Tutor Time Child Care/ Learning Centers

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 video footage and the Compliance Officer's observation, the file for Staff #2 (DOE 2/5/24) lacked documentation of a high school diploma or high school equivalency diploma. The document in the file was not evaluated to be equivalent to a high school diploma or high school equivalency diploma from the United States. The file also lacked documentation of 6 months of child care experience. Video footage documented Staff #2 working as a child educator when Staff #2 was seen removing a child from the Pre K classroom out into the main lobby area.”

AAC R9-5-510.A.1. A. A staff member shall provide guidance to help children respond to difficult situations. To develop self-regulation, children should receive adult support that is individual to the child and adapts as the child develops internal controls. This process should include: 1. Forming a positive relationship with the child, which occurs when the adult spends time talking to the child, listening to the child, following the child’s lead, playing with the child, and responding to the child’s needs; 2. Base expectations on the child’s developmental level; 3. Establishing and being proactive in teaching and supporting children in learning simple rules; 4. Modifying the learning/play environment to support the child’s appropriate behavior; 5. Creating a predictable daily routine and schedule; 6. Modeling desired behavior; 7. Showing children positive alternatives; 8.Using deliberate redirection, the staff member should encourage the child to use appropriate behavior, and provide positive feedback when the child exhibits the behavior; 9. Individualized positive discipline strategies based on the individual needs of children, such as using a buddy system, individualized schedule, special break, or another applicable positive discipline strategy; and 10. If applicable, a licensee shall develop a written plan with the enrolled child's parent to provide individualized social and emotional intervention supports for the enrolled child that includes methods for understanding the enrolled child's behavior, and developing, adopting, and implementing a team-based positive behavior support plan.

“Findings: Based on video footage and the Compliance Officers' observation, the licensee failed to ensure that staff use deliberate redirection and encourage children to use appropriate behavior in the Pre-K classroom. Video footage documented children in the Pre-K classroom throwing toys, fighting, hitting, and running around the classroom without intervention from the staff member present in the room.”

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;

“Findings: Per allegation, video footage, pictorial evidence, and the Compliance Officers' observations, the licensee failed to ensure that a staff member does not use or permit the use of physical punishment when Staff #1 was observed aggressively grabbing and dragging an enrolled child, leaving 3 marks on the child's arm. Video footage documented the following at 8:06 am on 5/22/26; Staff #1 (DOE 12/29/20) aggressively grabbed an enrolled child, leaned down into the child's face, said something, and then dragged the child to a table to fix the chairs. The child appeared upset and was grabbing their arm after the staff had let them go. Picture evidence from the same day showed three small 3 red marks on the child's right arm, in the same location where the staff member had grabbed the child.”

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

“Findings: Per allegation, staff statement, and based on the Compliance Officer's observation, staff failed to supervise each enrolled child at all times. Upon the arrival of the Compliance Officer to the outside playground, a staff member was observed with their back to the children while leaning over the fence talking to another staff member. Staff stated: *Sometimes kids get scratched and I can't tell you what happened. *(Staff's) supervision is not the best. *We've had an older kid walk out and (staff) had no clue. *There will be biting and (staff) doesn't know. *Sometimes things happen and I don't see.”

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 Officer's observation, there were pears on the floor under and around the tables where children eat in the Pre Kindergarten room.”

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: Based on the Compliance Officer's observation, an infant was moved from the infant room to the 1's room upon the arrival of the Compliance Officer. Staff stated the infant was in the process of transitioning from the infant room to the 1's room.”

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 the Compliance Officer's observation, the following rosters did not accurately reflect the number of children present in the activity area: *Infant: There were 9 infants present and 8 infants marked on the roster; and *Early Head Start: There were 5 children present and 4 children marked on the roster.”

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. 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 facility documentation and the Compliance Officer's observation, the kitchen lacked current infant feeding forms.”

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 Officer's observation, the Two's classroom had 3 diaper creams that lacked the enrolled children's first and last names.”

AAC R9-5-501.B.6. B. A licensee shall ensure that a staff member: 6. For enrolled children five-years or younger, and except as provided in subsection (C), prepares, posts, and implements a dated lesson plan in each indoor activity area for each calendar week, which is maintained on facility premises for 12 months after the lesson plan date and provides opportunities for each child to: a. Gain a positive self-concept; b. Develop and practice social skills; c. Think, reason, question, and experiment; d. Acquire language skills; e. Develop physical coordination skills; f. Participate in structured large muscle physical activity; g. Develop habits that meet health, safety, and nutritional needs; h. Express creativity; i. Learn to respect cultural diversity of children and staff; j. Learn self-help skills; and k. Develop a sense of responsibility and independence;

“Findings: Based on facility documentation and the Compliance Officer's observation, the Early Preschool classroom lacked a current lesson plan.”

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 Officer's observation, it was determined that 6 of 20 enrolled children's Emergency, Information, and Immunization records were lacking the following information: *Child #1, Child #3, and Child #6: The date of enrollment. *Child #2: The name of the individual to be contacted in case of injury or sudden illness of the child. *Child #4: The name and contact information for the child's health care provider and the name and contact information for a second emergency contact. *Child #5: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.”

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 observation, the soiled clothing containers lacked a waterproof liner in the Early Head Start room, the Toddler 2's room, the Toddler 1's room, and the Two's room.”

AAC R9-5-503.E.1. E. A licensee shall ensure that in an activity area with a diaper changing area: 1. The container required in subsection (A)(3) and (4) are inaccessible, and

“Findings: Based on the Compliance Officer's observation, in the Two's room, there was a soiled diaper in the bathroom trash accessible to the enrolled children.”

AAC R9-5-512.F.8.9. F. A licensee shall ensure that: 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 the Compliance Officer's observation, there was a loose seat on the toilet in the Head Start bathroom.”

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: Based on the Compliance Officer and Compliance Officer Supervisor's observation, the two play structures on the Toddler Playground lacked resilient surfacing.”

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 the following hazards were accessible to enrolled children on the Preschool Playground: *1 of 2 handles on a pink trike and a yellow trike were broken with sharp edging; and *1 yellow trike was missing 1 of 2 handles.”

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 the Compliance Officer Supervisor's observation, the medication forms for Child #7 and Child #8 lacked a prescription number and dates of authorization.”

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 Officer's observation, the soiled clothing containers in the Early Preschool Room and Early Head Start Room were located in the classroom bathroom and not in the diaper changing area as required.”

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 and Compliance Officer Supervisor's observations, the following diaper changing areas lacked the following: *Early Preschool: Lacked mounted paper towels and the diaper changing sink temperature was 80°F; and *Early Head Start: The diaper changing sink temperature was 75°F.”

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 Officer's observation, the following personal products lacked a label with the child's first and last name as required: Early Preschool: 1 diaper cream was labeled with the child's first name only and 1 diaper cream lacked a label; and Early Head Start: 5 of the 5 wipe containers reviewed were labeled with the child's first name only and 1 of 2 diaper creams reviewed lacked a label.”

AAC R9-5-403.B. B. A licensee shall ensure that:1. Each staff member who provides child care services completes 18 or more actual hours of training every 12 months after the effective date of this Chapter or the staff member’s starting date of employment or volunteer service in at least two topics listed in this subsection: a. Child growth and development, including: i. Infant growth and development, which may include sudden infant death syndrome prevention; ii. Developmental psychology; iii. Language development; iv. Observation and child assessment; v. Developmentally-appropriate activities; vi. Child guidance and methods of discipline which may include training on the appropriate techniques to prevent a child from harm or to prevent the child from harming others; and vii. Developmentally-appropriate activity areas; b. Health and safety issues, including: i. Accident and emergency procedures, including CPR and first aid for infants and children; ii. Recognition of signs of illness and infestation; iii. Nutrition and developmentally-appropriate eating habits; iv. Child abuse detection, reporting, and prevention; v. Safety of indoor and outdoor activity areas; and vi. Sun safety policies and procedures; c. Program administration, planning, development, or management; and d. Availability of community services and resources, including those available to children with special needs; and 2. As part of the required 18 hours of training in subsection (B)(1): a. A staff member who has less than 12 months of child care experience before the staff member’s starting date, completes at least 12 hours in one or more of the topics in subsection (B)(1)(a) in the staff member’s first 12 months at the facility; b. A staff member who has 12 months or more of child care experience, completes at least 6 hours in one or more of the topics in subsection (B)(1)(a) every 12 months after the staff member’s starting date; c. A staff member who provides child care services to an infant completes at least 6 hours in subsection (B)(1)(a)(i) every 12 months after the staff member’s starting date; and d. A facility director completes at least 6 hours in subsection (B)(1)(c) every 12 months after the facility director’s starting date.

“Findings: Based on the Compliance Officer and Compliance Officer Supervisors' observations, the following staff files lacked 18 hours of annual training as required: *Staff #1 (DOE 8/17/2022) lacked 10.5 of the 18 required hours for 8/17/2023-8/17/2024; and *Staff #2 (DOE 11/18/1991) lacked 9 of the 18 required hours for 11/18/2023-11/18/2024.”

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 the Compliance Officer's observation, the rosters in the following rooms did not accurately document the presence of enrolled children in an activity area: Early Head Start: There were 3 children marked on the roster and 4 children were present; and Early Preschool: There were 8 children marked on the roster and 9 children were present.”

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 the Compliance Officer's observation and facility documentation, 6 of 10 child admission and release records lacked the following: *Child #1 and Child #2 lacked a release time on 1/6/2025; *Child #3 lacked a release time and signature on 1/3/2025, 1/6/2025, and 1/7/2025; *Child #4 lacked a release time on 1/3/2025; *Child #5 lacked a release time and signature on 1/3/2025; and *Child #6 lacked an admission time and signature for 1/3/2025.”

AAC R9-5-302. A. 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. Age-appropriate discipline guidelines and methods; 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; and 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. B. A licensee shall provide a copy of the written statement of child care services: 1. To the Department: a. Before the facility receives a license, and b. Every 12 months after the date of the license as required by A.R.S. § 36-883.01; and 2. To a parent when the parent requests a copy of the written statement of child care services.

“Findings: Based on the Compliance Officer Supervisor's observation, the written statement of child care services included a statement on transportation, but the facility does not offer transportation.”

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 the Compliance Officer's observation, the soap dispenser in the Pre K/School Age bathroom lacked soap.”

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 CO #1's observations, the following toilet room areas were not maintained in a clean and sanitary condition: **Preschool - toilet with brown stains in the basin; toilet with yellow streak on seat **Pre-K - toilet unflushed with solid waste; toilet with brown stains on seat; dirt and calcium build-up around sink fixture/top ledge; dirt build-up on top of the toilet tanks **Head Start - rust-colored and cracked caulk at the base of toilet; dirt build-up around the base of the toilets”

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 CO #1's observations, the following areas were not maintained in a clean condition: **Toddler 2 - dark, tape residue on a shelf **Twos - debris on the area rugs; drywall dust at the west diaper changing sink; black stains in the east diaper changing sink **Early Preschool - dark, tape residue on a shelf; debris in the corners of the housekeeping area **Early Head Start - child's chair in the children's restroom **Preschool - dark, tape residue on a housekeeping shelf **Pre-K - debris on the area rugs **Head Start - dark, tape residue on a cabinet”

AAC R9-5-503.F.1. F. A licensee shall ensure that in an activity area with a diaper changing area: 1. The containers required in subsections (A)(3) and (4) are inaccessible, and

“Findings: Based on CO #1's observations, in the EHS room and Early Preschool rooms, the soiled diaper containers were accessible to enrolled children.”

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 #1's observations, in the EHS room, the soiled clothing container lacked a tight-fitting lid. The container lid was open at the time of inspection. In the Early Preschool room, the soiled clothing container lacked a waterproof liner.”

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 #1's observations, the following diaper changing surfaces were not kept clear of items not required for diapering: **Early Preschool - plastic bin and backpack next to sink **Toddler 2 - cracked caulking around the diaper changing surface; loose paper towel roll next to sink; classroom phone on low ledge above sink”

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 CO #1's observations and a review of facility documentation, 10 of 12 infant feeding instructions were not posted in the kitchen.”

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 CO #1's observations and a review of facility documentation, 2 (Child #8, Child #10) of 12 infant feeding instructions lacked the amounts of formula/breast milk and times to be fed.”

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 CO #1's observations, in the Infant and Toddler 1 rooms, enrolled children's diapering ointments were not labeled with the child's name: **Infant - labeled with first name and last initial only **Toddler 1 - labeled with first name only or not labeled”

AAC R9-5-501.A.19. A. A licensee shall ensure that:19. Except as provided in subsection (A)(20), the following are stored separate from food storage areas and are inaccessible to an enrolled child: a. All materials and chemicals labeled as a toxic or flammable substance; b. All substances that have a child warning label and may be a hazard to a child; and c. Lawn mowers, ladders, toilet brushes, plungers, and other facility equipment that may be a hazard to a child;

“Findings: Based on CO #1's observations, in the Preschool and Pre-K rooms, each restroom had a package of wipes on top of the paper towel dispenser, accessible to enrolled children.”

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 #1's observations: **Infant and Twos rooms - diaper changing sinks drained very slowly **Pre-K - children's restroom lacked single-use paper towels in the dispenser”

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: Based on CO #1's observations, there was a 1-year old with 7 infants in the Infant room. The CO observed the child walk unaided across the room to retrieve a toy.”

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 #1's observations, in the Early Preschool room, the staff-to-child ratio was 1:12, with a required ratio of 2:12. The youngest child in the room was 2 years old.”

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 Compliance Officer (CO) #2’s observations and a review of facility documentation, 6 of 45 Emergency Information and Immunization Record cards reviewed lacked documentation of immunizations or an exemption affidavit. **Child #3, Child #5, Child #6, Child #7, Child #8, Child #9”

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 Compliance Officer (CO) #2’s observations and a review of facility documentation, 5 of 45 Emergency Information and Immunization Record cards reviewed lacked the following required information: **Child #1, Child #4 - health care provider name and phone number **Child #2 - individual to contact in case of sudden injury/illness noted as “any contact” **Child #3, Child #5 - date of enrollment”

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 CO #1's observations, in the Toddler 2, Early Preschool and Preschool rooms, drinking water was inaccessible to enrolled children.”

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 Compliance Officers' (CO) observations, a review of 1 staff file, and staff interview, Staff #1's (date of hire 03/20/2023) fingerprint clearance card expired on 10/20/2023. Staff stated that they had renewed the card in March of 2023. The status of Staff #1's fingerprint clearance card was determined to be expired per a DPS website search at the time of the 11/28/2023 investigation.”

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 (Complaint #69341, 11/28/2023), based on staff interview, the health, safety and welfare of enrolled children was placed at risk of harm, when a staff member handled enrolled children inappropriately. Per staff interview: **Staff member "held kids down with arm on child, kids try to get up, can't get up." **Staff member "grabs children hard, looks bad, as a parent, would be concerned." **Staff member "verbally abusive to other adults." **Staff member was observed stating "I just want to shake 'child', if there wasn't a shaken baby syndrome, I would." **Staff member "screaming across room." **Staff member "snatched child off of diaper changing table." **"concerns with tone of voice" **"touching children firmly" **"As a parent, would be concerned with stern tone of voice and aggressive." **Staff member "loud when face to face with children." **Staff member "hands on shoulders of child, stern voice, aggressive." **"Kids seem afraid of" staff member. **Staff member "rude and aggressive to staff; talks down to people." **"Wouldn't want my child in that room." Per CO #1's observations, 3 napping children's heads were covered with a blanket in the 3's room.”

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: Based on staff interview (Complaint #69341, 11/28/2023), a staff member failed to teach, model and encourage orderly conduct, personal control and age-appropriate behavior when the staff member handled enrolled children inappropriately. Per staff interview: **Staff member "held kids down with arm on child, kids try to get up, can't get up." **Staff member "grabs children hard, looks bad, as a parent, would be concerned." **Staff member "verbally abusive to other adults." **Staff member was observed stating "I just want to shake 'child', if there wasn't a shaken baby syndrome, I would." **Staff member "screaming across room." **Staff member "snatched child off of diaper changing table." **"concerns with tone of voice" **"touching children firmly" **"As a parent, would be concerned with stern tone of voice and aggressive." **Staff member "loud when face to face with children." **Staff member "hands on shoulders of child, stern voice, aggressive." **"Kids seem afraid of" staff member. **Staff member "rude and aggressive to staff; talks down to people." **"Wouldn't want my child in that room."”

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: Per allegation (Complaint #69341, 11/28/2023), based on staff interview, the health, safety and welfare of enrolled children was placed at risk of harm, when a staff member handled enrolled children inappropriately. Per staff interview: **Staff member "held kids down with arm on child, kids try to get up, can't get up." **Staff member "grabs children hard, looks bad, as a parent, would be concerned." **Staff member "verbally abusive to other adults." **Staff member was observed stating "I just want to shake 'child', if there wasn't a shaken baby syndrome, I would." **Staff member "screaming across room." **Staff member "snatched child off of diaper changing table." **"concerns with tone of voice" **"touching children firmly" **"As a parent, would be concerned with stern tone of voice and aggressive." **Staff member "loud when face to face with children." **Staff member "hands on shoulders of child, stern voice, aggressive." **"Kids seem afraid of" staff member. **Staff member "rude and aggressive to staff; talks down to people." **"Wouldn't want my child in that room."”

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 COs' observations and a review of 1 staff file, Staff #1 (date of hire 03/20/2023) was acting in the capacity of a teacher-caregiver and lacked the educational documentation to qualify as a teacher-caregiver.”