Q.C.U.S.D.#95 - Silver Valley Elementary School

AAC R9-5-603.D. D. A licensee shall ensure that the following is provided and maintained within the fall zones of swings and climbing equipment in an outdoor activity area: 1. A shock-absorbing unitary surfacing material manufactured for such use in outdoor activity areas; or 2. A minimum depth of 6 inches of a non-hazardous, resilient material such as fine loose sand or wood chips.

“Findings: Based on the Compliance Officer's observation, the outdoor activity area lacked the following resilient surfacing: *2 of the required 6 inches of wood chips in the fall zones under and around the swings. *3 of the required 6 inches of wood chips in the fall zone under and around the uneven bars on the climbing structure.”

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 facility documentation and the Compliance Officer's observation, the authorization form for a non-prescription medication was not consistent with the manufacturer's recommendations on the label.”

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 Officer's observation, there were gaps between the floor and the base of the toilet where the caulking was cracked or missing in the bathrooms of Room #321, Room #318, and Room #317.”

AAC R9-5-512.F.7. F. A licensee shall ensure that: 7. Toys, materials, and equipment are maintained in a clean condition;

“Findings: Based on the Compliance Officer's observation, in the outdoor activity area, there was a heavy buildup of dirt on the rails and posts of the climbing structure.”

AAC R9-5-403.A. A. Within 10 calendar days of the starting date of employment or volunteer service, a licensee shall provide, and each staff member who provides child care services shall complete, training for new staff members that includes all of the following:1. Facility philosophy and goals; 2. Names and ages of and developmental expectations for enrolled children for whom the staff member will provide child care services; 3. Health needs, nutritional requirements, any known allergies, and information about adaptive devices of enrolled children for whom the staff member will provide child care services; 4. Lesson plans; 5. Child guidance and methods of discipline; 6. Hand washing techniques; 7. Diapering techniques and toileting, if assigned to diaper changing duties; 8. Food preparation, service, sanitation, and storage, if assigned to food preparation; 9. If a staff member is assigned to feeding infants, the preparation, handling, and storage of infant formula and breast milk; 10. Recognition of signs of illness and infestation; 11. Child abuse or neglect detection, prevention, and reporting; 12. Accident and emergency procedures; 13. Staff responsibilities as required by A.R.S. Title 36, Chapter 7.1, Article 1 and this Chapter; 14. Sun safety policies and procedures; 15. Safety in outdoor activity areas; 16. Transportation procedures, if applicable; and 17. Field trip procedures, if applicable.

“Findings: Based on facility documentation and the Compliance Officer's observation, the file for Staff #1 lacked documentation for the 10-day orientation for new staff members (Start date-7/22/2024).”

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, the two medications for Child #1 did not match the prescription number listed on the authorization form.”

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

“Findings: Based on the Compliance Officer's observation, there were 5 1/2 to 6-inch gaps from the bottom of the fence to the ground on the East side of the playground.”

AAC R9-5-603.E. E. A licensee shall ensure that the following is provided and maintained within the fall zones of swings and climbing equipment in an outdoor activity area:1. A shock-absorbing unitary surfacing material manufactured for such use in outdoor activity areas; or 2. A minimum depth of 6 inches of a non-hazardous, resilient material such as fine loose sand or wood chips.

“Findings: Based on the Compliance Officer's observation, the outdoor activity area lacked the following resilient surfacing: *2 of the required 6 inches of woodchips in the fall zones under the slide and monkey bars. *4 of the required 6 inches of woodchips in the fall zones under the swings.”

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, it was determined that the Licensee lacked documentation of a current, violation-free fire inspection report as required.”

AAC R9-5-302. A. 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. Age-appropriate discipline guidelines and methods; 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; and 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. B. A licensee shall provide a copy of the written statement of child care services: 1. To the Department: a. Before the facility receives a license, and b. Every 12 months after the date of the license as required by A.R.S. § 36-883.01; and 2. To a parent when the parent requests a copy of the written statement of child care services.

“Findings: Based on CO's observations and a review of facility documentation, the facility's statement of services for the Preschool and School-Age programs lacked the following required information: **Preschool - Facility's address **School-Age - Facility's address; notice stating inspection reports are available on-site; provision stating that AZDHS regulates the facility, including the Department’s local street address, city, state, zip code, and local telephone number”

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 CO's observations and a review of facility documentation, the School-Age Maker-Space lacked a posted capacity.”

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 Compliance Officer's (CO) observations and a review of 12 staff files, Staff #1 (DOE 04/01/2024) and Staff #2 (DOE 02/08/2024) lacked documentation of contact with DPS to verify their fingerprint cards as valid before their starting date of employment.”

AAC R9-5-509.C.22. C. A licensee shall ensure that:22. A refrigerator at the child care facility maintains a temperature of 41° F or below, as shown by a thermometer kept in the refrigerator at all times;

“Findings: Based on CO's observations, the thermometers in the refrigerators used to store enrolled children's food were reading at: **Rooms 701 - 52° F **Room 317 - 58° F”

AAC R9-5-305.A. A. A licensee shall not permit an enrolled child to attend a facility until the facility receives: 1. An immunization record for the enrolled child with the information required in 9 A.A.C. 6, Article 7, documenting that the enrolled child has received all current, age-appropriate immunizations required under 9 A.A.C. 6, Article 7: a. Provided by a healthcare provider, or b. Generated from the Arizona State Immunization Information System, which is the Department’s child immunization reporting system established in A.R.S. § 36-135; or 2. An exemption affidavit for the enrolled child provided by the enrolled child’s parent that contains: a. A statement, signed by the enrolled child’s health care provider, that the immunizations required by 9 A.A.C. 6, Article 7 would endanger the enrolled child’s health or medical condition; or b. A statement, signed by the enrolled child’s parent, that the enrolled child is being raised in a religion whose teachings are in opposition to immunization.

“Findings: Based on CO's observations and a review of facility documentation, Child #3 lacked documentation of immunizations or an exemption affidavit.”

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 CO's observations and a review of facility documentation, children's attendance records in Room 701 were unavailable for review.”

AAC R9-5-509.C.23. C. A licensee shall ensure that:23. A freezer at the child care facility maintains a temperature of 0° F or below, as shown by a thermometer kept in the freezer at all times; and

“Findings: Based on CO's observations, the thermometer in the refrigerator (Room 317) used to store enrolled children's food was reading at 46° F.”

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 CO's observations, the climbing structure on the Preschool playground had heavy dark build-up at the hood of the slide.”

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 CO's observations and a review of 12 staff files, question #2 was not answered on Staff #3's (DOE 01/30/2023) Criminal History Affidavit.”

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 CO's observations, in Room 317, the exhaust fan in the children's restroom was not operational.”

AAC R9-5-301.I. I. At least once a month, and at different times of the day, a licensee shall ensure that an unannounced fire and emergency evacuation drill is conducted and each staff member and enrolled child at the facility participates in the fire and emergency evacuation drill. 1. If child care services for a child with special needs are provided at a facility, the licensee shall provide for the enrolled child’s participation in each fire and emergency evacuation drill according to the enrolled child’s individualized plan as specified in R9-5-507(A)(1). 2. A licensee shall document each fire and emergency evacuation drill and maintain the documentation on facility premises for 12 months after the date of the fire and emergency evacuation drill.

“Findings: Based on CO's observations and a review of facility documentation, the School-Age Before Care program lacked documentation of fire drills completed October 2023 - March 2024. The completed fire drills were conducted during the morning program only.”

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's observations and a review of facility documentation, 5 of 15 Emergency Information and Immunization Record cards reviewed lacked the following required information: **Child #1, Child #3 - 2nd emergency contact **Child #2 - Medical/dietary needs; child's susceptibility to illness; physical conditions of child; individual requirements for health maintenance **Child #4 - Both parent/guardians' street address, state, zip code **Child #5 - Both parent/guardians' city, state, zip code”

AAC R9-5-203.G. G. If 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 CO's observations and a review of 12 staff files, Staff #1 (DOE 01/31/2024), Staff #2 (DOE 01/08/2024), Staff #3 (DOE 12/06/2021), Staff #4 (DOE 01/21/2022), Staff #5 (DOE 07/19/2022), and Staff #6 (DOE 08/15/2023) lacked documentation of submission to DCS to complete a background check.”

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 CO's observations and a review of 12 staff files, 3 of 12 staff files lacked documentation of freedom from tuberculosis before starting dates of employment. **Staff #3 (DOE 0/30/2023)- Results dated 01/30/2023 **Staff #5 (DOE 07/19/2022) - Results dated 07/21/2022 **Staff #6 (DOE 08/15/2023)- Results dated 08/17/2023”

AAC R9-5-401.1. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:1. A facility director is 21 years of age or older and provides the licensee with documentation of one of the following: a. At least 24 months of child care experience, a high school or high school equivalency diploma, and: i. Six credit hours or more in early childhood, child development, or a closely-related field from an accredited college or university; or ii. At least 60 actual hours of instruction, provided in conferences, seminars, lectures, or workshops in early childhood, child development, or a closely-related field, and an additional 12 hours of instruction, provided in conferences, seminars, lectures, or workshops in the area of program administration, planning, development, or management; b. At least 18 months of child care experience and: i. An N.A.C., C.D.A., or C.C.P. credential; or ii. At least 24 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; c. At least six months of child care experience and an associate degree from an accredited college or university in early childhood, child development, or a closely-related field; or d. At least three months of child care experience and a bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field;

“Findings: Based on CO's observations and a review of 12 staff files, Staff #2 (DOE 02/08/2024) was acting in the capacity of the Facility Director and lacked documentation of experience and the minimum required training hours or ECE college credits.”

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 CO's observations and a review of 12 staff files, Staff #3 (DOE 01/30/2023 - Review period 01/30/2023 - 01/30/2024) and Staff #4 (DOE 01/21/2022 - Review period 01/21/2023 - 01/21/2024) each lacked documentation of completion of 18 annual training hours.”

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 CO's observations and a review of 12 staff files, Staff #1's (DOE 04/01/2024) 10-day new staff training lacked the Director's signature and date.”

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

“Findings: Based on CO's observations, the School-Age first aid kit contained burn cream and antibiotic ointment.”

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 CO's observations and a review of facility documentation, the School-Age lesson plan in the Multi-Purpose room lacked a date.”

AAC R9-5-516.G. G. A licensee shall return all unused prescription and nonprescription medications to a parent when the medication prescription date has expired or the medication is no longer being administered to the enrolled child or dispose of the medication if unable to locate the enrolled child's parent after the child's disenrollment

“Findings: Based on CO's observations and a review of facility documentation, Child #6's non-prescription medication had expired 02/2024, and the medication had not been returned to the parent.”

AAC R9-5-509.C.14. C. A licensee shall ensure that:14. Each staff member is informed of a modified diet prescribed for an enrolled child by the child’s parent or health care provider, and the modified diet is posted in the kitchen and in the child’s activity area;

“Findings: Based on CO's observations and a review of facility documentation, enrolled School-Age children's modified diets were not posted in the Multi-Purpose room and Maker-Space.”

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

“Findings: Based on the Compliance Officer and the Compliance Officer Supervisor's observations, children were not being supervised at all times, and the following was observed: *2 children were observed walking from the playground to the gym alone and unsupervised. *2 additional children were observed leaving the playground and entering the gym alone and unsupervised. *1 child entered the gym from the cafeteria alone and unsupervised, which is located in a different building.”

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 the Compliance Officer's observations, on the playground, there were 62 children present and 64 children were marked on the roster.”

AAC R9-5-401.1. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:1. A facility director is 21 years of age or older and provides the licensee with documentation of one of the following: a. At least 24 months of child care experience, a high school or high school equivalency diploma, and: i. Six credit hours or more in early childhood, child development, or a closely-related field from an accredited college or university; or ii. At least 60 actual hours of instruction, provided in conferences, seminars, lectures, or workshops in early childhood, child development, or a closely-related field, and an additional 12 hours of instruction, provided in conferences, seminars, lectures, or workshops in the area of program administration, planning, development, or management; b. At least 18 months of child care experience and: i. An N.A.C., C.D.A., or C.C.P. credential; or ii. At least 24 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; c. At least six months of child care experience and an associate degree from an accredited college or university in early childhood, child development, or a closely-related field; or d. At least three months of child care experience and a bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field;

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that Staff #2 is the director. Staff #2 was not qualified as the director because the file lacked documentation of education, experience, and 72 of the required 72 training hours.”

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 Officer and the Compliance Officer Supervisor's observations, on the playground, the staff to child ratio was 3:62, with school-age children present, and a required ratio of 4:62. During the investigation, several children were observed walking from either the playground and the cafeteria without a staff member. During the investigation, the ratio in the cafeteria was 2:57 when a staff member was observed in a room in the gym (separate building from the cafeteria) obtaining snack for the children, with a required ratio of 3:57.”

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 the Compliance Officer's observation of 2 staff files, the file for Staff #1 (DOH 1/21/2022) lacked documentation of a negative Mantoux skin test administered within 12 months before the starting date of employment. The test in Staff #1's file was dated 2/2/2022.”

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 Supervisor’s observation, the health, safety and welfare of enrolled children was placed at risk of harm. On the playground, there was a 20' long by 4' wide 6-8" deep standing pool of water and there were 62 children present on the playground.”