Tutor Time Child Care/ Learning Centers

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

“Per allegation Findings: Based on staff statements and the Compliance Officer's observation, it was determined that enrolled children were not supervised at all times. During the inspection, in the Pre-K Classroom (4s/5s), a staff member was sitting at a table with their back facing all the children while they were in the play area. The staff member was on their iPad and not interacting with or supervising the children. Staff members stated the following: *7 out of 10 times we see an incident take place. *It is hard to supervise the children and follow the daily schedule. *We don't see all the incidents that take place. *The majority of the incidents could be mitigated with better supervision. *The layout of the room makes it hard to see the kids and supervise them.”

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 five years.

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that Staff #1's (DOE 03/06/2023) fingerprint clearance card expired on 11/21/2025. Staff #1 worked from 11/21/2025 through 12/12/2025 (21 days) without a valid fingerprint clearance card.”

AAC R9-5-303.B. B. A licensee shall ensure that the licensed capacity of each indoor activity area or room is posted in that activity area or room.

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that the Toddler 1 Room and the Preschool Room lacked the required posted capacity.”

AAC R9-5-501.A.17. A. A licensee shall ensure that: 17. 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 facility documentation and the Compliance Officer's observation, in the Infant Room and the EHS 1 Room (infants), enrolled children's pacifiers lacked an identifying label specific to each child.”

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, it was determined that the following classrooms lacked a current posted lesson plan: *Preschool Room: The lesson plan posted was dated 12/14/2025-12/5/2025. *Toddler 1 Room: The lesson plan posted was dated 10/27/2025-10/31/2025. *School Aged Room: The lesson plan posted was dated 1/6/2025-1/10/2025.”

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 following rooms had personal items that lacked the required labeling: *Infant Room: 7 diaper creams lacked a child's first and last name. *Toddler 1 Room: 1 lotion lacked a child's last name, and 1 ointment and 2 lotions lacked a child's first and last name. *Toddler 2 Room: 1 Hydrocortisone cream lacked the child's first and last name. *Pre-K Room: 1 diaper cream lacked a child's last name, and 2 lotions and 1 nystatin cream lacked a child's first and last name.”

AAC R9-5-502.C.1.d. C. A licensee shall ensure that: 1. A staff member providing child care services in an infant room: d. Keeps dated, daily, documentation of each infant including: i. A description of any activities the infant participated in, ii. The infant’s food consumption, iii. Diaper changes, and iv. Tummy time;

“Findings: Based on facility documentation and the Compliance Officer's observation, the Infant Room and the EHS 1 Room (infants) lacked physical or virtual tummy time documentation. Staff stated that they did not document tummy time in the classrooms.”

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 observation, in the Two's Room, there was apple sauce in the diaper changing sink.”

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, in the Infant Room, the soiled clothing container lacked a lid, and in the Toddler 1 Room, the soiled clothing container lacked a waterproof liner.”

AAC R9-5-517.A.9. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall: 9. Ensure that the motor vehicle has: a. A working mechanical heating system capable of maintaining a temperature throughout the motor vehicle of at least 60° F when outside air temperatures are below 60° F; b. Except as provided in subsection (E), a working air-conditioning system capable of maintaining a temperature throughout the motor vehicle at or below 86° F when outside air temperatures are above 86° F; c. Except as provided in subsection (F), a first aid kit that meets the requirements of R9-5-514(A); d. Two large, clean towels or blankets; and e. Sufficient drinking water available to meet the needs of each enrolled child in the motor vehicle and sufficient cups or other drinking receptacles so that each enrolled child can drink from a different cup or receptacle;

“Findings: Based on the Compliance Officer's observation, Bus #1 and Bus #2 lacked 2 of the 2 required towels or blankets.”

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 10 out of 25 Emergency, Information, and Immunization cards reviewed lacked the following information: *Child #1, Child #2, Child #3, Child #4, Child #5, Child #6: Date of enrollment. *Child #7: The name and telephone number of the child’s health care provider. *Child #8: Date of enrollment and the name and telephone number of the child’s health care provider. *Child #9: Date of enrollment and the name of the individual to be contacted in case of injury or sudden illness of the child. *Child #10: The name and telephone number of the child’s health care provider, the name of the individual to be contacted in case of injury or sudden illness of the child, and home address for 1 of 2 parents/guardians.”

AAC R9-5-517.A.9. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall:9. Ensure that the motor vehicle has: a. A working mechanical heating system capable of maintaining a temperature throughout the motor vehicle of at least 60° F when outside air temperatures are below 60° F; b. Except as provided in subsection (E), a working air-conditioning system capable of maintaining a temperature throughout the motor vehicle at or below 86° F when outside air temperatures are above 86° F; c. Except as provided in subsection (F), a first aid kit that meets the requirements of R9-5-514(A); d. Two large, clean towels or blankets; and e. Sufficient drinking water available to meet the needs of each enrolled child in the motor vehicle and sufficient cups or other drinking receptacles so that each enrolled child can drink from a different cup or receptacle;

“Findings: Based on Compliance Officer #2's observation, the 2024 Ford Transit van was lacking 2 towels or blankets.”

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 Compliance Officer #1's observation, in the outdoor activity area, there was 1-inch of standing water in the drinking fountain on the west wall. In the School-age classroom's toilet room, there were 2 red and 2 green square magnetic blocks on the floor next to 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 Compliance Officer #1's observation, in the Preschool classroom's toilet room, there was a long strip of toilet paper on the floor next to the toilet. In the School-age classroom's toilet room, there was a yellow colored substance in both of the toilet bowls.”

AAC R9-5-503.B. B. A licensee shall ensure that a staff member does not:1. Permit a bottle, formula, food, eating utensil, or food preparation in a diaper changing area; 2. Draw water for human consumption from a diaper changing area sink; or 3. Except as provided in subsection (C), if responsible for food preparation, change diapers until food preparation duties have been completed for the day.

“Findings: Based on Compliance Officer #1's observation, in the Twos classroom, there was ice in the diaper changing area's hand washing sink.”

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 Compliance Officer #1's observations, in the Toddlers 2 classroom, there were 3 ointments labeled with the child's first name and last initial. There was 1 ointment labeled with the child's first name.”

AAC R9-5-501.C.5. C. A licensee shall ensure that a staff member:5. Except as provided in subsection (D), prepares and posts 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 Compliance Officer #1's observation, in the Twos classroom, the posted lesson plan was dated for the week of 12/09/2024. In the Preschool classroom, the posted lesson plan was dated for the week of 12/02/2024.”

AAC R9-5-501.A.13. A. A licensee shall ensure that:13. Toys and play equipment, required in this Article, are maintained: a. Free from hazards, and b. In a condition that allows the toy or play equipment to be used for the original purpose of the toy or play equipment;

“Findings: Based on Compliance Officer #1's observations, the following hazards were accessible to enrolled children: In the Pre-K classroom, there was exposed particle board that had rough sharp edges on the broken corner of the roof of the doll house. In the Toddler 2 classroom, there was torn vinyl with exposed foam on the couch with the attached book shelves in the reading center. In the School-age classroom, there was torn vinyl with exposed foam on the couch in the reading center.”

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 Compliance Officer #1's observation, in the Twos classroom, the health, safety or welfare of an enrolled child was placed at risk of harm during naptime when an enrolled child was observed sleeping with a blanket covering their face and head.”

AAC R9-5-309.C. C. A licensee shall maintain on facility premises: 1. A current fire inspection report including documentation of any repairs or corrections required by the fire inspection report; and 2. If there are gas pipes that run from a gas meter to an appliance or location on the facility premises, a current gas inspection report including documentation of any repairs or corrections required by the gas inspection report.

“Findings: Based on facility documentation and the Compliance Officers' observations, the fire inspection conducted on 04/18/2024 did not pass and there were no corrections noted and a re-inspection was not conducted.”

AAC R9-5-308.A. A. A licensee shall secure and maintain the following minimum insurance coverage: 1. General facility liability insurance of at least $300,000; and 2. Motor vehicle insurance coverage, required by A.R.S. Title 28, Chapter 9, Article 4, for each motor vehicle provided by a licensee to transport enrolled children.

“Findings: Based on facility documentation and the Compliance Officers' observations, it was determined that the file for Child #9 contained a "Release and Waiver of Liability" agreement dated 07/10/2024.”

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 facility documentation and Compliance Officer #2's observation, it was determined that 4 out of 10 enrolled children's attendance forms lacked the following information: Child #5: A release signature and time for 12/04/2024, 12/06/2024, 12/09/2024, and 12/10/2024. Child #6: A release signature for 12/05/2024 and 12/06/2024. Child #7: A release signature for 12/10/2024. Child #8: An admission signature and time for 12/02/2024.”

AAC R9-5-305.B. B. A licensee shall attach an enrolled child’s written immunization record or exemption affidavit, required in subsection(A), to the enrolled child’s Emergency, Information, and Immunization Record card, required in R9-5 304(B).

“Findings: Based on facility documentation and Compliance Officer #2's observation, the immunization records for Child #1, Child #2, and Child #4 were not attached to the Emergency Information and Immunization Record cards as required.”

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 observation, it was determined that 4 out of 15 enrolled children's Emergency, Information and Immunization Record Cards reviewed lacked the following required information: Child #1: The date of enrollment. The name, address, and phone number of the second parent. Child #2: The date of enrollment. The name, address, and phone number of the second parent. The name and phone number of the child’s health care provider. Child #3: The date of enrollment. The name and phone number of the child’s health care provider. The name of the individual to be contacted first in case of injury or sudden illness. Child #4: The date of enrollment.”

AAC R9-5-517.A.3. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall:3. Ensure that the motor vehicle is registered by the Arizona Department of Transportation as required by A.R.S. Title 28, Chapter 7;

“Findings: Based on facility documentation and Compliance Officer #2's observation, the licensee lacked a valid license plate for the 2024 Ford Transit van, the temporary license plate that was on the vehicle expired on 11/30/2024.”

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 Compliance Officer's (CO) observations, the water temperature at the 2 diaper changing areas in the 2's room were measured at 118° F.”

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 CO's observations and a review of facility documentation, Child #1's medication authorization lacked a start date, end date, and the times and frequency was noted as "as needed".”

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's observations, the following toilet rooms were not kept in a clean and sanitized condition: **Preschool - Air conditioning vent with dirt build-up **Pre-K room - Unflushed toilet with solid waste **School-Age - Toilet paper wads on the ceiling”

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

“Finidngs: Based on CO's observations, the following outdoor areas were not maintained free from hazards and accessible to enrolled children: **Toddler - Chipping particle board panel at the water spigot **Preschool - 1/2" hole on the west wall; flaking paint and rust on the bottom rail of the south and west fence; overgrowth of tall, thick weeds in the north and west areas”

AAC R9-5-516.G. G. A licensee shall return all unused prescription and nonprescription medications to a parent when the medication prescription date has expired or the medication is no longer being administered to the enrolled child or dispose of the medication if unable to locate the enrolled child's parent after the child's disenrollment

“Findings: Based on CO's observations and a review of facility documentation, Child #1's prescription medication expired January 2024, and the prescription label indicated to discard on 10/12/2023. The medication had not been returned to the child's parent.”

AAC R9-5-517.A.9. A. A licensee who transports an enrolled child in a motor vehicle that the licensee owns, or acquires for use by contract, shall: 9. Ensure that the motor vehicle has: a. A working mechanical heating system capable of maintaining a temperature throughout the motor vehicle of at least 60° F when outside air temperatures are below 60° F; b. Except as provided in subsection (E), a working air-conditioning system capable of maintaining a temperature throughout the motor vehicle at or below 86° F when outside air temperatures are above 86° F; c. Except as provided in subsection (F), a first aid kit that meets the requirements of R9-5-514(A); d. Two large, clean towels or blankets; and e. Sufficient drinking water available to meet the needs of each enrolled child in the motor vehicle and sufficient cups or other drinking receptacles so that each enrolled child can drink from a different cup or receptacle;

“Findings: Based on CO #1's observations, the vehicle (Lic# CK34843) used to transport enrolled children lacked blankets or towels.”

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 CO #1's observations, the following outdoor activity areas were not kept free from hazards and accessible to enrolled children: **Toddler playground - Chipping particle board at a water-logged panel where the water spigot is located **Preschool playground - 1/2" hole on the west wall; flaking paint and rust on the bottom rail of the south and east fence; 5 1/4" gap between fence pickets on the west fence”

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 CO #1's observations, the north playground structure on the Preschool playground lacked 3" of the required 6" of resilient material (wood chips) at the end of the slide.”

ARS § 36-883.02.A. A. Except as provided in subsection B of this section, child care personnel, including volunteers, shall submit the form prescribed in subsection C of this section to the employer and shall have valid fingerprint clearance cards issued pursuant to section 41-1758.07 before starting employment or volunteer work.

“Findings: Based on CO #2's observations, a review of 6 staff files, and a DPS website search, Staff #3's (date of employment 05/12/2022) fingerprint clearance card was not issued before starting employment. The DPS application was received on 05/10/2022 and a card was issued on 05/12/2022.”

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, 2 of 2 diaper changing areas in the Twos room lacked the following: **East station - soiled clothing container **West station - tight-fitting lid”

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 Toddler 1 room, there were used pull-ups in the children's restroom's garbage can, accessible to enrolled children.”

AAC R9-5-503.A.2.a. 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 CO #1's observations, the water at the following diaper changing areas were measured at: **Twos - 123.6° F (east station); 122.4° F (west station)”

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, 8 of 8 infant feeding instructions from Infant 1 were not posted in the room and in the kitchen. Feeding instructions in the classroom were located in each child's portfolio file.”

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, 5 of 13 infant feeding instructions (Infant 1 and Infant EHS) lacked the following: **Child #10, Child #12, Child #13, Child #14 - Amounts of formula and times to be fed **Child #11 - Feeding instructions were not available for review”

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, enrolled children's personal products were not labeled with the child's name: **Toddler 1 - diaper ointments labeled with first names and last initial only **Twos - diaper ointments with a first name only, first name and initial only, spray ointment with no name”

AAC R9-5-501.C.5. C. A licensee shall ensure that a staff member: 5. Except as provided in subsection (D), prepares and posts 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 CO #1's observations and a review of facility documentation, the lesson plans in the following activity areas were not current for the calendar week: **Toddler 1, Preschool - Dated 12/11/2023 - 12/15/2023”

AAC R9-5-501.C.4. C. A licensee shall ensure that a staff member: 4. Except as provided in subsection (D), prepares and posts in each indoor activity area, a current schedule of children’s age-appropriate activities, including the times the following are provided: a. Meals and snacks; b. Naps; c. Indoor activities; d. Outdoor or large muscle development activities; e. Quiet and active activities; f. Teacher-directed activities; g. Self-directed activities; h. Activities for individuals, groups of five or fewer children, and groups of six or more children; and i. Activities that develop small muscles;

“Findings: Based on CO #1's observations and a review of facility documentation, the School Age room lacked a posted activity schedule.”

AAC R9-5-501.A.21. A. A licensee shall ensure that: 21. Except when used as part of an activity, the following are stored in an area inaccessible to an enrolled child: a. Garden tools, such as a rake, trowel, and shovel; and b. Cleaning equipment and supplies, such as a mop and mop bucket.

“Findings: Based on CO #1's observations, cleaning equipment was accessible to enrolled children in the following activity areas: **Toddler 1/Toddler 2 shared restroom - broom and dustpan; plunger **Preschool playground - broom”

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, the following activity areas lacked accessible drinking water for enrolled children: **Toddler 1, Toddler 2, Preschool - water was placed on a countertop out of children's reach”

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 CO #1's observations and a review of facility documentation, in the Preschool room, there were 11 children present with 13 children noted on the roster as in attendance.”

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 CO #2's observations and a review of facility documentation, 3 of 15 enrolled children's attendance records lacked the following required information: **Child #7 - Departure time and signature on 12/11/2023 **Child #8 - Arrival signature and departure time on 12/07/2023 **Child #9 - Departure times and signatures on 12/11/2023 and 12/15/2023”

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 CO #2's observations and a review of facility documentation, 6 of 15 enrolled children's Emergency Information and Immunization Record cards lacked the following required information: **Child #1 - Parent/Guardian #2's name, street address, city, state, zip code, phone number **Child #2, Child #5, Child #6 - Date of enrollment **Child #3 - Date of enrollment; health care provider phone number; individual to contact in case of sudden injury/illness **Child #4 - Date of enrollment; health care provider phone (noted as "ER 911") 5 of 5 Transportation Emergency Information and Immunization Record cards reviewed lacked the following required information: **Child #15, Child #16 - Date of enrollment; health care provider name and phone number; page 2 (medical/dietary needs/child allergies/medical needs/parent signature) **Child #17 - Parent/Guardian #2's street address, city, state, zip code; page 2 (medical/dietary needs/child allergies/medical needs/parent signature) **Child #18 - Child's home phone number; page 2 (medical/dietary needs/child allergies/medical needs/parent signature) **Child #19 - Date of enrollment; parent/guardian #1's city, state, zip code; page 2 (medical/dietary needs/child allergies/medical needs/parent signature)”

AAC R9-5-301.I. I. At least once a month, and at different times of the day, a licensee shall ensure that an unannounced fire and emergency evacuation drill is conducted and each staff member and enrolled child at the facility participates in the fire and emergency evacuation drill. 1. If child care services for a child with special needs are provided at a facility, the licensee shall provide for the enrolled child’s participation in each fire and emergency evacuation drill according to the enrolled child’s individualized plan as specified in R9-5-507(A)(1). 2. A licensee shall document each fire and emergency evacuation drill and maintain the documentation on facility premises for 12 months after the date of the fire and emergency evacuation drill.

“Findings: Based on CO #2's observations and a review of facility documentation, the facility lacked documentation of completed fire drills from January 2023 through July 2023.”

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 Compliance Officer (CO) #2's observations and a review of 6 staff files, the following staff lacked documentation of negative TB results on or before the starting date of employment: **Staff #1 (date of hire 09/12/2022) - results dated 09/16/2022 **Staff #2 (date of hire 11/15/2023) - results dated 11/18/2023”

AAC R9-5-504.3. A licensee providing child care services for 1-year-old and 2-year-old children shall: 3. Ensure that each activity area has a supply of age-appropriate toys, materials, and equipment that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Art supplies; b. Books; c. Rubber or soft plastic balls; d. Puzzles and toys to enhance manipulative skills; e. Blocks; f. Washable soft toys and dolls; g. Musical instruments; and h. Indoor and outdoor equipment to enhance large muscle development;

“Findings: Based on CO #1's observations, in Toddler 2, there were no balls or puzzles accessible to enrolled children.”

AAC R9-5-506.3. A licensee providing child care services for school-age children shall: 3. Provide age-appropriate toys, materials, and equipment accessible to enrolled children in each activity area in a quantity sufficient to meet the needs of the enrolled children in attendance including: a. Arts and crafts, b. Games, c. Puzzles and toys to enhance manipulative skills, d. Books, e. Science materials, f. Sports equipment, and g. Outdoor play equipment; and

“Findings: Based on CO #1's observations, the School-Age room lacked games that were accessible to enrolled children.”

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

“Findings: Based on CO #1's observations, in the Preschool room, 2 of 11 napping children lacked sheets on their cots.”

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, in Infant 1, the diapering changing area was located directly next to a classroom shelf that contained baskets of classroom materials. On top of the shelf were items used for diaper changing (laundry basket with items, spray bottles, a roll of paper towels, basket with gloves, and a roll of garbage liners).”

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 rooms were not kept in a clean and sanitary condition: **Toddler 1/Toddler 2 shared - children's chair in toilet room **Preschool - 1 of 2 toilets lacked caulking in areas and dirt-build-up around the base; exhaust vent with dirt build-up **Pre-K - Step stool with dirt build-up; toilet wads on the ceiling **School-Age - Toilet paper wads on the ceiling; sink basin with debris and gray stains”

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 CO #2's observations and a review of facility documentation, enrolled children's medication authorizations lacked the following required information: **Child #20 - Prescription number **Child #21 - medication authorization for prescribed medication”

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 CO #2's observations and a review of facility documentation, Child #20's prescribed medication indicated a quantity of 2 with only 1 vial in the box.”

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 and based on staff interview and staff written statement, it was determined that an enrolled child was placed at risk of harm when the child held onto the door frame as the staff member (who was holding the hand of the child) and the child entered the classroom, causing injury to the child. Staff stated that they were holding the hand of the child when they were opening the door and the child held onto the door, trying to run away. Staff written statement indicated that staff "held the child's hand and walked the 'child' down the hallway into the 2's room to be changed. 'Child' grabbed onto the door frame trying to run away. 'Staff' moved 'child's' arm off of the door frame and went into the classroom before the door closed".”