Tiny Toes Child Care

A.R.S. § 36-897.03.B. B. Applicants, certificate holders 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 or C 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 a certificate to operate a child care group home or a license to operate a child care facility for the care of children in this state or another state or had a license to operate a child care facility or a certificate to operate a child care group home revoked for reasons that relate to the endangerment of the health and safety of children.

“Findings: Based on documentation and the Compliance Officer's observations, Resident #2 lacked documentation of a criminal history affidavit.”

AAC R9-3-202.A.2. A. A certificate holder shall ensure that: 2. An adult resident completes, signs, dates, and submits to the certificate holder before the resident’s starting date of residency or the date of certification of the child care group home the form required in A.R.S. § 36-897.03(B).

“Findings: Based on documentation and the Compliance Officer's observations, Staff #1 (DOH: 3/1/2009), Staff #2 (DOH: 3/19/2024), Resident #1, and Resident #2 lacked documentation of the central registry background check.”

AAC R9-3-202.I I. Within 30 calendar days after the day of a staff member’s or adult resident’s 18th birthday, the staff member or adult resident shall provide to the certificate holder copies of a valid fingerprint clearance card and a valid background check document specified in subsection (C).

“Findings: Based on documentation and the Compliance Officer's observations, Resident #2 lacked a fingerprint clearance card within 30 days of the adult resident's 18th birthday.”

AAC R9-3-305.A.1. A. A certificate holder shall ensure that: 1. An enrolled child is signed into and signed out from the child care group home by: a. The enrolled child’s parent; b. An individual authorized in writing or by telephone by the enrolled child’s parent; or c. The enrolled child, if the enrolled child is a school-age child and the enrolled child’s parent has given written permission for the enrolled child to self-admit or self-release;

“Findings: Based on staff statement and the Compliance Officer's observations, there was no record of the times or signatures of the enrolled children's arrivals or departures. Staff stated they have not been doing it.”

AAC R9-3-504.D.2. D. If there are gas pipes that run from a gas meter to an appliance or location on the premises: 2. A certificate holder shall ensure that: a. Each unused natural gas outlet at the child care group home has its valves removed by and is capped at the wall or floor by a licensed plumber or individual authorized by the local jurisdiction; b. A licensed plumber or individual authorized by the local jurisdiction conducts a gas inspection that verifies there are no gas leaks in the gas pipes that run from the gas meter to any appliance or location on the premises at least once every 12 months after the date of the certificate; and c. A copy of a current gas inspection report, including documentation of any repairs or corrections required by the gas inspection report, is maintained on the premises.

“Findings: Based on documentation and the Compliance Officer's observations, the Provider lacked a current gas inspection report. The gas inspection available on site for review expired on 9/24/2025.”

AAC R9-3-508.1. A certificate holder shall ensure that: 1. Each dog, cat, or ferret at the child care group home has a current vaccination against rabies;

“Findings: Based on staff statement and the Compliance Officer's observations, 1 of 7 pets in the child care group home lacked documentation of a current rabies vaccine. Staff stated the pet did not have the current vaccination.”

AAC R9-3-202.G G. If required by A.R.S. § 8-804, before an individual’s starting date of employment or volunteer service, a certificate holder shall comply with the submission requirements in A.R.S. § 8-804(C) for the individual.

“Findings: Based on the certificate holders documentation, 2 of the 3 staff members lacked the DCS Centralized Background check.”

AAC R9-3-305.A.2. A. A certificate holder shall ensure that: 2. The individual signing the enrolled child into or out from the child care group home: a. Records the time of the enrolled child’s arrival or departure, and b. Signs the attendance record with at least the first initial of the individual’s first name and the individual’s last name; and

“Findings: Based on the certificate holders documentation, statements, and the Compliance Officer’s observation, there was no record of the times or signatures of the enrolled children's arrivals or departures. The provided stated that the QR code used to check children in was not working and there was no paper record at the time of the inspection.”

AAC R9-3-506.5. A certificate holder shall ensure that: 5. Each bathroom used by an enrolled child at the child care group home has the following within the reach of enrolled children: a. Mounted toilet tissue, b. Soap contained in a dispenser, and c. Singly dispensed paper towels;

“Findings: Based on CO's observations, the bathroom used by enrolled children lacked singly dispensed paper towels.”

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“Findings: Based on CO's observations and a review of facility documentation, enrolled children were served doughnuts and dry cereal for breakfast. The menu indicated waffles, eggs, strawberries, and milk, and the substitutes were not noted on the menu.”

AAC R9-3-406.C.1. When a child care group home provides food for enrolled children, the certificate holder shall ensure that: 1. Each meal or snack is prepared and served according to the meal pattern requirements in Table 4.2;

“Findings: Based on CO's observations and a review of facility documentation, the breakfast served to children was doughnuts and dry cereal, lacking 2 components (fruit/vegetable and milk).”

AAC R9-3-403.A.4.b. A. A certificate holder shall ensure that: 4. When feeding an enrolled infant who is no longer being held for feeding or an enrolled one- or two-year-old child, a staff member: b. If the feeding chair is manufactured with a safety strap, fastens the safety strap around the enrolled infant or one- or two-year-old child while the enrolled infant or one- or two year-old child is seated in the feeding chair

“Findings: Based on CO's observations, 2 enrolled children were in feeding chairs without the straps fastened around them.”

AAC R9-3-305.A.1. A. A certificate holder shall ensure that: 1. An enrolled child is signed into and signed out from the child care group home by: a. The enrolled child’s parent; b. An individual authorized in writing or by telephone by the enrolled child’s parent; or c. The enrolled child, if the enrolled child is a school-age child and the enrolled child’s parent has given written permission for the enrolled child to self-admit or self-release;

“Findings: Based on CO's observations and a review of facility documentation, enrolled children's attendance records were not available for review. The Provider was unable to pull up the electronic files.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“Findings: Based on CO's observations and a review of facility documentation, 5 of 10 Emergency Information and Immunization Record cards lacked the following required information: **Child #1, Child #5 - Parent/guardian #2 name, street address, city, state, zip code, phone number **Child #2 - Child's phone number **Child #3, Child #4 - Child's city, state, zip code”

AAC R9-3-302.C. C. A certificate holder shall ensure that each staff member completes a total of 12 or more actual hours of training every 12 months after becoming a staff member in two or more of the following: 1. Child growth and development, which may include sudden infant death prevention; 2. Developmentally appropriate activities; 3. Nutrition and developmentally appropriate eating habits; 4. Responding to accidents and emergencies, including CPR and first aid for infants and children; 5. Recognizing signs of illness and infestation; 6. Detecting, preventing, and reporting child abuse or neglect; 7. Guiding and disciplining children; and 8. Availability of community services and resources, including those available to children with special needs.

“Findings: Based on CO's observations and a review of 3 staff files, Staff #1 (DOE 04/11/2022) lacked 4 of the required 12 hours of annual training based on the review period 04/11/2023 - 04/11/2024.”

AAC R9-3-202.G G. If required by A.R.S. § 8-804, before an individual’s starting date of employment or volunteer service, a certificate holder shall comply with the submission requirements in A.R.S. § 8-804(C) for the individual.

“Findings: Based on Compliance Officer's (CO) observations and a review of 3 staff files, Staff #1 (DOE 04/11/2022) and Staff #2 (DOE 03/29/2024) lacked documentation of submission to DCS to complete a background check.”

AAC R9-3-508.1. A certificate holder shall ensure that: 1. Each dog, cat, or ferret at the child care group home has a current vaccination against rabies;

“Findings: Based on CO's observations and a review of facility documentation, 1 (Oliver - cat) of 3 pets lacked documentation of a current rabies vaccination.”

AAC R9-3-505.D.9. D. A certificate holder shall ensure that: 9. An enrolled child does not have access to the following on the premises: a. Lawn mowers, ladders, toilet brushes, plungers, and other equipment that may be a hazard to a child; b. An air conditioner, evaporative cooler, heat pump, or furnace; c. A hot tub or spa; d. A pond or fountain; e. An irrigation ditch, abandoned mine, or well; or f. A trampoline.

“Findings: Based on CO #1's observations, there was a trampoline in the back yard accessible to enrolled children. Staff stated that the trampoline is used with enrolled children.”

AAC R9-3-508.1. A certificate holder shall ensure that: 1. Each dog, cat, or ferret at the child care group home has a current vaccination against rabies;

“Findings: Based on CO #2's observations and a review of facility documentation, the Provider lacked documentation of a current rabies vaccination for the pet dog, Chloe.”

AAC R9-3-303.B. B. Except as required in A.R.S. § 36-309, before a child is enrolled at a child care group home, a certificate holder shall require the individual enrolling the child to complete a Department-provided Emergency, Information, and Immunization Record card containing: 1. The child’s name, home address, city, state, zip code, 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 child care group home or to be contacted if the child’s parent cannot be contacted; 5. The name and contact telephone number of the child’s physician, physician assistant, or registered nurse practitioner; 6. Written authorization for emergency medical care of the child; 7. The name of the individual to be contacted in case of injury or sudden illness of the child; 8. A written description provided by a child’s parent of the nutritional and dietary needs of the child; 9. A written description provided by the child’s parent noting the child’s susceptibility to illness, physical conditions of which a staff member should be aware, and any individual requirements for health maintenance; and 10. The dated signature of the individual completing the Emergency, Information, and Immunization Record card.

“Findings: Based on Compliance Officer (CO) #1's observations and a review of facility documentation, 4 of 5 Emergency Information and Immunization Record cards reviewed lacked the following required information: **Child #1 - Child's city, state, zip code; individual to contact in case of sudden illness/injury; question #2 regarding the child's susceptibility to illness was not answered. **Child #2 - Parent/guardian #2's name, address, city, state, zip code; question #4 regarding child's physical conditions was not answered. **Child #3 - Individual to contact in case of sudden illness/injury. **Child #4 - Child's city, state, zip code”

AAC R9-3-504.D.2. D. If there are gas pipes that run from a gas meter to an appliance or location on the premises: 2. A certificate holder shall ensure that: a. Each unused natural gas outlet at the child care group home has its valves removed by and is capped at the wall or floor by a licensed plumber or individual authorized by the local jurisdiction; b. A licensed plumber or individual authorized by the local jurisdiction conducts a gas inspection that verifies there are no gas leaks in the gas pipes that run from the gas meter to any appliance or location on the premises at least once every 12 months after the date of the certificate; and c. A copy of a current gas inspection report, including documentation of any repairs or corrections required by the gas inspection report, is maintained on the premises.

“Findings: Based on CO #2's observations and a review of facility documentation, the Provider's gas inspection expired on 05/03/2024.”

AAC R9-3-403.A.3.b. A. A certificate holder shall ensure that: 3. When feeding an enrolled infant, a staff member: b. Feeds formula, breast milk, or other food to the enrolled infant according to current written instructions from the enrolled infant’s parent; and

“Findings: Based on CO #1's observations and a review of facility documentation, the 1 enrolled infant lacked documentation of written feeding instructions from the enrolled child's parent.”

AAC R9-3-402.A. A. A certificate holder shall ensure that: 1. Each enrolled child who naps or sleeps at the child care group home is furnished with a bed, cot, mat, or crib that accommodates the enrolled child’s height and weight; 2. The bed, cot, mat, or crib is not used by another individual while in use by the enrolled child; 3. The cot, mat, or bed’s mattress is covered with a clean sheet that is laundered when soiled, at least once every seven calendar days, and before use by a different enrolled child; 4. The crib mattress is covered with a clean fitted-sheet designed for the crib mattress size that is laundered when soiled, at least once every 24 hours, and before use by a different enrolled child; and 5. A clean blanket or sheet is provided to each enrolled child.

“Finding: Based on CO #1's observations, 2 of 3 cribs had sheets that were not fitted to the size of the mattresses.”

AAC R9-3-305.A.1. A. A certificate holder shall ensure that: 1. An enrolled child is signed into and signed out from the child care group home by: a. The enrolled child’s parent; b. An individual authorized in writing or by telephone by the enrolled child’s parent; or c. The enrolled child, if the enrolled child is a school-age child and the enrolled child’s parent has given written permission for the enrolled child to self-admit or self-release;

“Findings: Based on CO #1's observations and a review of facility documentation, enrolled children's attendance records were not available for review. Staff stated that they hadn't been able to get their tablet to work.”

AAC R9-3-508.1. A certificate holder shall ensure that: 1. Each dog, cat, or ferret at the child care group home has a current vaccination against rabies;

“The Compliance Officer requested the documentation of a rabies vaccination for Uzi (cat), the Provider did not have documentation of current rabies vaccination for this animal.”

AAC R9-3-301.A.4.d. A. A certificate holder shall: 4. Ensure that the provider: d. Prepares a dated attendance record for each day and ensures that each staff member records on the attendance record the staff member’s start time and end time of providing child care services for the child care group home;

“Findings include: Based on the Compliance Officer’s observation, it was determined that Staff #1's dated attendance records were last recorded on 10/2/2023.”

AAC R9-3-406.F. F. A certificate holder shall ensure that a staff member: 1. Prepares a weekly menu specifying the foods to be served at each meal and snack on each day, 2. Dates each menu, and 3. Writes food substitutions on a posted menu no later than the morning of the day of the meal or snack to which the substitution applies.

“Findings include: Based on the Compliance Officer’s observation, the posted snack menu lacked a date.”

AAC R9-3-505.D.5. D. A certificate holder shall ensure that: 5. Except as provided in R9-3-503(C)(4) and subsection (D)(6)(d), the following are stored in a labeled container separate from food storage areas and are inaccessible to an enrolled child: a. Materials and chemicals labeled as a toxic substance, and b. Substances that have a child warning label and may be a hazard to a child;

“Findings include: Based on the Compliance Officer’s observation, the storage cabinet in the restroom was unlocked and it contained baby wipes. The baby wipes were accessible to the enrolled children.”

AAC R9-3-507.B.1. B. A certificate holder shall ensure that: 1. A staff member: a. Cleans, sanitizes, and dries a diaper-changing surface using a single-use paper towel before and after each diaper change; b. Washes the staff member’s hands with soap and running water before and after each diaper change; c. Wears single-use non-porous gloves during each diaper change; d. Washes an enrolled child’s hands with soap and running water or with a washcloth or disposable wipe after the enrolled child’s diaper is changed and uses each washcloth or disposable wipe on only one child and only one time before it is laundered or discarded; and e. Documents the daily diaper changes for each enrolled child in a dated diaper-changing log after changing the enrolled child’s diaper;

“Findings include: Based on the Compliance Officer’s observation and information provided by Staff #1, it was determined that the diaper changing log had not yet been completed.”