Primrose School at Palm Valley

AAC R9-5-512.F.8.9. F. A licensee shall ensure that: 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 Officers' observations, the Restroom in Explorer's room was in an inoperable condition; there was an out-of-order sign on the restroom door.”

AAC R9-5-503.E.2. E. A licensee shall ensure that in an activity area with a diaper changing area: 2. A staff member: a. Documents each diaper change with the date and time, for an: i. Infant, in the infant’s dated, daily, documentation required in R9-5-502(C)(1)(d); or ii. Enrolled child who is not an infant, in a dated diaper changing log; b. Maintains the diaper changing log on facility premises for 12 months after the date of the diaper changing log; c. Empties clothing soiled with feces into a flush toilet without rinsing; d. Places an enrolled child’s clothing soiled by feces or urine in a plastic bag labeled with the enrolled child’s name, stores the clothing in a container used for this purpose, and sends the clothing home with the enrolled child’s parent; and e. Removes disposable diapers and disposable training pants from a diaper changing area as needed or at least twice every 24 hours to a waste receptacle outside the facility building.

“Per allegation findings: Based on staff statements, the soiled diaper containers are not emptied as often as needed. Staff stated the following: *The diapers need to be squeezed in sometimes. *Before the end of the day, the trash for diapering is full; I just throw the peed diapers in the food trash. *[Rooms] have smaller Diaper Genies and get full pretty fast when they combine classes in the afternoon; if it overflows, I'll throw them in a regular trash can, but they get bagged. *They get overfilled; you can't put any more diapers in. I double bag it and put the diapers at the bottom of the regular trash.”

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;

“Per allegation findings: Based on the Compliance Officers' observations, the water temperature in all the diaper-changing sinks was not maintained between 86 and 110 degrees; the water temperature observed was 81 degrees. Staff stated the following: *Takes forever to get hot; you have to let [the water] run for minutes [it gets] a little warm only. *The water is not hot enough to shower in. *Water doesn't get hot; it's warm.”

AAC R9-5-515.A. A. A licensee shall not permit an enrolled child to remain at the facility if a staff member determines that the enrolled child shows signs of illness or infestation.

“Per allegation findings: Based on staff statements, children who are showing signs of illness are allowed to remain in the facility. Staff stated the following: *When they [children] get sick, they don't always send them home. They get sent home after three blowouts. I have seen sick kids stay at the center. *Children who are sick do not get sent home all the time; it depends who you talk to. I had sick kids; I asked them to call the parents they said no. When I talk to parents at the end of the day, they say they never got called.”

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

“Per allegation findings: Based on staff statements, ratios were not maintained at all times. Staff stated the following: *One or two months ago, it was off on ratios; They even changed the ages in the system for ratios. It happened in the mornings, 8:30 to 10. A lot of shuffling because of short staffing. *We are not over ratio for too long, though; it is a big problem in the preschool. They overenrolled; the last time I was out of ratio was right before summer, after [department's] last visit. The walkies don't work; they gave me one that they know is broken. *Ratio is an issue every single room every day, depends on how many staff we have.”

AAC R9-5-501.A.12. A. A licensee shall ensure that: 12. The facility premises, including the buildings, are maintained free from hazards;

“Per allegation findings: Based on the Compliance Officers' observations, there were bird droppings along the Infants, Toddlers, and Preschool playground fence accessible to the enrolled children. Children were playing in an area where the droppings were observed. Staff stated the following: *I've seen it a few times near the edges in the uncovered areas [playground]. *Bird droppings only on the sidewalk and fences.”

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

“Per allegation findings: Based on the Compliance Officer's observations and staff interviews, the required staff-to-child ratio was not maintained at all times. During the ratio count, a staff member was observed entering the one-year-old room. When the CO entered the room, the staff member was in the process of removing a child. At that time, one staff member was alone with seven one-year-old children. Staff stated the following: *Not too often, when the seventh child comes, I call, and someone comes a few minutes later. *My concern is 1-year-olds in the two's room, a week out before they turn two, sometimes we have 14 children with 1-year-old and 2-year-old children with two staff.”

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

“Per allegation findings: Children are not supervised at all times, the staff stated the following: *"I have seen a lack of supervision on the playground, teachers sitting down, not doing a walk around, and children climbing fences and trees. Some staff are on the tablets while the kids are outside". *"One time, one kid went through the gate into [a] classroom, and someone came immediately. Teachers are a little too focused on the tablet. I have seen staff sitting on the floor, not standing by the equipment".”

AAC R9-5-503.D. D. A licensee shall ensure that the written diaper changing procedure in subsection (C) states that an enrolled child’s diaper is changed as soon as it is soiled, and that a staff member, when diapering: 1. Uses a separate washcloth and towel only once for each enrolled child; 2. Washes and dries the enrolled child using the enrolled child’s individual personal products labeled with the enrolled child’s name; 3. Uses single-use non-porous gloves; 4. Washes the staff member’s own hands with soap and running water between 86° F and 110° F before and after each diaper change; 5. Washes each enrolled child’s hands with soap and running water between 86° F and 110° F after each diaper change; 6. Cleans, sanitizes, and dries the diaper changing surface following each diaper change; and 7. Uses single-use paper towels from a dispenser to dry the diaper changing surface or the hands of the enrolled child or staff member.

“Per allegation findings: Based on the Compliance Officers' observations, proper diaper changing procedures were not followed. In the Preschool (Pathways Room), a staff member was observed changing a child's diaper while seated by the restroom door. During this time, other children were standing nearby with their pants down, waiting to be changed. The staff was not wearing gloves and was simultaneously documenting diaper changing on a tablet. The Compliance Officers instructed the staff member to use the diaper changing area to change the child's diaper. The staff member then moved the child to the appropriate diapering area and put on gloves. Then the staff member proceeded to change the next child, and the staff member did not wash her hands or the child's hands, nor did she change the gloves between diaper changes.”

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, there were items not required for diapering in the following diaper changing areas: *Young Toddlers (One's): There was a clear box with plastic balls on the diaper changing sink. *Toddlers (One's): There was a box of tissues, a blue and green toy, a plastic cup, and an orange cup with paint brushes in the diaper changing sink.”

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 water temperature in the following diaper changing areas was not maintained between 86° F and 110° F: *Young Toddler: The water temperature was 127° F. *Toddler 2: The water temperature was 124° F. *Early Preschool 3: The water temperature was 128° F.”

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 the Compliance Officers' observations, in the Preschool 6 Restroom, there was a yellow puddle on the floor near the toilet bowl and the wall. **Previously cited on 12.09.24”

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 Officers' observations, the Preschool 2 Boys' Restroom lacked toilet paper. **Previously cited on 12.09.24”

AAC R9-5-302. A licensee shall prepare a written statement of child care services provided by the licensee that includes the following: 1. A description of the facility’s child care services classifications in R9-5-204; 2. Hours of operation; 3. The facility’s street address, city, state, zip code, mailing address, and telephone number; 4. Child enrollment and disenrollment procedures; 5. Charges, fees, and payment requirements for child care services; 6. Child admission and release requirements; 7. Guidelines for positive discipline reflective of age-appropriate methods for children that include clear, appropriate, consistent expectations; 8. Transportation procedures; 9. Field trip requirements and procedures; 10. Responsibilities and participation of parents in facility activities; 11. A general description of activities and programs; 12. A description of the liability insurance required by R9-5-308 that is carried by the licensee and a statement that documentation of the liability insurance coverage is available for review on the facility premises; 13. Medication administration procedures; 14. Accident and emergency procedures; 15. A notice stating inspection reports are available on-site; 16. A provision stating that the facility is regulated by the Arizona Department of Health Services including the Department’s local street address, city, state, zip code, and local telephone number; 17. The procedures for notifying a parent at least 48 hours before a pesticide is applied on a facility’s premises; 18. A statement that a parent has access to the areas on facility premises where the parent’s enrolled child is receiving child care services; and 19. Policies and procedures for suspension and expulsion of children to include clear, appropriate, consistent expectations, including suspension and expulsion prevention strategies.

“Findings: Based on the Compliance Officers' observations and the review of the facility documentation, it was determined that the Statement of Services lacked the following required items: *Responsibilities and participation of parents in facility activities. *A description of the liability insurance that the licensee carries and a statement that documentation of the liability insurance coverage is available for review on the facility premises. *A notice stating inspection reports are available on-site *A provision stating that the facility is regulated by the Arizona Department of Health Services, including the Department’s address and telephone number.”

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 and the review of the facility documentation, the prescribed medication for Child #1 lacked the second dose; the facility did not obtain a doctor's note to separate the prescription medication.”

AAC R9-5-503.A.3.4. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 3. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled diapers; and 4. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled clothing.

“Findings: Based on the Compliance officers' observations, the diaper changing area in the Preschool 5 Room lacked a soiled clothing container.”

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, the outdoor activity area was not maintained free from hazards, a dead mouse head and tail were accessible to children in the Infant Outdoor area. **Previously cited on 12.09.24”

AAC R9-5-605.B.10. B. A licensee shall ensure that: 10. Toilet rooms are ventilated to the outside of the building, either by a screened window open to the outside air or by an exhaust fan and duct system that is operated when the toilet room is in use;

“Findings: Based on the Compliance Officers' observations, exhaust fans in the restrooms were inoperable throughout the facility.”

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 Officers' observations, the personal products in the Toddler 2 Room lacked the child's first and last name.”

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 Officers' observations, in the Explorer Girls' Restroom, there was a vent that lacked a cover, exposing a 4-inch hole at the base of the wall accessible to enrolled children.”

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 CO #1's observations, the following outdoor activity areas were not kept free from hazards: **Bird feces on the bottom rail of the iron fencing in several areas in the Infant, northwest, and southwest playgournds. **Splintering and rough wood border in the northwest and southwest playgrounds. **Dark build-up on the climbing rails in the southwest playground.”

AAC R9-5-501.A.21. A. A licensee shall ensure that:21. Except when used as part of an activity, the following are stored in an area inaccessible to an enrolled child: a. Garden tools, such as a rake, trowel, and shovel; and b. Cleaning equipment and supplies, such as a mop and mop bucket.

“Findings: Based on CO #1's observations, a plunger was on the floor accessible to children in the shared Preschool I and Preschool II east children's restroom.”

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 CO #1's observations and a review of facility documentation, 3 (Child #6, Child #7, Child #8) of 7 infant feeding instructions lacked an update of solid foods being fed to the infants.”

AAC R9-5-502.C.1.m. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: m. Posts the current written dietary instructions in the infant room and the kitchen and maintains the instructions on facility premises for 12 months after the date of the instructions; and

“Findings: Based on CO #1's observations and a review of facility documentation, 1 (Child #9) of 7 infant feeding instructions was not posted in the kitchen.”

AAC R9-5-504.3. A licensee providing child care services for 1-year-old and 2-year-old children shall:3. Ensure that each activity area has a supply of age-appropriate toys, materials, and equipment that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Art supplies; b. Books; c. Rubber or soft plastic balls; d. Puzzles and toys to enhance manipulative skills; e. Blocks; f. Washable soft toys and dolls; g. Musical instruments; and h. Indoor and outdoor equipment to enhance large muscle development;

“Findings: Based on CO #1's observations, puzzles were not accessible to children in the Young Toddler and Toddler rooms.”

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 CO #2's observations and a review of facility documentation, the December menu did not have the specifics for yogurt and mixed fruit.”

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 CO #1's observations, in Pre-K II, the toilet in the Boys' restroom was unflushed, and there were pieces of toilet paper on the floor in the Girls' restroom.”

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 CO #1's observations, in the east Preschool I/Preschool 2 shared children's restroom and in Pre-K D1 Boys' restroom, the toilet tissue dispensers were empty.”

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 Compliance Officer's (CO) observations and a review of facility documentation, 5 of 6 children's attendance records reviewed lacked the following required information: **Child #1 - Departure signature signed with initials on 12/06/2024 **Child #2, Child #5 - Arrival signature on 12/05/2024 **Child #3 - Arrival signatures on 12/02/2024 and 12/03/2024 **Child #4 - Arrival signature signed with a line on 12/03/2024”

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 COs' observations, the health, safety, or welfare of an enrolled child was placed at risk of harm when napping children's heads were covered with blankets in the following activity areas: **Toddler 2 - 1 child **Early Preschool 2 - 1 child”

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 COs' observations and a review of 3 staff files, Staff #2 (DOE 08/30/2023) lacked documentation of contact with DPS to verify Staff #2's fingerprint clearance card before they became a staff member. Staff 2's fingerprint clearance card was verified as valid on 10/17/2023.”

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 COs' observations and a review of staff files, Staff #1 (DOE 08/07/2023) lacked documentation of freedom from Tuberculosis.”

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 Compliance Officer (CO) #1's observations and a review of 5 staff files, Staff #1's (date of hire 06/20/2023) expired on 11/09/2023. Per a DPS website search, the renewal application was received on 11/15/2023, and a fingerprint card was issued on 11/22/2023.”

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 CO #2's observations and a review of facility documentation, 5 of 35 Emergency Information and Immunization Record cards reviewed lacked the following required information: **Child #1 - health care provider name and phone number **Child #2, Child #3, Child #4, Child #5 - date of enrollment”

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 CO #1's observations and a review of facility documentation, rosters in Early Preschool 1 and Pre-K 1 were not maintained as required: **Early Preschool 1 - 14 children present in the room and a roster was not available for review **Pre-K 1 - 11 children present in the room; 12 noted on the roster as in attendance”

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 CO #1's observations and a review of facility documentation, the facility lacked a current, violation-free fire inspection.”

AAC R9-5-404.C.3. C. A licensee shall ensure that: 3. When six or more enrolled children are present in a facility, an infant is not placed for supervision with a child who is not an infant.

“Findings: Based on CO #1's observations, there was an infant in the Young Toddler room with 8 other children. The child was a year-old but not able to walk independently across a room.”

AAC R9-5-501.A.2. A. A licensee shall ensure that: 2. Except for an enrolled school-age child, drinking water is provided sufficient for the needs of and accessible to each enrolled child in both indoor and outdoor activity areas;

“Findings: Based on CO #1's observation, water was not accessible to enrolled children in the Young Toddler room. The water was located on a counter out of children's reach.”

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 CO #1's observations, toys were not maintained free from hazards and accessible to enrolled children: **Pre-K playground - play ball with peeling coating and exposed foam **Early Preschool playground - wood finish peeling off of the top of wooden scooters”

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 CO #1's observations: **Infant - wipes accessible to enrolled children **Toddlers - diaper ointment labeled with first name only **Early Preschool 1 - wipes accessible to enrolled children; wipes labeled with first names only; diaper ointments labeled with no name or first name/last initial”

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 CO #1's observations, the diaper changing areas in the following areas were not seamless and smooth: **Toddlers - cracked caulking around the perimeter of the surface; finish worn at the back of the sink fixture exposing raw wood **Early Preschool 2 - finish worn at the back of the sink fixture exposing raw wood”

AAC R9-5-503.A.2.a. 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 CO #1's observations, the water temperatures of the following diaper changing areas were measured at: **Infant - 79.9° F **Toddlers - 118° F”

AAC R9-5-504.3. A licensee providing child care services for 1-year-old and 2-year-old children shall: 3. Ensure that each activity area has a supply of age-appropriate toys, materials, and equipment that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Art supplies; b. Books; c. Rubber or soft plastic balls; d. Puzzles and toys to enhance manipulative skills; e. Blocks; f. Washable soft toys and dolls; g. Musical instruments; and h. Indoor and outdoor equipment to enhance large muscle development;

“Findings: Based on CO #1's observations, there were 2 books available for 16 children in Early Preschool 1.”

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 CO #1's observations, the following toilet rooms were not maintained in a clean and sanitary condition: **Pre-K - yellow substance in toilet basins of the boys' and girls' restroom **Pre-K 2 - strong urine odor in the boys' restroom”

AAC R9-5-516.F. F. A licensee shall maintain documentation of all medications administered to an enrolled child. 1. Documentation shall contain: a. The name of the enrolled child; b. The name and amount of medication administered and the prescription number, if any; c. The date and time the medication was administered; and d. The signature of the staff member who administered the medication to the enrolled child; and 2. A licensee shall maintain the documentation on facility premises for 12 months after the date the medication is administered.

“Findings: Based on COs' observations and a review of facility documentation, enrolled children's medication authorizations lacked the following required information: **Child #1 - end date noted as "none" **Child #6 - end date **Child #7 - prescription number on medication did not match the prescription number on the medication authorization”

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 CO #1's observations, there was 7' of cracked tile with dark build-up in the shared restroom between the Early Preschool 1 and Early Preschool 2 rooms.”