The Learning Experience - Mesa-Dobson Ranch

AAC R9-5-404.C.3. C. A licensee shall ensure that when there are: 3. 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: Per allegation; based on staff interviews, facility documentation, and the Compliance Officer's observation, infants are placed for supervision with the one-year-old classrooms. Documentation showed Child #1 (14 months) was enrolled in a Toddler one-year-old classroom without being able to walk steadily. The staff stated: *Child #1 is in the Tod A room and not walking yet. *Infants visit the classroom (Toddler) before they fully transition.”

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, based on the staff statements, documentation, and the Compliance Officer's observation, the required staff-to-children ratio was not maintained at all times. Documentation showed Toddler A's classroom ratio for 6/18 was 1:7 rather than 2:7 for a 1-year-old ratio. Staff stated the following: *There was a day that I had 19 children by myself (mixed age group that included 1-year-olds) *We (classroom teacher) were overatio and waited hours for an extra person to come in. *I am sometimes over at the end of the day, when the other class comes over.”

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 observations, in Preschool 1A (3s), there was a build-up of rust on the baseboards behind the toilet.”

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

“Findings: Based on the Compliance Officer's observations, in Preschool 2 (3s), there was a cracked wooden writing desk with a sharp and pointy edge accessible to the enrolled children.”

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 #1's medication consent form lacked the starting and ending dates of the dosage period.”

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

“Findings: Based on the Compliance Officer's observations, on the soccer field, there was exposed rust on the screws at the base of the dual goal posts, and one of the screws was loose.”

AAC R9-5-401.4. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 4. An assistant child educator is 16 years of age or older and provides the licensee with documentation of one of the following: a. Current and continuous enrollment in high school or a high school equivalency class; b. High school or high school equivalency diploma; c. Enrollment in vocational rehabilitation, as defined in A.R.S. § 23-501; or d. Employment or service as a volunteer in a licensed child care facility for 12 months;

“Findings: Based on staff statements, a review of facility documentation, and the Compliance Officer's observations, Staff #3's (DOH 02-02-2026) file lacked documentation of a high school or a high school equivalency diploma. Staff stated that Staff #3 occasionally works in the capacity of an assistant child educator.”

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 observations, the following toys/materials were not maintained, as required; *Infant room- there was a ripped black seat cushion with the inner material accessible to the enrolled infants. *Preschool 2- There was a ripped red couch with inner foam accessible to the enrolled children.”

AAC R9-5-203.A. A. A licensee shall ensure that a staff member completes, signs, dates, and submits to the licensee, before the staff member’s starting date of employment or volunteer service: 1. The form required in A.R.S. § 36-883.02(C); and 2. If required by A.R.S. § 8-804, the form in A.R.S. § 8-804(I).

“Findings: Based on a review of facility documentation and the Compliance Officer's observations, Staff #1 (DOH 08-25-2025) and Staff #2 (DOH 12-01-2025) lacked documentation of a DCS background check.”

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 review of facility documentation, the roster in the Prepper A classroom reflected the presence of 9 children, however there were actually 10 children present in the classroom.”

AAC R9-5-514. F.1. F. If while attending a facility an enrolled child has an accident, injury, or emergency that, based on an evaluation by a staff member, requires medical treatment by a health care provider, a licensee shall ensure that a staff member: 1. Notifies the enrolled child's parent immediately after the accident, injury, or emergency;

“Per allegation findings: Based on Compliance Officers' observations and information provided by the staff, after an incident where an enrolled child had an injured arm, the staff failed to notify the parent/guardian immediately acknowledging "I didn't call (parent/guardian) when I should have" and that a call had was placed to the parent/guardian and staff "apologized for not calling sooner".”

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 CO's observations, 2 children were unsupervised by staff when left alone with the school's contracted photographers.”

AAC R9-5-510.B.1. B. A licensee shall ensure that a staff member does not use or permit: 1. A method of discipline that could cause harm to the health, safety, or welfare of an enrolled child;

“Findings: Based on staff statements and staff interview, Staff #2 used a method of discipline that could cause harm to the health, safety, or welfare of an enrolled child when Staff #2 kicked over a table causing the chairs to "go flying" in the classroom with 9 children present, after spilling some medication on the floor. Staff stated that Staff #2 said that she did this to ensure there wasn't any medication missed that the children could grab.”

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 CO's observations, the ratio was 0:2 with a required ratio of 1:2 when 2 children were left with photographers on picture day without a staff member present.”

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 Officer's (CO) observations and a review of facility documentation, the roster in Preschool 2 did not match the number of children present. There were 6 present and 8 noted on the roster as in attendance.”

AAC R9-5-510.A.2. A. A licensee shall ensure that a staff member: 2. Teaches, models, and encourages orderly conduct, personal control, and age-appropriate behavior;

“Findings: Per allegation and based on staff interview and staff statements, staff failed to teach, model, and encourage orderly conduct, personal control, and age-appropriate behavior: **Staff stated that Staff #1 pointed a finger in the child's face, and said "Do not push babies!" **Staff stated that a child hit Staff #1's hand, and staff #1 flicked the child's forehead, and said "Don't treat me this way!". The child began to cry. **Staff stated that Staff #1 said to a child, "I'm going to poke you right between the eyes"; "I don't like you, you have problems." **Staff stated that Staff #2 said that "you have to be mean and direct in order to get them to listen." **Staff stated that Staff #2 said to a child, "I will slap the s--t out of you!" **Staff stated that Staff #2 had used inappropriate language on multiple occasions - words such as s--t and a--. **Staff stated that Staff #2 "flicked a child forcefully at least twice during the day causing the child to cry in pain." **Staff stated that Staff #2 "would make fun of kids in a very mean manner." Per facility documentation, Staff #2 stated that she slapped a child on the hand when the child grabbed her hair.”

AAC R9-5-501.A.1. A. A licensee shall ensure that:1. In addition to complying with the requirements in this Chapter, the health, safety, or welfare of an enrolled child is not placed at risk of harm;

“Findings: Per allegation anad based on staff interviews and a review of facility documentation, the health, safety, and welfare of enrolled children were placed at risk of harm when staff became angry in the classroom and kicked over a table, by grabbing and pulling children's arms, and pushing children down onto the floor forcefully. **Staff stated that Staff #1 became angry in the classroom while there were 9 children present in the room, "kicked the table underneath and it flipped over. The chairs went flying. Children got scared, staring at her." **Staff stated that Staff #1 "kicked the middle table backwards causing the chairs to either flip over or get stuck under the table. The kids all stopped and looked a little scared." **Staff stated that Staff #2 was "grabbing and pulling arms of children, and forcefully pushing them down onto the floor."”

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, 4 of 20 Emergency Information and Immunization Record cards lacked the following required information: **Child #1 - Child's city, state, zip code **Child #2 - Child and both parent/guardians' city, state, zip code **Child #3 - Date of birth **Child #4 - Page 2 questions not answered (nutritional and dietary needs of the child; susceptibility to illness, physical conditions, and any individual requirements for health maintenance.)”

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, 6 of 20 children's attendance records lacked the following required information: **Child #5 - Arrival signature on 02/05/2025 **Child #6 - Arrival signatures on 02/06/2025 and 02/11/2025 signed with a first name only **Child #7 - Arrival signature on 02/06/2025 **Child #8 - Departure signature on 02/05/2025 **Child #9 - Arrival signatures on 02/04/2025, 02/07/2025, and 02/10/2025 - 02/12/2025 signed with initials only **Child #10 - Departure signatures on 02/03/2025 - 02/07/2025, 02/10/2025, and 02/11/2025 signed with initials only; departure time and signature on 02/07/2025”

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 CO's observations and a review of 8 staff files, Staff #2 (DOE 01/02/2025) lacked documentation of new employee training within 10 days of their starting date of employment.”

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's observations, the children's vinyl couches in Preschool 1B and Preschool 2 had tears in the seats exposing the wooden frame and foam, accessible to enrolled children.”

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 CO's observations, a child was in the restroom with the door closed, and the 2 staff were on the opposite side of the classroom tending to other children. Upon exiting, the child began talking with the CO, and the CO asked if the child had washed their hands after toileting. The child responded "no". The CO informed one of the staff members and after a few minutes of the child walking through the room, a staff member helped the child wash their hands at the classroom sink. When the CO checked the restroom, multiple pieces of toilet paper were on the floor.”

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 caulking at the diaper changing areas in Toddler B, Twaddler A, and Twaddler B were separating in areas around the perimeter of diaper changing surface. In Prepper A, there was a white board and debris on the diaper changing surface.”

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 container in the Infant room lacked a waterproof liner and tight-fitting lid.”

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

“Findings: Based on CO's observations, the Infant room's diaper changing area lacked a soiled clothing container.”

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's observations, Toddler B and Twaddler A rooms lacked puzzles and art supplies accessible to enrolled children.”

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 8 staff files, Staff #1 (DOE 11/05/2024) lacked documentation of freedom from tuberculosis on/before their starting date of employment. Staff #1's negative result was dated 11/09/2024.”

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 CO's observations and a review of facility documentation, Child #11's authorizations for 2 medications lacked the prescription number, dosage, route, start/end dates, and times/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, in Preschool 1B's children's restroom, soap was not operational, and the fixture at the handwashing sink was very loose.”

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: Per allegation and based on CO #1's observations and staff interview, an infant (Child #1) was placed in the Toddler B room. CO #1 observed the infant in the Toddler room with 9 other toddlers. Staff stated that the child was not yet walking, and has spent 1-2 hours in the Toddler room, since last week. This week, Child #1 has spent the entire day in the Toddler room. Staff also stated that 2 other infants (Child #2/Child #3) who are not yet walking, have been spending the afternoons in the Toddler room. According to Staff, Child #2 began the transition into the Toddler room "a few weeks ago", and Child #3's first day in the Toddler room was "yesterday" (01/09/2025).”

AAC R9-5-502.C.2.b. C. A licensee shall ensure that:2. A staff member providing child care services in an infant room does not: b. Place an infant to sleep using a positioning device that restricts movement, unless the infant’s health care provider has instructed otherwise in writing;

“Findings: Based on CO #1's observations and staff interview, an infant was swaddled while sleeping in a crib. Staff stated that medical authorization to swaddle the infant was not obtained from the infant's health care provider.”

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, it was determined that the file for Staff #1 and Staff #2 lacked documentation for a 10-day orientation for new staff members.”

AAC R9-5-203.A. A. A licensee shall ensure that a staff member completes, signs, dates, and submits to the licensee, before the staff member’s starting date of employment or volunteer service:1. The form required in A.R.S. § 36-883.02(C); and 2. If required by A.R.S. § 8-804, the form in A.R.S. § 8-804(I).

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that the file for Staff #1 lacked documentation of a DCS Central Registry Background Check.”

AAC R9-5-510.A.2. A. A licensee shall ensure that a staff member: 2. Teaches, models, and encourages orderly conduct, personal control, and age-appropriate behavior;

“Findings: Per allegation, based on staff interviews, a staff member failed to teach, model, and encourage orderly conduct, personal control, and age-appropriate behavior. It was determined through staff interviews that Staff #1 yelled at a child while disciplining. According to staff statements, on Friday 12/20 Staff #1 was talking to a child about their behavior when Staff #1's voice became elevated to a yell. The administration spoke with the staff member about the exchange. During the interviews, multiple staff members expressed concern about Staff #1’s interactions while correcting behaviors.”

AAC R9-5-501.A.1. A. A licensee shall ensure that:1. In addition to complying with the requirements in this Chapter, the health, safety, or welfare of an enrolled child is not placed at risk of harm;

“Findings: Per allegation and based on staff statements, review of facility documentation, and COs' observations, the health, safety, and welfare of an enrolled child was placed at risk of harm when staff did not notice a growing bump on an infant's right forehead while the infant was in care from 7:30 a.m. to 5:30 p.m on 10/17/2024. There were 8 staff in and out of the infant classroom throughout the day on 10/17/2024, and none of the staff noticed the bump while the infant was in care, nor were they aware of whether this occurred at the center. Photographs were taken by staff of the infant being fed by staff in the morning. During staff interview, the COs presented the photographs to staff, and several staff acknowledged a noticeable bump on the infant's forehead. A photograph taken in the afternoon by staff also showed the bump on the infant's right forehead. Photographs of the infant taken by staff the day before on 10/16/2024, did not show any unusual lumps or bumps on the face or forehead.”

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 CO #2’s observations, in classroom Prepper A, there were 7 children in the classroom unsupervised while the staff member was with a child in the bathroom helping them clean up after a toileting accident.”

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 Officer (CO) #2’s observation, the following rosters did not reflect the enrolled children in the classroom: **Prepper A - 8 children present in classroom; 7 children noted on roster **Preschool 1 - 12 children present in classroom; 13 children noted on roster”