Tuty's Child Care

AAC R9-3-507.A.1. A. A certificate holder shall ensure that a staff member changes diapers only on a nonabsorbent, sanitizable diaper changing surface that: 1. Is kept clear of items not required for diaper changing;

“The Compliance Officer observed a child's jacket draped over the side of the diaper changing table.”

AAC R9-3-507.A.1. A. A certificate holder shall ensure that a staff member changes diapers only on a nonabsorbent, sanitizable diaper changing surface that: 1. Is kept clear of items not required for diaper changing;

“Compliance Officer observed a wire basket hanging on diapering table.”

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

“Compliance Officer observed Dawn soap and Clorox wipes under the sink in the bathroom. Both containers had a child warning label and were accessible to the children.”

AAC R9-3-504.A.4. A. A certificate holder shall ensure that: 4. The child care group home’s residence has at least two portable fire extinguishers: a. One of which is labeled as rated at least 1A-10-BC by the Underwriters Laboratories is mounted on the kitchen wall and is easily accessible, and b. One of which is labeled as rated at least 2A-10-BC by the Underwriters Laboratories and is maintained in a location accessible to staff members in an area of the child care group home approved for providing child care services;

“Compliance Officer observed a fire extinguisher mounted in the kitchen. Staff 2 was not able to locate the 2nd extinguisher.”

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

“According to Staff 2, the children ate mac n cheese, mandarin oranges and milk for lunch and bananas and crackers for lunch. The substitutions were not noted on the menu.”

AAC R9-3-304.A.1. A. A certificate holder shall not permit an enrolled child to receive child care services at a child care group home until the child care group home receives: 1. An immunization record for the enrolled child with the information required in 9 A.A.C. 6, Article 7, stating that the enrolled child has received all current, age-appropriate immunizations required under 9 A.A.C. 6, Article 7, that is: a. Provided by a physician, physician assistant, registered nurse practitioner, or another individual authorized by state law to administer immunizations; 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

“Compliance Officer observed that the immunization records for Child 1 and 2 were not current. Child 3 did not have documentation of their immunization record.”

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

“Compliance Officer observed that Staff 1 did not have any documented training hours for employment year September 2022- September 2023.”

AAC R9-3-301.D.2. D. A certificate holder shall ensure that: 2. At least one adult staff member, in addition to the provider or the staff member specified in subsection (D)(1), is on the premises when six or more enrolled children are at the child care group home.

“Upon entering the home, Compliance Officer observed Staff 2 alone with 6 children. Upon review of the children and staff attendance records, Staff was also alone with 6 children on 9/5/24-9/9/24, and was alone with 7 children on 9/6/24.”

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

“Compliance Officer observed that Staff 1 did not sign out on 9/4/24. According to Staff 2, Staff 1 has been working. According to the staff attendance record, Staff 1 last signed in on 9/4/24.”

AAC R9-3-401.C.4. A certificate holder shall ensure that a staff member: 4. Except as specified in subsection (C)(5), labels the personal items of an enrolled child with an identifier that is specific to the enrolled child and stores the personal items separately from the personal items of other enrolled children and residents;

“Compliance Officer observed diaper wipes not labeled.”

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

“The Compliance Officer observed a roll of toilet paper on the floor. The children's bathroom did not contain mounted toilet paper.”

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

“Per the allegations and based on the Compliance Officer's observations the following allegation was substantiated: Child 1 and Child 2 were not signed out on 5/3/2024.”

AAC R9-3-309.F.2. F. Except as provided in subsection (G), a certificate holder shall ensure that: 2. Medication belonging to a staff member or resident is stored in a locked, leak-proof storage cabinet or container that is separate from the storage container for enrolled children’s medications.

“The Compliance Officer observed medication (Alicolox) on the kitchen counter, not locked.”

AAC R9-3-401.B.1. B. A certificate holder shall ensure that: 1. A staff member: a. Supervises each enrolled child at all times, b. Plays and communicates with an enrolled child throughout the day, and c. Responds immediately to signs of distress from an enrolled child;

“Per the allegations and based on the interview with the Provider, and the documentation of the toilet training policy, the following allegation was substantiated: The Provider reported that she does not physically assist the children with toilet training, and gives them their privacy. Child 3 required assistance as evidenced by the photograph provided. The Provider failed to supervise the child to ensure the child's needs were met.”

AAC R9-3-401.B.2. B. A certificate holder shall ensure that: 2. The areas of the child care group home approved for providing child care services are maintained free from hazards;

“The Compliance Officer observed a bean bag type pillow on the floor in the room with the cribs. Staff reported that the children use the pillow. Staff 2 reported placing a child who is not yet walking on the pillow when they wake up from nap but are still tired. The Compliance Officer (CO) observed a mop bucket with water on the kitchen floor. The CO observed plastic bags and a fire extinguisher on the floor in the room with the cribs accessible to the enrolled children.”

AAC R9-3-505.D.6. D. A certificate holder shall ensure that: 6. Flammable liquids are stored: a. In an original container; b. Separate from food storage areas; c. Away from any heat-producing appliance or equipment, such as a water heater or furnace; and d. Except for hand sanitizers being provided for use, in a location inaccessible to enrolled children;

“The Compliance Officer observed 2 cans of Lysol on the children's shelf accessible to the children in the main room.”