacy.”

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 facility documentation and Compliance Officer #2’s observation, the following medication forms were incomplete: Child #28: lacked documentation of the start and end dates, route, reason, parent/guardian signature, and authorization date. Child #29: lacked documentation of the start and end dates, route, prescription number, and reason for the medication.”

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 #1’s observation, in the Early Preschool 1 Classroom, the temperature of the diaper changing sink was 78° F. rather than 86° F to 110° F. as required.”

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 Preschool 3, the soiled clothes container lacked a liner as required.”

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 Toddler 2 Classroom, the diaper changing bin was next to the diaper changing sink accessible to enrolled children.”

AAC R9-5-509.C.18. C. A licensee shall ensure that:18. A staff member: a. Prepares a weekly menu at least one week in advance, b. Includes on the menu the specific foods to be served on each day, c. Dates each menu, d. Posts each menu at least one day before the first meal on the menu will be served, and e. Writes food substitutions on a posted menu no later than the morning of the day of meal service;

“Findings: Based on facility documentation and Compliance Officer #2's observations, the posted menu documented fruit, mixed veggies, and fruit cocktail but lacked the specific type of fruit, mixed veggies, and fruit cocktail to be served to the enrolled children.”

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 Compliance Officer #1’s observation, the following areas were not maintained in a clean condition; Toddler 2 Classroom *The dark brown carpets had a build-up of spots and debris. Preschool 2 Classroom *There was color square carpet that had a build-up of dark gray spots. Early Preschool 1 Classroom *There was a large carpet that had a build-up of dark gray and light-colored spots. Early Preschool 2 Classroom *There was a large carpet that had a build-up of dark gray and light-colored spots. Early Preschool 3 Classroom *There was a large carpet that had a build-up of dark gray and light-colored spots. Pathways Classroom *There was a large carpet that had a build-up of dark gray and light-colored spots. PreK Toilet Room *There were 48 rolls of toilet paper, 5 rolls of paper towels, 1 cardboard box of soap and 1 cardboard box of plastic liners on a shelf above the toilet.”

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 Pathways toilet rooms, the first toilet had a loose-to-the-touch toilet seat and the second toilet had a 3-inch chip out of the lid causing a rough sharp edge.”

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 the files for Staff #1 (DOE-11/07/2024, Signed 11/21/2024) and Staff #2 (DOE-10/17/2024, Signed 12/11/2024) lacked documentation of the Criminal History Affidavit signed before start date of employment.”

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 Compliance Officer #2’s observation, it was determined that the file for Staff #10 (DOE-07/8/24, Rec'vd 07/15/2024) lacked documentation of a valid fingerprint clearance card prior to date of employment.”

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 facility documentation and Compliance Officer #2’s observation, Staff #9 (DOE-2/28/2024)10-day training for new staff members lacked the director's signature and date.”

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 Compliance Officer #2’s observation, it was determined that 3 out of 12 staff files reviewed lacked the required training documentation: Staff #3: An additional 18 hours of annual training for the time period of 2/22/2023-2/22/2024. Staff #4: An additional 18 hours of annual training for the time period of 2/7/2023-2/7/2024. Staff #8: An additional 18 hours of annual training for the time period of 12/6/2023-12/6/2024.”

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 Compliance Officer #1’s observations, the following hazards were accessible to enrolled children: Preschool 3 *There was a red vinyl chair and red vinyl that were peeling, exposing foam. *There was a road carpet, that had 4 feet of frayed edge. Early Preschool 3 *There was a red vinyl chair and red vinyl that were peeling, exposing foam. Preschool 2 *There was a red vinyl chair that was peeling, exposing foam. Early Preschool 2 *There was a red vinyl couch that was peeling, exposing foam.”

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 Compliance Officer #2’s observation, it was determined that the Mantoux skin test for Staff #1 was not administered on or before the starting date of employment (DOE- 11/07/2024, no test to review).”

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: Per allegation and based on staff statements and the Compliance Officers’ observations, the health, safety, and welfare of enrolled children was placed at risk of harm when an enrolled child had access to a prescription medication when the enrolled child found a white package labeled Clonazepam Orally Disintegrating Tablet, USP 2mg on the playground. Staff Stated: *The next day the facility was informed of what the Emergency Room documented about the child taking a pill. *The child stated to staff, I found a white candy, it was a circle but I already ate it. *The staff had not gone out before the children, to perform a check of the playground. *There were 3 staff on the playground, none of them saw the child in the area. *Staff did not see the child grab anything. *Kids sometimes grab through the fence.”

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 Officer #1's observations, the ratio in Pathways was 2:19 instead of 3:19 as required with a 2-year-old child present.”

AAC R9-5-301.H. H. A licensee shall prohibit the use or possession of the following items when an enrolled child is on facility premises, during hours of operation, or in any motor vehicle used for transporting an enrolled child:1. Any beverage containing alcohol; 2. A controlled substance as listed in A.R.S. Title 36, Chapter 27, Article 2, except where used as a prescription medication in the manner prescribed; 3. A dangerous drug as defined in A.R.S. § 13-3401, except where used as a prescription medication in the manner prescribed; 4. A prescription medication as defined in A.R.S. § 32-1901, except where used in the manner prescribed; or 5. A firearm as defined in A.R.S. § 13-105.

“Findings: Per allegation and based on staff statements and the Compliance Officers’ observations, an enrolled child had access to a prescription medication when the child found a white package labeled Clonazepam Orally Disintegrating Tablet, USP 2mg on the playground. Staff Stated: *The next day the facility was informed of what the Emergency Room documented about the child taking a pill. *The child stated to staff, I found a white candy, it was a circle but I already ate it. *The wrapper stated Clonazepam. Staff has a photo of the wrapper. *The wrapper was 10-15 feet away from where the child showed staff they found the wrapper. *The staff had not gone out before the children, to perform a check of the playground. *There were 3 staff on the playground, none of them saw the child in the area. *Staff did not see the child grab anything. *Kids sometimes grab through the fence.”

AAC R9-5-501.C.1. C. A licensee shall ensure that a staff member: 1. Supervises each enrolled child at all times;

“Findings: Per allegation and based on staff statements and the Compliance Officers’ observations, an enrolled child was unsupervised when the enrolled child found a white package labeled Clonazepam Orally Disintegrating Tablet, USP 2mg on the playground and ingested the contents. Staff Stated: *There were 3 staff on the playground, none of them saw the child in the area. *Staff did not see the child grab anything. *Staff did not see where the child was.”

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 Officer #2’s observation, in Preschool 2 Classroom, a child sleeping on a cot was blocking a designated exit that provides escape from the building.”

AAC R9-5-502.C.4.g. C. A licensee shall ensure that: 4. When feeding an infant, a staff member: g. Holds and feeds an infant under 6 months of age and an infant older than 6 months of age who cannot hold a bottle for feeding; and

“Findings: Based on Compliance Officer #1’s observation, in Infant 1 Classroom, there was an infant seated in a bouncer with a blanket being used to propped their bottle rather than being held by a staff member.”

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 Compliance Officer #1’s observation, in Infant 1 Classroom, one enrolled infant was asleep in the bouncy seat located on the floor rather than in a crib as required.”

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 Compliance Officer #1's observation, in Infant 1 Classroom, there were 2 unlabeled bottles of white liquid.”

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 observations, in the Infant 1 classroom, Child #5 lacked written dietary instructions. In the Infant 2 classroom, Child #6 and Child #7 lacked the amounts in ounces for bottles on the written dietary instructions.”

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 facility documentation, staff statements, and Compliance Officer #1's observation, in the Infant 1 classroom, it was determined that tummy time lacked documentation. Staff Stated: *"No we do not document tummy time."”

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 the Infant 1 classroom, there was 1 diaper cream that lacked the enrolled child's first and last name, 3 wipes that lacked the enrolled child's first and last name and 2 wipes that lacked the enrolled child's last name. In the Infant 2 classroom, there was 1 diaper cream that lacked the enrolled child's first and last name, 2 diaper creams that lacked the enrolled child's last name and 2 wipes that lacked the enrolled child's first and last name. In EPS 2 classroom, there were 3 diaper creams that lacked the enrolled child's first and last name. In EPS 1 classroom there was 1 diaper cream that lacked the enrolled child's first and last name and 4 that lacked the enrolled child's last name. In the Toddler 2 classroom, there were 4 diaper creams and 2 wipes that lacked the enrolled child's last name. In the Toddler 1 classroom, there were 2 wipes and 2 diaper creams that lacked the enrolled child's last name and 2 diaper creams that lacked the enrolled child's first and last name. In the Preschool classroom, there was 1 diaper cream that lacked the enrolled child's first and last name, and 1 wipe that lacked the enrolled child's last name.”

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 observations, it was determined that all facility classrooms lacked documentation of a lesson plan. The lesson plans were dated for the week of Feb 5-9th 2024.”

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 Compliance Officer #1’s observation, in the Pathways toilet room, there was a plunger in the bathroom accessible to enrolled children.”

AAC R9-5-501.A.14. A. A licensee shall ensure that: 14. Temperatures are maintained between 68° F and 82° F in each room used by enrolled children;

“Findings: Based on the Compliance Officers' observations, in the Infants, Toddlers, Preschool, Pathways and EPS classrooms, the temperature in the rooms was not maintained between 68° F to 82° F. as required. *Infant 1 read 58° F at 8:45 am *Infant 2 read 59° F at 8:48 am *Toddler 1 read 60.8° F at 9:11 am *Toddler 2 read 60° F at 9:26 am *Preschool read 57° F at 9:38 am *Pathways read 57° F at 10:00 am *EPS 1 read 63° F at 10:16 am *EPS 2 read 64° F at 10:25 am”

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 #1’s observations, the following hazards were accessible to enrolled children: EPS 2 *There were dents on the west wall exposing sharp metal edges. *There was broken plastic with sharp edges on the window panes. EPS 1 *There was 2 .5-1-inch indents in the east wall exposing drywall. *There was a .5-inch indent with shape metal edges on east wall. Pathways *There was broken plastic with sharp edges on the window panes. Toddler 1 *There was a .5-inch hole in exposing drywall near the dramatic play kitchen *There was a 1-inch by 2-inch area with exposed drywall behind the sink and paper towels Toddler 2 *There were 3 .5-inch holes in the west wall exposing drywall. *There were 5 1-inch to 2-inch tears in the wall exposing drywall. Preschool 1 *The caulking in the corner of the wall near the circle time carpet was peeling exposing metal. Preschool 2 *There was a 1-inch and 2-inch hole on the south wall exposing drywall. *There was a 1-inch hole on the north wall exposing drywall.”

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 Officer #1's observation, the ratio in the Pre-K Classroom was 1:17 instead of 2:17 as required for 4-year-old 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 #1’s observation, it was determined that the roster in the Pre-K classroom did not reflect the number of children present (17 children present, 15 children listed on the roster).”

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 Compliance Officer #2’s observations, it was determined that 4 out of 15 enrolled children's attendance forms lacked the following information: Child #1: A release signature for 02/09/2024. Child #2: A release signature for 02/09/2024. Child #3: An admission signature for 02/07/2024. Child #4: An admission signature for 02/06/2024.”

AAC R9-5-303.B. B. A licensee shall ensure that the licensed capacity of each indoor activity area or room is posted in that activity area or room.

“Findings: Based on Compliance Officer #1's observation, Preschool 1 lacked an accurate posted capacity.”

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 Compliance Officer #2’s observations, it was determined that the Mantoux skin test for Staff #2 was not administered on or before the starting date of employment (DOE-01/18/2024, date of TB test- 01/22/2024). Staff #3 lacked documentation of the Mantoux skin test (DOE-06/26/2023).”

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 facility documentation and Compliance Officer #1's observation, the file for Staff #1 lacked documentation of a valid fingerprint clearance card. The fingerprint clearance card expired on 11/20/23, the application was received at DPS on 01/31/2024 and a new card was issued on 02/05/2024. Staff #1 worked from 11/20/23-02/05/2024 without a valid card.”

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 facility documentation and Compliance Officer #2’s observations, it was determined that the file for Staff #1 lacked documentation of the Criminal History Affidavit and the files for Staff #1 and Staff #2 lacked documentation and submission of the DCS Registry.”

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 observations, in the Infants' classroom, the water temperature in the diaper changing sink was 78 degrees F, rather than between 86-110 degrees F as required. In the EPS 1 classroom, the water temperature in the diaper changing sink was 79 degrees F, rather than between 86-110 F as required.”

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 Officer #1's observation, in Toddler 2 classroom, a door lever lock blocked a designated exit that provides escape to the outside of the building.”

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 observations, the following hazards were accessible to enrolled children in the outdoor activity area: 4's Playground: *There was rust, paint, and metal chipping off the white wrought iron fence and areas of large openings with sharp edges. *The cement fence had a 6-foot crack separating the cement 1 to 2 inches. *There were 4 flat cement slabs loose on the top of the fence. 3's Playground/Courts: *There was foam exposed on a vinyl ball. *There was rust, paint, and metal chipping off the white wrought iron fence and areas of large openings with sharp edges. *There was standing water on the cement area next to the wrought iron fencing. Two's Playground: *There was rust, paint, and metal chipping off the white wrought iron fence. *The plastic tree house had exposed screws with rough broken plastic pieces on the ladybug.”

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 facility documentation and Compliance Officer #2’s observation, Child #8's medication form lacked a prescription number.”

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 observations, the following toilet rooms had hazards: Pre-K: *The girl's toilet seat was loose to the touch. *The boy's toilet seat was loose to the touch. Preschool 2: *There was a 2-inch hole in the wall behind the toilet. *The toilet seat was loose to the touch. Preschool 1: *The toilet seat was loose to the touch. Pathways: *The sinks next to the toilet rooms were loose and detaching from the wall. EPS 2: *The sink outside the toilet room lacked caulking in the corner next to the bathroom door.”

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 Compliance Officer #1's observations, the following toilet rooms were not maintained in a clean condition: EPS 1: *There was a liquid substance on the floor near the drain. Preschool 1: *There was a yellow substance in the toilet bowl. Preschool 2: *There was a yellow substance at the base of the pipe connected to the toilet bowl.”

AAC R9-5-512.C. C. A licensee shall ensure that floor coverings are:1. Clean; and 2. Free from: a. Dampness, b. Odors, and c. Hazards.

“Findings: Based on Compliance Officer #1's observations, in the following activity areas, the floor was not maintained: Toddler 2: *There was a 6-inch x 3-inch white crusted substance on the carpet. Preschool 1: *There was a 4-inch x 2-inch gauge in the tile exposing raw wood and sharp edges.”

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 Compliance Officer #1's observation, in the Pre-K classroom, there was vinyl peeling on the couch and chair leaving exposed foam accessible to enrolled 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 #1's observations, in the Infant 1 and Toddler 2 classrooms, the diaper changing container was next to the diaper changing area accessible to enrolled children.”

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 observations, the Preschool classroom lacked a waterproof, sanitizable container with a waterproof liner and a tight fighting lid for soiled clothing. In the Toddler 1 classroom, the soiled clothing container lacked a 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 Compliance Officer #1's observations, in the Toddler 1 classroom, there were gloves on the counter, and cots next to the diaper changing table. In the Toddler 2 classroom, there was a toy banana, pear, 2 watermelons tomato, and peach in the diaper changing sink, gloves on the counter and cots and a laundry basket next to the diaper changing table. In the Preschool 3 classroom, there were cots next to the diaper changing table. In EPS 1 classroom, there were cots next to the diaper changing table.”