T.U.S.D.#1 - Maxwell Preschool Program

AAC R9-5-516.B.4. B. If prescription or nonprescription medications are administered, a licensee shall ensure that: 4. A staff member: a. Administers a prescription medication provided by a parent only from a container dispensed by a pharmacy; b. Administers a nonprescription medication provided by a parent for an enrolled child only from a container prepackaged and labeled for use by the manufacturer and labeled with the enrolled child’s name; c. Does not administer any medication that has been transferred from one container to another; and d. Does not administer a nonprescription medication to an enrolled child inconsistent with the instructions on the nonprescription medication’s label, unless the facility receives written authorization from the enrolled child’s health care provider.

“Findings: Based on review of medications stored onsite the Secondary Compliance Officer noted that Child 1's medication is dispensed in a two-pack, but the facility only had one dosage onsite.”

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 review of medications stored onsite the Secondary Compliance Officer observed that Child 1's medication consent form did not document the following required information: -Start and end dates of authorization -Times and frequency of administration”

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 statement, signed by the enrolled child's: a. 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. Parent, that the enrolled child is being raised in a religion whose teachings are in opposition to immunization.

“Findings: Based on review of 10 Emergency, Information and Immunization Record (EIIR) cards the Secondary Compliance Officer observed that Child 2's file contained the incorrect Immunization Exemption Affidavit.”

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 review of sign in and out documents the Compliance Officer noted the following: -Child 1 was signed out without the time being documented on 01/23/25. -Child 2 was signed out without the time being documented on 01/21/25. -Child 3 did not have a time in or time out documented on 02/06/25. -Child 4 was signed in without the time being documented on 02/04/25 and 02/06/25.”

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: The Compliance Officer observed a carton of chocolate milk in the large garbage can near the main entrance of the classroom. The garbage can had a liner, but did not have a lid.”

AAC R9-5-509.C.14. C. A licensee shall ensure that:14. Each staff member is informed of a modified diet prescribed for an enrolled child by the child’s parent or health care provider, and the modified diet is posted in the kitchen and in the child’s activity area;

“Findings: Based on review of required postings the Compliance Officer noted that Child 5's modified diet was not posted in their classroom. *The staff updated the posting during the inspection*”

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: The Compliance Officer inspected the children's restroom and observed that the toilet contained unflushed urine.”

AAC R9-5-603.E. E. A licensee shall ensure that the following is provided and maintained within the fall zones of swings and climbing equipment in an outdoor activity area:1. A shock-absorbing unitary surfacing material manufactured for such use in outdoor activity areas; or 2. A minimum depth of 6 inches of a non-hazardous, resilient material such as fine loose sand or wood chips.

“FINDINGS: The Compliance Officer inspected the Preschool Playground and measured 4 inches of wood chips under and around the fall zones of the climbing equipment.”

AAC R9-5-516.C. C. A licensee shall allow an enrolled child to receive an injection only after obtaining a written authorization from a health care provider

“FINDINGS: The Compliance Officer reviewed the medication for Child 2 and observed that it lacked written consent from their physician for the medication.”

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: The Compliance Officer reviewed the Medication Consent Forms for Children 1 and 2 and observed the following: The form for Child 1 lacked the start and end date The form for Child 2 lacked the prescription number and the end date. It was observed that the form for their second medication was blank.”