The Lily Pad Day Care Center

AAC R9-5-501.B.9. B. A licensee shall ensure that a staff member: 9. Does the following when a parent permits or asks a staff member to apply personal products on an enrolled child, such as petroleum jelly, diaper rash ointments, sun screen or sun block preparations, toothpaste, and baby diapering preparations: a. Obtains the enrolled child’s personal products from the enrolled child’s parent or, if the licensee provides the personal products for use by the enrolled child, obtains written approval for use of the products from the enrolled child’s parent; b. Labels the personal products with the enrolled child’s name; and c. Keeps the personal products inaccessible to enrolled children;

“Findings: Based on the Compliance Officers' observations, the following personal products were not labeled with the child's first and last name as required: 1s Room: *2 packs of wipes and 1 diaper cream labeled with the enrolled children's first names only. *1 unlabeled pack of wipes. 2s Room: *7 packs of wipes labeled with the enrolled children's first names only. *2 packs of wipes labeled with the enrolled children's first names and last initials.”

AAC R9-5-304.B. B. Except as required in A.R.S. § 36-3009, before an enrolled child receives child care services, a licensee shall require the enrolled child’s parent to complete an Emergency, Information, and Immunization Record that is no more than a two-page written notice, and is signed by the enrolled child’s parent containing: 1. The child’s name, home address, sex, and date of birth; 2. The date of the child’s enrollment; 3. The name, home address, email address, and telephone number of each parent of the child; 4. The name and contact telephone number of at least two individuals authorized by the child’s parent to collect the child from the facility in case of emergency, or if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s health care provider; 6. The written authorization for emergency medical care of the enrolled child when the parent cannot be contacted at the time of the emergency; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. The written instructions of a child’s parent or health care provider for the nutritional and dietary needs of the child including, if applicable, the request in R9-5-509(C)(14); and 9. A written record completed by the child’s parent or health care provider noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance.

“Findings: Based on facility documentation and the Compliance Officers' observations, 6 of 15 enrolled children's Emergency Information and Immunization Records lacked the following documentation: *Child #1: The name and contact telephone number for 1 of 2 individuals authorized to collect the child from the facility in case of an emergency. *Child #2: The name and contact telephone number of the child's health care provider. *Child #3: The name, address, and telephone number of the child's second parent. *Child #4 and Child #5: The name, address, and telephone number of the child's second parent, and the name of the individual to be contacted first in case of injury or sudden illness. *Child #6: The name and contact telephone number of the child's health care provider, and the child's home phone number.”

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

“Findings: Based on the Compliance Officers' observations, in the 1s Room and 2s Room, there was an accumulation of debris in the corners of the diaper-changing surfaces.”

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: The Compliance Officer observed that there were several packages of wipes and several clean diapers in the diaper changing handwashing sink in the front toddler’s room.”

AAC R9-5-516.H. H. Except as provided in subsection (J), a licensee shall ensure that prescription and nonprescription medications are stored as follows:1. An enrolled child’s medication is kept in a locked, leak-proof storage cabinet or container that is used only for storing enrolled children’s medications and is located out of reach of children; 2. Medication for a staff member is kept in a locked, leak-proof storage cabinet or container that is separate from the storage container for enrolled children’s medications and is located out of reach of children; and 3. Medications requiring refrigeration are kept in a locked leak-proof container in a refrigerator.

“Findings: The Compliance Officer observed that the director’s cough medication was on a shelf in the director’s office and was not in locked storage.”

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, a section of rope on a rope ladder on a climbing structure was frayed and broken.”

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 two staff statements and a staff member’s written statement, staff 2 did not model personal control when staff 2 told a child they were going to “pop them” if they did not lay down on a cot and take a nap during nap time.”

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

“Findings: The Compliance Officer observed that In the preschool classroom after lunch, the director was sweeping the floor and a second staff was trying to get children settled on their mats. There were 17 children in the classroom and children in the classroom were not being supervised. A child was off their cot and was sitting next to another child on a cot rubbing their bare back. The child that got off their cot placed the other child on their stomach on the cot and was rubbing the child’s back with their hand after pulling up this child’s shirt. Other children were behind a shelving unit playing on the floor and these children could not be seen by staff in the room. Another group of children were around a small table looking at books and leaving the area at different times.”

AAC R9-5-404.E. E. In addition to maintaining the required staff-to-children ratios, a licensee shall ensure that:1. Staff members are present on facility premises to perform facility administration, food preparation, food service, and maintenance responsibilities; and 2. Facility maintenance does not depend on the work of enrolled children.

“Findings: The Compliance Officer observed and staff stated that due to staff breaks and staff shortage, the director was needed in a classroom to meet the required ratio. The director was sweeping the floor and cleaning tables after lunch and also trying to get children on their mats. The director was unable to perform facility administration duties during this time.”

AAC R9-5-402.A. A. A licensee shall maintain a file for each staff member containing:1. The staff member’s name, date of birth, home address, and telephone number; 2. The staff member’s starting date of employment or volunteer service; 3. The staff member’s ending date of employment or volunteer service, if applicable; 4. The name and telephone number of an individual to be notified in case of an emergency; 5. The staff member’s written statement attesting to current immunity against measles, rubella, diphtheria, mumps, and pertussis; 6. The form required in A.R.S. § 36-883.02(C); 7. Documents required by R9-5-203; 8. Documents required by R9-5-301; 9. Documents required by R9-5-401, if applicable; 10. If applicable: a. The form required in A.R.S. § 8-804(I), b. Documentation of the submission required in A.R.S. § 8-804 and the information received as a result of the submission, and c. Documentation of training provided by a licensee as required by R9-5-403, if applicable; 11. A copy of any current license or certification required by A.R.S. Title 36, Chapter 7.1, Article 1. or this Chapter; and 12. Documentation of the requirements in A.R.S. § 36-883.02(D).

“Findings: The Compliance Officer reviewed 2 staff files. The file for staff 1 lacked documents required in R9-5-203 - a copy of the staff member’s fingerprint clearance card.”

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: The Compliance Officer observed that the rosters for the 1’s and 2’s group combined in the front activity area did not accurately document the number of children present in the room.”

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;

“Based on an observation, sippy, cups, a food container and silverware were observed in the diaper changing sink and counter.”