Saving Grace Preschool

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 a review of facility documentation and the Compliance Officer's observations, 6 of 15 Emergency, Information, and Immunization Records reviewed lacked the following required information: *Child #1- The home address of the child's 2nd parent/guardian. *Child #2- The name and telephone number of the child's 2 of 2 emergency contacts. *Child #3- The name and telephone number of the child's 1 of 2 emergency contact. *Child #4- The name, home address, and telephone number of the child's 2nd parent. *Child #5 and Child #6- The telephone number of the child's health care provider.”

AAC R9-5-503.A.1. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 1. A nonabsorbent, sanitizable diaper changing surface that is: a. Seamless and smooth, and b. Kept clear of items not required for diaper changing;

“Findings: Based on the Compliance Officer's observations, the diaper-changing surfaces in the following rooms had exposed gaps in the surface, lacked sufficient caulking, and were not seamless and smooth, as required: *Infant Room. *1s Room. *2s Room 1. *2s Room 2. *3s Room.”

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 a review of facility documentation and the Compliance Officer's observations, Child #7's medication consent form lacked the prescription number of the child's medication. The prescription number on the form did not match the prescription number on the medication.”

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 CO's observations and a review of 7 staff files, Staff #2's (DOE 07/09/2024) fingerprint clearance card was issued on 08/12/2024, after the starting date of employment.”

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 #9, Child #11, Child #12, Child #13, Child #16, and Child #17 had medications that were no longer being administered per their medication authorizations and the medications were not returned to the parent/guardian.”

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 CO's observations and a review of facility documentation: **Child #14 - Prescription medication lacked a prescription label with the child's information and prescription number. **Child #10, Child #11, Child #13, Child #15, Child #17 - Non-prescription medication lacked the child's first and last name. **Child #11, Child #15, Child #16 - Non-prescription medication lacked a health care provider's authorization to dispense the medication inconsistent with the medication's label.”

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, a shelf of plastic bins and bags of clothing was stored in the shared restroom between Rooms 5 and Room 6.”

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 Infant room freezer was reading at 10.9 F°, and Room 4's freezer lacked a thermometer.”

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 thermometer in the Infant room refrigerator was reading at 47 F°.”

AAC R9-5-509.C.3. C. A licensee shall ensure that:3. An enrolled child is not permitted to eat food directly off the floor, carpet, or ground or with utensils placed directly on the floor, carpet, or ground;

“Findings: Based on CO's observations, in Room 4, 2 children were sitting on the floor near the cubbies. 1 was eating a snack, and 1 was drinking from their sippy cup.”

AAC R9-5-503.A.3. 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

“Findings: Based on CO's observations, the soiled diaper containers in Rooms 5 and 6 lacked tight-fitting lids. The containers were overflowing in which the lid could not be shut tightly.”

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's observations and a review of facility documentation, 2 of 9 infants lacked infant feeding instructions, and 2 of 9 infants lacked updates to foods the infants were eating.”

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's observations, personal products were not labeled with a child's first and last name in the following activity areas: **Room 2 - Wipes labeled with fist name/last initial **Room 4 - Wipes labeled with initials only and first name/last initial **Room 5 - Wipes labeled with first name/last initial **Room 6 - Wipes labeled with a first name/last initial and first name only”

AAC R9-5-501.A.9. A. A licensee shall ensure that:9. If a staff member places an enrolled child in a feeding chair when feeding the enrolled child: a. The feeding chair is constructed to prevent toppling; b. The tray or feeding surface of the feeding chair is smooth and free of cracks; and c. The staff member: i Cleans the feeding chair before and after each enrolled child’s use; ii. Sanitizes the tray or feeding surface before and after each enrolled child’s use; and iii. If the feeding chair was manufactured with a safety strap, fastens the feeding chair’s safety strap while the enrolled child is in the feeding chair;

“Findings: Based on CO's observations, in Room 4, 2 children were seated in high chairs and the straps were not fastened.”

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, 4 of 10 children's attendance records lacked the following required information: **Child #6 - Arrival and departure signatures signed with initials only on 12/23/2024 **Child #7 - Arrival signature signed with a scribble on 12/23/2024 **Child #8 - Arrival signature signed with a first name only on 12/23/2024 **Child #9 - Arrival and departure signatures signed with a first name and last initial on 12/23/2024”

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 20 Emergency Information and Immunization Record cards lacked the following required information: **Child #1 - Health care provider name, telephone number **Child #2, Child #4, Child #5 - Date of enrollment **Child #3 - Date of enrollment; health care provide telephone number; individual to contact in case of sudden injury/illness”

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 Compliance Officer's (CO) observations and a review of 7 staff files, Staff #1 (DOE 01/26/2024) lacked documentation of freedom from tuberculosis on or before the starting date of employment. Staff #1's negative result was dated 02/19/2024.”

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 CO's observations, in the Infant room, 2 bottles on the counter were labeled with a last name only; 4 bottles in the refrigerator were not labeled with a name; and individual bags of breastmilk in the freezer were not labeled with a child's name.”

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 compliance officers' observations and a review of facility documentation, the rosters in the infant and 3's rooms did not match the number of children present. **Infants - 4 noted on the roster; 2 children present **3's - 5 noted on the roster; 4 children present”

AAC R9-5-508.C. C. If a licensee provides food, a licensee shall prepare and serve food according to the meal pattern requirements found in Table 5.1, "Meal Pattern Requirements for Children."

“Findings: Based on the Compliance Officers' observations, enrolled children were served cheerios and milk for breakfast and lacked a serving of a 3rd meal component (Vegetable, fruit, or both).”

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

“Findings: Based on the Compliance Officers' observations, there was a child table in the Knights room that was unstable.”

AAC R9-5-511.A. A. A licensee shall provide each enrolled child who naps or sleeps at the facility with a separate cot or mat or a crib that meets the requirements of R9-5-502(A)(8) and ensure that:1. A cot, mat, or crib used by the enrolled child accommodates the enrolled child’s height and weight; 2. A staff member covers each cot, crib mattress, or mat with a clean sheet that is laundered when soiled, or at least once every seven days and before use by a different enrolled child; 3. A clean blanket or sheet is available for each enrolled child; 4. A rug, carpet, blanket, or towel is not used as a mat; and 5. Each cot, mat, or crib is maintained in a clean and repaired condition.

“Findings: Based on the Compliance Officers' observations, there was 1 cot sheet that had burgundy smudges and 1 cot sheet with grey marks and debris in the Seedlings 2 room.”

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 the Compliance Officers' observations, there was a dust pan in the Champions and Warriors restroom, and a dust pan and broom in the Builders restroom accessible to enrolled children.”

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's observations, the following activity areas had children's personal products that were not labeled with a child's name: **Room 4 (Seedlings 2) - diaper ointments with no name or first name/last initial only **Room 6 (Knights) - sunscreens with no name and a first name only; insect repellant with no name”

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's observations, brooms were accessible to enrolled children in the shared children's restrooms between Rooms 1 (Castle) and 2 (Warriors) and between Rooms 3 (Champions) and 4 (Seedlings 2).”

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's observations, water was not accessible to enrolled children in the following activity areas: **Room 3 (Champions, 3's/4's) - water was located on a counter out of children's reach, with no cups available **Room 2 (Seedlings 2) - water”

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 - 2 emergency contacts **Child #2 - 1 emergency contact (2 of 3 contacts same as parents) **Child #3 - date of enrollment **Child #4 - 1 emergency contact (1 of 2 contact same as parents) **Child #5 - health care provider and phone number”

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 7 staff files, the following staff lacked documentation of freedom from tuberculosis within the required timeframes: **Staff #2 (DOE 11/07/2023) - results dated 11/10/2023 **Staff #4 (DOE 11/27/2023) - results dated 12/01/2023 **Staff #5 (DOE 12/11/2023) - results dated 08/21/2022 **Staff #6 (DOE 10/09/2023) - results dated 08/05/2022”

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 7 staff files, the following staff lacked documentation of contact with DPS to verify their fingerprint clearance cards as valid prior to them becoming staff members. **Staff #1 (Date of employment "DOE" 12/04/2023) - lacked date of verification **Staff #2 (DOE 11/07/2023) - verified on 11/07/2023 **Staff #3 (DOE 11/13/2023) - verified on 11/13/2023 **Staff #4 (DOE 11/27/2023) - verified on 12/07/2023 **Staff #5 (DOE 12/11/2023) - verified on 12/13/2023”

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 CO's observations and a review of facility documentation, enrolled children's medication authorizations lacked the following required information: **Child #12 - end date; times and frequency noted as "as needed" **Child #13 - end date; time and frequency noted as "as needed"”

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's observations, the drinking fountain on the playground had standing water and debris in the basin.”

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's observations, the following shared toilet rooms were not kept in a clean and sanitary condition: **Rooms 1/2 (Castles/Warriors) - toilet tissue pieces on the floor; exhaust vent with dirt build-up **Rooms 3/4 (Champions/Seedlings 2) - exhaust vent with dirt build-up”

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's observations, the diaper changing surfaces in the Infant room and Room 5 (Builders) had unsealed gaps around the perimeters of the surfaces. In Room 4 (Seedlings 2), there was a ceramic dish next to the diaper changing sink.”

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 CO's observations, in the Infant room, 2 bottles were labeled with a first name only and 1 bottle lacked an enrolled child's name.”

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's observations and a review of facility documentation, 6 of 8 enrolled infant feeding instructions lacked the following required information: **Child #6, Child #9, Child #11 - amounts and feeding times **Child #7, Child #10 - amounts to feed **Child #8 - lacked feeding instructions”

AAC R9-5-502.A.11. A. A licensee providing child care services for infants shall: 11. Label each food container received from the parent with the infant's name.

“Findings: Based on CO's observations, in the Infant room, there were enrolled children's food containers that lacked the child's name or were labeled with a first name and last initial only.”

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's observations and a review of facility documentation, the facility's fire inspection expired on 12/05/2023.”

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 COs' observations, in the 2's/3's room, there were 10 children present and 9 noted as in attendance on the roster. In the 4's room, there were 7 children present and 9 children noted as in attendance on the roster.”

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: Per allegation (Cases #64294 and 64341), based on CO #2's observations, in the 2's/3's room, the ratio was 1:10 with a required ratio of 2:10.”

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 CO #2's observations, enrolled children were placed at risk of harm when 6 (4-year-old) children were in the patio area which was not fully enclosed. The south side of the patio did not have a fence and was adjacent to a major street.”

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 #2's observations, in the 1's/2's room, there was an art apron next to the diaper changing sink.”

AAC R9-5-503.E. E. A licensee shall ensure that the written diaper changing procedure in subsection (D) 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.

“Findings: Per allegation (Case #64341), and based on COs' review of facility documentation, the facility lacked documentation of diaper changes for 3 enrolled children, after 11:30am to the time of departure, on 09/25/2023.”

AAC R9-5-508.C. C. If a licensee provides food, a licensee shall prepare and serve food according to the meal pattern requirements found in Table 5.1, "Meal Pattern Requirements for Children."

“Findings: Per allegation (Case #64341), based on COs' review of facility documentation, the PM snack menus from 10/09/2023 - 11/10/2023 lacked one of two components as required.”

AAC R9-5-509.B. B. If a licensee contracts with a food establishment to prepare and deliver food to the facility, the licensee shall obtain and provide the Department with a copy of the food establishment’s permit, issued under 9 A.A.C. 8, Article 1, at the following times: 1. Before the Department issues a license to the facility, 2. Upon contracting with the food establishment, and 3. Every 12 months after the date the contract is entered into while the contract is in effect

“Findings: Based on COs' review of facilty documentation and staff interview, pizza was served to enrolled children for lunch on 10/20/2023 and 11/03/2023. Staff stated that the pizza is ordered from a local pizza restaurant, and the facility lacked documentation of a current food permit for that establishment.”

AAC R9-5-208.B. B. At least 30 calendar days before the date of an intended change in a facility’s service classification, space utilization, or licensed capacity, a licensee shall submit a written request for approval of the intended change to the Department that includes: 1. The licensee’s name; 2. The facility’s name, street address, city, state, zip code, mailing address, and telephone number; 3. The name, telephone number, and fax number of a point of contact for the request; 4. The facility’s license number; 5. The type of change intended: a. Service classification, b. Space utilization, or c. Licensed capacity; 6. A narrative description of the intended change; and 7. The following additional information, as applicable: a. If the intended change affects individual rooms, the following information about each affected activity area, as applicable: i. Identification of the activity area, ii. Current and intended square footage, iii. Current and intended operating hours, iv. Current and intended service classification, v. Current and intended licensed capacity, and vi. Whether the activity area has or will have a diaper changing area; b. If the intended change is to increase licensed capacity, the square footage of the outdoor activity area; and c. If the intended change includes an alteration or addition to the physical plant of a licensed facility, the following, as applicable: i. If the facility is not located in a public school or if providing child care services to infants, one-year-old children, or two-year-old children in a facility located in a public school, the information required in R9-5-201(A)(5)(g) and (A)(5)(h) showing the intended change; or ii. If the facility is located in a public school and provides child care only for three-year-old, four-year-old, or five-year-old, or school-age children, a set of final construction drawings or a school map, including the information required in R9-5-201(5)(j) showing the intended change.

“Findings: Based on Compliance Officer (CO) #2's observations, there were 6 enrolled children (4 year olds) with 1 staff and 2 ABA therapists in the patio area between 2:20 pm - 2:30 pm. The patio is unlicensed space.”