Todays Tomorrow Learning Academy

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 Supervisor's observations, Child #1 and Child #2's Emergency, Information, and Immunization Records lacked the child's second emergency contact's telephone number.”

AAC R9-5-302. A licensee shall prepare a written statement of child care services provided by the licensee that includes the following: 1. A description of the facility’s child care services classifications in R9-5-204; 2. Hours of operation; 3. The facility’s street address, city, state, zip code, mailing address, and telephone number; 4. Child enrollment and disenrollment procedures; 5. Charges, fees, and payment requirements for child care services; 6. Child admission and release requirements; 7. Guidelines for positive discipline reflective of age-appropriate methods for children that include clear, appropriate, consistent expectations; 8. Transportation procedures; 9. Field trip requirements and procedures; 10. Responsibilities and participation of parents in facility activities; 11. A general description of activities and programs; 12. A description of the liability insurance required by R9-5-308 that is carried by the licensee and a statement that documentation of the liability insurance coverage is available for review on the facility premises; 13. Medication administration procedures; 14. Accident and emergency procedures; 15. A notice stating inspection reports are available on-site; 16. A provision stating that the facility is regulated by the Arizona Department of Health Services including the Department’s local street address, city, state, zip code, and local telephone number; 17. The procedures for notifying a parent at least 48 hours before a pesticide is applied on a facility’s premises; 18. A statement that a parent has access to the areas on facility premises where the parent’s enrolled child is receiving child care services; and 19. Policies and procedures for suspension and expulsion of children to include clear, appropriate, consistent expectations, including suspension and expulsion prevention strategies.

“Findings: Based on a review of facility documentation and the Compliance Officer Supervisor's observations, the written statement of child care services lacked the following required components: *Transportation procedures. *Field trip requirements and procedures. *A statement that documentation of the liability insurance coverage is available for review on the facility premises.”

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 Supervisor's observations, the following staff members’ files lacked the required background check documentation: Staff #1 (DOH 06-17-2015), Staff #3 (DOH 09-09-2024), and Staff #6 (DOH 03-31-2025)- The results. Staff #2 (DOH 10-08-2025), Staff #4 (DOH 07-28-2025), and Staff #5 (08-18-2025)- The form and results.”

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: Based on a review of facility documentation and the Compliance Officer Supervisor's observations, Staff #6's (DOH 03-31-2025) file lacked documentation of the 2 required good-faith effort references.”

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

“Findings: Based on the Compliance Officer Supervisor's observations, the fire alarm panel was in trouble mode.”

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 the hallway bathroom, there was a chunk of flooring missing behind the toilet.”

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, in the 1's Room, there was a clipboard and a pen on the diaper changing surface.”

AAC R9-5-503.A.2. A. A licensee shall ensure that each diaper changing area required in R9-5-601(4) contains: 2. A hand-washing sink next to the diaper changing surface for staff use when changing diapers and for washing an enrolled child during or after diapering that provides: a. Running water between 86° F and 110° F, b. Soap from a dispenser, and c. Single-use paper hand towels from a dispenser;

“Findings: Based on the Compliance Officer's observations, the temperature of the following diaper-changing sinks was not maintained between 86° F and 110° F: *Preschool Room- 76° F. *Young 1's- 78° F. *1's and Infant Room- 79° F. *2's Room- 80° F.”

AAC R9-5-503.A.3.4. 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 4. At least one waterproof, sanitizable container with a waterproof liner and a tight fitting lid for soiled clothing.

“Findings: Based on the Compliance Officer's observations, the following containers were not maintained as required: *1's Room- the soiled diaper container lacked a lid and lining. *2's Room- the soiled clothing container lacked the lining. *Young 1's Room- the soiled diaper container lacked a lid.”

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, in the Pre-K toilet room, there was a soft cloth and two unlidded clear bins with toys on a shelf being stored in the toilet room.”

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, these hazards were accessible on the following playgrounds: *1st Playground- there was raw, rough splintery wood on the black wooden fence, and the resilient grass surfacing was lifting with gaps on the ground. *2nd Playground- there was raw, rough splintery wood on the black wooden fence, there were pieces of cracked plastic on a bin causing sharp ends, and the orange slide equipment had a dark black build-up on the handles.”

ARS § 36-883.02.C. C. Applicants, licensees and child care personnel shall attest on forms that are provided by the department that: 1. They are not awaiting trial on or have never been convicted of or admitted in open court or pursuant to a plea agreement committing any of the offenses listed in section 41-1758.07, subsection B in this state or similar offenses in another state or jurisdiction. 2. They are not parents or guardians of a child adjudicated to be a dependent child as defined in section 8-201. 3. They have not been denied or had revoked a certificate to operate a child care group home or a license to operate a child care facility in this or any other state or that they have not been denied or had revoked a certification to work in a child care facility or child care group home.

“Findings: Based on a review of facility documentation and the Compliance Officer Supervisor's observations, Staff #2 (DOH 10-08-2025), Staff #5 (DOH 08-18-2025), and Staff #6's (DOH 03-31-2025) files lacked documentation of a completed Criminal History Affidavit. The forms lacked the facility's address or CDC number.”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 3. A child educator is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience if working with enrolled children five years old and younger, or three months of child care experience if working with school-aged children; and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on a review of facility documentation and the Compliance Officer Supervisor's observations, the following staff files lacked the required documentation: Staff #2 (DOH 10-08-2025)- Documentation of six months of child care experience, and a high school diploma/high school equivalency diploma. Staff #4 (DOH 07-28-2025)- Documentation of six months of child care experience.”

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 a review of facility documentation and the Compliance Officer and Compliance Officer Supervisor's observations, in the 1's-2's Room, there were 9 enrolled children present, but only 7 marked on the roster.”

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 positive discipline, including separation; 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; 17. Field trip procedures, if applicable; 18. Infant tummy time, if applicable; 19. Prevention of sudden infant death syndrome and use of safe sleeping practices, if applicable; and 20. Prevention of shaken baby syndrome, pediatric abusive head trauma, and child maltreatment.

“Findings: Based on a review of facility documentation and the Compliance Officer Supervisor's observations, Staff #6's (DOH 03-31-2025) file lacked documentation of the required 10-day new staff training.”

AAC R9-5-510.B.1. B. A licensee shall ensure that a staff member does not use or permit: 1. The use of physical punishment including: a. Hitting, spanking, shaking, slapping, twisting, pulling, squeezing, or biting; b. Demanding excessive physical excercise or excessive rest; and c. Forcing a child to eat or consume soap, food, or foreign substances;

“Per allegation findings: Based on Compliance Officer's observation and information provided in interviews, on 9/30/25 Staff #1 (start date 8/2/23) was observed by Staff #2 (Start date 8/4/25) pinching the ear of Child #1. Via an interview conducted on 10/3/25, Child #1 confirmed the incident stating "A teacher pulled my ear. Made me cry" and referred to a photo of Staff #1 as the teacher who was responsible for the incident.”

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 observation and review of facility documentation, the roster in the 3/4/5’s classroom reflected the presence of 8 children, however 9 children were actually present in the classroom.”

AAC R9-5-511.A.1.2.3.4.5. 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, 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; 5. Each cot, mat, or crib is maintained in a clean and repaired condition;

“Findings: Based on Compliance Officer's observation, in the 1/2's classroom there was a child sleeping directly on the cot surface without a sheet between the child and the cot surface.”

AAC R9-5-502.A.8.a. A. A licensee providing child care services for infants shall: 8. Provide a crib for each infant that: a. Has bars or openings spaced no more than 2-3/8 inches apart and a crib mattress measured to fit not more than 1/2 inch from the crib side;

“Findings: Based on Compliance Officer's observation, there was an infant asleep on a mat placed directly on the floor, not within the required infant crib.”

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 the 2’s room, there was exposed drywall on the West wall to the left of the outside door, accessible to enrolled children.”

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 the Compliance Officer's observation, in the 1’s room, there was sticky tape residue on the windows.”

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 the the Compliance Officer's observations, in the Young 1's room, the following items lacked a label of the child's first and last name as required: *3 packets of wipes and an ointment lacked a last name. *1 ointment lacked a first and last name.”

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 the Compliance Officers’ observations, the following diaper changing areas lacked a soiled clothing container: Young 1’s & Preschool room (3s). In the Infant room, there were white rags and a container of Soft Soap in the container.”

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 Compliance Officer #1’s observation, the Infant room diaper changing surface was not kept clear of items not required for diaper changing. There was an iPad on the diaper counter surface.”

AAC R9-5-502.C.4.h. C. A licensee shall ensure that:4. When feeding an infant, a staff member: h. If an infant is no longer being held for feeding, seats the infant in a feeding chair or at a table with a chair that allows the infant to reach the food while sitting.

“Findings: Based on Compliance Officer #1’s observation, in the Infant room, an infant was observed being fed while seated on the floor.”

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 Compliance Officer #2’s observations, in the Infant room, there were 6 unlabeled bottles, and 3 bottles labeled with a child’s first name only.”

AAC R9-5-502.C.1.m. C. A licensee shall ensure that:1. A staff member providing child care services in an infant room: m. Posts the current written dietary instructions in the infant room and the kitchen and maintains the instructions on facility premises for 12 months after the date of the instructions; and

“Findings: Based on the Compliance Officers’ observations, in the Infant room, the infant feeding plans were not posted. The kitchen lacked posted feeding plans.”

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 the Compliance Officers’ observations, the following areas were not maintained in a clean condition: 1’s room: There was sticky tape residue on the window. Main room: There were 5 black garbage bags on the floor in the toilet room. Infant room: There was a dirty grey stool on the floor, and there was a yellow liquid substance on the bottom of the refrigerator.”

AAC R9-5-504.5.d. A licensee providing child care services for 1-year-old and 2-year-old children shall:5. Ensure that: d. If a parent brings a sippy cup for the parent’s enrolled child, the sippy cup is labeled with the enrolled child’s name.

“Findings: Based on Compliance Officer #1’s observations, in the 2’s room, there were 2 unlabeled sippy cups that lacked an enrolled child’s name.”

AAC R9-5-203.D. D. A licensee shall ensure that each staff member submits to the licensee a copy of the staff member’s valid fingerprint clearance card each time the fingerprint clearance card is issued or renewed every six years.

“Findings: Based on facility documentation and Compliance Officer #1's observations of 8 staff files, Staff #1 (DOH 2/21/2024) & Staff #2's (DOH 3/26/2024) files lacked documentation of a copy of the back side of their fingerprint clearance cards.”

AAC R9-5-301.F. F. A licensee shall ensure that a staff member submits, on or before the starting date of employment or volunteer services, one of the following as evidence of freedom from infectious active tuberculosis: 1. Documentation of a negative Mantoux skin test or other tuberculosis screening test recommended by the U.S. Centers for Disease Control and Prevention, administered within 12 months before the starting date of employment or volunteer service, that includes the date and the type of tuberculosis screening test; or 2. If the staff member has had a positive Mantoux skin test or other tuberculosis screening test, a written statement that the staff member is free from infectious active tuberculosis that is signed and dated by a health care provider within six months before the starting date of employment or volunteer service.

“Findings: Based on facility documentation and Compliance Officer #1's observations of 8 staff files, the files for the following staff lacked a negative Mantoux skin test administered within 12 months before the starting date of employment: Staff #3 (DOH 6/5/2023): TB test dated on 6/4/2023 lacked the results of the test. Staff #5 (DOH 10/2/2023): TB test read on 11/2/2023. Staff #6 (DOH 5/13/2024): TB test read on 5/15/2024.”

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 facility documentation and Compliance Officer #2's observations, it was determined that 2 out of 25 enrolled children's Emergency Information and Immunization Record Cards reviewed lacked the following required information: Child #1 and Child #3: The name of the individual to be contacted in case of sudden injury or illness.”

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

“Findings: Based on facility documentation and Compliance Officer #2's observations, it was determined that the Emergency, Information and Immunization Record Cards for Child #1 and Child #2 lacked a written immunization record or exemption affidavit.”

AAC R9-5-306.B. B. A licensee shall: 1. Develop, document, and implement policies and procedures to ensure that a staff member maintains daily documentation of the presence of an enrolled child in an activity area that includes a method to account for any temporary absences of the enrolled child from the activity area, and 2. Maintain the documentation of the presence of enrolled children in an activity area required in subsection (B)(1) on facility premises for 12 months after the date of the documentation.

“Findings: Based on facility documentation and Compliance Officer #2's observation, in the 1's room, there were 3 children present and 1 child was listed on the roster.”

AAC R9-5-512.C. C. A licensee shall ensure that floor coverings are:1. Clean; and 2. Free from: a. Dampness, b. Odors, and c. Hazards.

“Findings: Based on the Compliance Officers’ observations, floor coverings in the following areas were not maintained in a clean condition: 2’s room: There were discolored stains on the green alphabet rug. 1’s room: There were discolored stains on the blue fish rug. Young 1’s: There were discolored stains on the blue circle rug.”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility:3. A teacher-caregiver is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on facility documentation and Compliance Officer #1's observations, Staff #1 (DOH 2/21/2024) and Staff #4's (DOH 1/9/2024) files lacked documentation of a high school diploma or high school equivalency diploma. The documents in the files were not translated and evaluated to be equivalent to a high school diploma or high school equivalency diploma from the United States.”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on the Compliance Officers' observations and staff statement, in the Main room, the staff to child ratio was 0:1, with a one-year-old child present in the room, and a required ratio of 1:1. Staff stated the cook was supposed to be watching the child.”

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 the Compliance Officers’ observations, drinking water was not available for 6 children present on the playground. There were 16 children present on the playground and only 10 water cups available.”

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 Compliance Officer #2’s observations, the licensee lacked written feeding instructions for Child #4, Child #7 & Child #8. Child #5 & Child #6’s feeding instructions were not current and did not list the current foods the infants eat.”

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 Compliance Officer #2’s observations, in the Infant room, there were 6 containers of formula labeled with a child’s first name only and 1 container lacked a child’s name.”

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 Officers' observations, the following hazards were accessible to enrolled children: 2’s room: There was a 10” by 2” patch of exposed drywall on the west wall to the left of the outside door. Young 1’s: There was a peeling chunk of paint on the east wall, and patches of exposed drywall on the east wall. Pre K room (4/5s): There was a 4” by 3” patch of exposed drywall on the north wall.”

AAC R9-5-501.A.18. A. A licensee shall ensure that:18. Each enrolled child’s pacifier is labeled with an identifier that is specific to the enrolled child and maintained in a clean condition;

“Findings: Based on Compliance Officer #1’s observations, in the Infant room, there were 2 unlabeled pacifiers that lacked an identifier specific to an enrolled child.”

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 the Compliance Officers’ observations, the following children’s personal products lacked an enrolled child’s first and last name, as required: Infant room: 3 containers of wipes labeled with a child’s first name only, and 2 unlabeled diaper creams. 2’s room: 1 unlabeled container of wipes, 1 container of wipes labeled with a child’s first name only, and 1 diaper cream labeled with a child’s first name and last initial. 1’s room: 2 containers of wipes labeled with a child’s first name only. Young 1’s room: 2 containers of wipes labeled with a child’s first name only. Preschool (3s): 2 unlabeled containers of wipes, and children’s personal products were located in children’s cubbies and were 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 the Compliance Officers’ observations and staff statement, enrolled children were not supervised at all times. In the Main room, a child was seated at a table eating alone and unsupervised . Staff stated the kitchen cook was supposed to be supervising the child.”

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 Compliance Officer #1's observations of 8 staff files, Staff #3 (DOH 6/5/2024) & Staff #4's (DOH 1/9/2024) files lacked documentation of the DCS Registry Affidavit.”

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 Compliance Officers' observations, the following hazards were observed on facility playgrounds: *the metal door on the patio had an accumulation of rust and sharp metal edges near the base of the door. *there was a wooden pallet leaning against the shed on the patio. *the telephone pole on the western side of the playground had exposed wiring, and rough splintering wood that was accesible to enrolled children.”

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, there were 6 children present in the Infant room, however only 5 children were documented on the roster.”

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 Compliance Officers' observations, the caulking at the base of the toilets in the 3/4’s restroom was deteriorating and unable to be sanitized.”

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 Compliance Officers' observations, there was paint peeling from the walls in the threes classroom.”

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 Compliance Officers' observations, the diaper changing area in the Infant room lacked a soiled clothing container.”

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 Compliance Officers' observations, the Infant room refrigerator lacked a thermometer.”

AAC R9-5-605.B.6. B. A licensee shall ensure that: 6. Except for a room used only for an enrolled school-age child, each unused electrical outlet is covered with a safety plug cover or insert;

“Findings: Based on Compliance Officers' observations, there was an electrical outlet in the PreK classroom that lacked a safety cover.”

AAC R9-5-401.3. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 3. A teacher-caregiver is 18 years of age or older and provides the licensee with documentation of one of the following: a. Six months of child care experience and: i. A high school diploma or high school equivalency diploma; or ii. At least 12 credit hours from an accredited college or university, including at least six credit hours in early childhood, child development, or a closely-related field; b. Associate or bachelor degree from an accredited college or university in early childhood, child development, or a closely-related field; or c. N.A.C., C.D.A., or C.C.P. credential;

“Findings: Based on Compliance Officer's observation and review of facility documentation, the file for Staff #1 (start date 8/2/23) lacked documentation of a valid high-school diploma as the foreign diploma in the file was not translated and evaluated.”

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;

“Findings: Based on Compliance Officer's observation and review of facility documentation, on 9/25/23 a parent was not notified by facility management immediately after a child received a lip injury at facility.”