Watch Me Grow Child Care

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

“Per allegation findings; Based on staff interviews/statements, video, and the Compliance Officer's observation, staff members failed to supervise enrolled children at all times. On 11/19/2024, there were 4 incidents of inappropriate child-to-child touching, while children were on the playground. Child #1 stalked Child #2 and inappropriately touched Child #2 four different times without any intervention from the classroom's (Butterflies/3-year-olds) teachers while on the playground. Staff stated they did not see the incidents. Another staff member stated, that as they were giving breaks on an adjacent playground at the time, they witnessed one incident, and called out to the children to stop, saying, "That's not okay" but failed to bring the incident to the supervising teachers or the administration attention. Incident #1: Child #1 and Child #2 were playing on a merry-go-round. Child #2 crawled off the equipment and turned around and then Child #1 pulled down the back of Child #2’s pants. Child #1 made a wiping motion with their hand on Child #2’s backside/butt and pulled the pants back up. Both children began playing on the merry-go-round again. Incident #2: Child #2 crawled off the merry-go-round and went toward the corner of the playground. Child #1 followed Child #2 by crawling behind Child #2. Child #2 stopped and leaned back toward Child #1. Child #1 pulled Child #2’s pants down, touched Child #2's butt cheeks, and pulled their pants up again. Incident #3: Child #1 and Child #2 were playing on a yellow school bus toy. Child #2 crawled off the toy and sat on the ground facing Child #1. Child #2 began to turn their body away from Child #1, when Child #1 pulled them back by the shoulders nudging them back to a sitting position facing one another. Child #1 pushed Child #2’s legs apart and with one hand holding the front part of Child #2’s pants open, the other hand went inside the pants. Child #2 tried to turn away but Child #1 sat on Child #2's foot preventing them from crawling away. Once Child #2's foot was free, Child #2 crawled forward and Child # 1 and Child #2 stopped playing. Incident #4: Child #2 knelt up and Child #1 pushed Child #2 back down onto all fours. Child #2 pushed up into a downward dog position and Child #1 pulled Child #2's pants down and up.”

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 staff interviews/statements, video, and the Compliance Officer's observation, the health, safety, and welfare of children were placed at risk of harm. On 11/19/24, there were 4 incidents of inappropriate child-to-child touching, while children were on the playground. Staff were aware of some inappropriate behavior/play among children in the classroom and while on the playground and did not follow through to stop the behavior. Per staff statement, staff observed Child #1 touching and spreading apart Child#2's legs while Child #2's pants were on. As per staff, it was like, Child #1 was pretending to change a diaper. Staff stated that Child #1 was acting suspicious (kept looking at me) and was told, "Do not touch (Child #2) like that, go play." Staff noticed Child #1 and Child #2 continued their game and told them "Get away from each other and go play." The staff never noticed anything more after that. Child #1 and Child #2 were just kind of laying on each other and touching each other (while on the playground). Staff stated we have gotten on Child #1 a lot this week, repeatedly asking them not to play puppy (kitty) in the classroom or the playground with other children. When children are playing they seem to combine playing house, being mom, dad and baby, diapering and dog/kitten. Another staff member witnessed an incident as they were giving breaks on an adjacent playground, Child #1 opened Child #2's pants and was reaching into the pants and I yelled at them, telling Child #1 to "Stop! That it is not okay to do that." The staff did not bring the incident/concern to the supervising staff or the administration's attention.”

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 facility documentation and the Compliance Officer’s observation, it was found that a prescription medication was dispensed as a two-pack but only one injector was present at the facility and a physician’s authorization to separate the injections was not present.”

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, on the Caterpillar 1 playground and Caterpillar 2 playgrounds, there were rough splintered wooden posts on the straw umbrella shade structure.”

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 facility documentation and the Compliance Officer’s observation, 2 out of 6 staff files reviewed lacked the required annual training documentation: Staff #3: 4 of 18 hours of required annual training for the time period of 5/24/2023 until 5/24/2024. Staff #4: 18 of 18 hours of required annual training for the time period of 10/10/2022 until 10/10/2023.”

AAC R9-5-203.A. A. A licensee shall ensure that a staff member completes, signs, dates, and submits to the licensee, before the staff member’s starting date of employment or volunteer service:1. The form required in A.R.S. § 36-883.02(C); and 2. If required by A.R.S. § 8-804, the form in A.R.S. § 8-804(I).

“Findings: Based on facility documentation and the Compliance Officer's observations, the Criminal History Affidavit for Staff #1 was incomplete. The questions on the form were not answered.”

AAC R9-5-501.A.12. A. A licensee shall ensure that: 12. The facility premises, including the buildings, are maintained free from hazards;

“Findings: Based on the Compliance Officer’s observation, in the Caterpillar 2’s room, there was a quarter-sized hole in the wall with exposed drywall located near the back door.”

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 the Compliance Officer’s observation, in the Bumble Bees 2 classroom, there were several small holes in the blue vinyl sofa.”

AAC R9-5-301.B. B. A licensee shall ensure that a facility director: 1. Designates, in writing, an individual who meets the requirements of R9-5-401(2) to act on behalf of the facility director when the facility director is not present in the facility; 2. Supervises or assigns a teacher-caregiver to supervise each staff member who does not meet the qualifications of R9-5-401(3); 3. Prepares a dated attendance record for each day and ensures that each staff member documents on the attendance record the time of each arrival and departure of the staff member; and 4. Maintains on the facility premises, the dated attendance record required in subsection (B)(3) for 12 months after the date on the attendance record.

“Findings: Based on facility documentation and the Compliance Officer’s observation, it was determined that Staff #2 was a teacher-caregiver in the classroom at the time of the inspection. Staff #2 was not qualified as a teacher-caregiver and was not supervised by a qualified staff member.”

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

“Findings: Based on facility documentation and the Compliance Officer’s observation, it was determined that Child #8 lacked a written immunization record.”

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 the Compliance Officer’s observation, 7 out of 25 Emergency, Information & Immunization Record Cards lacked the following information: Child #1: The name and contact information of the individual to be contacted in case of injury or sudden illness of the child. Child #2, Child #3, Child #6, & Child #7: The date of enrollment. Child #4: The signature of the enrolling parent. Child #5: The name and contact information of the child's health care provider.”

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 the Compliance Officer’s observation, in the bathroom between the Bumble Bee’s classrooms, a toilet brush was on the floor behind the first toilet on the left.”

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

“Findings: Based on facility documentation and the Compliance Officer’s observation, Staff #2 was a teacher-caregiver in the Bumble Bee’s 1 classroom. Staff #2 was not qualified as they lacked 6 months of child care experience in a licensed child care facility.”

AAC R9-5-511.C. C. A licensee shall provide an unobstructed passageway at least 18 inches wide between each row of cots or mats to allow a staff member access to each enrolled child.

“Findings: Based on the Compliance Officer’s observation, in the Bumble Bees 2 classroom, 5 of the occupied nap mats were spaced 6 - 9 inches apart rather than 18 inches between rows as required.”

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 facility documentation and the Compliance Officer’s observation, in the Cuddle Bugs 2 (infant) room, 3 of the 11 Infant feeding instruction forms lacked the required information. In the Cuddle Bugs 1 (infant) room, 1 out of the 11 enrolled children lacked an infant feeding instruction form.”

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 the Compliance Officer’s observation, in the Bumble Bee’s 1 classroom, the lesson plan lacked a date. In the Butterflies classroom, the lesson plan was not current. The plan posted was dated 9/16/2024 to 9/20/2024.”

AAC R9-5-203.E. E. If a staff member possesses a fingerprint clearance card that was issued before the staff member became a staff member at the facility, a licensee shall:1. Contact the Department of Public Safety before the individual becomes a staff member to determine whether the fingerprint clearance card is valid; and 2. Document this determination, including the name of the staff member, the date of contact with the Department of Public Safety, and whether the fingerprint clearance card is valid.

“Findings: Based on the facility documentation and the Compliance Officer’s observation, it was determined the files for Staff #2 (date of employment 8/8/2024) and Staff #5 (date of employment 8/20/2024) lacked documentation that DPS was contacted for validation of fingerprint clearance cards.”

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 the Compliance Officer’s observation, in the Caterpillar 1 classroom and the Bumble Bee1 classroom, the temperature of the diaper changing sink was 114° F. rather than 86° F to 110° F. as required.”

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 the Compliance Officer's observations, in the Bumblebee's 1 classroom and the Caterpillar's 2 classroom, the diaper changing container was on the ground next to the diaper changing table accessible to enrolled children.”

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, in the outdoor activity area, the following hazards were accessible to enrolled children: Playground 1: *There was a torn rug with exposed frayed edges located on the South wall. Playground 2: *There were loose screws and a wooden piece hanging loosely from the wooden table. Playground 3: *There was a hose laying on the ground near the West wall Playground 4: *There was peeling laminate with exposed foam located on an orange and white bicycle.”

AAC R9-5-605.B.1. B. A licensee shall ensure that: 1. All designated exits, corridors, and passageways that provide escape from the building are unobstructed and unlocked during hours of operation;

“Findings: Based on the Compliance Officer's observation, in the Cuddlebugs 2 classroom, two cribs were in front of a designated exit that provides escape from the building.”

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

“Findings: Based on facility documentation and the Compliance Officer’s observation, it was determined that the Mantoux skin test for Staff #1 was not administered on or before the starting date of employment (Date of employment- 10/10/2022, date of TB test- 10/13/2022).”

AAC R9-5-401.4. A licensee shall ensure that staff members meet the following qualifications for employment or volunteer service at a facility: 4. An assistant teacher-caregiver is 16 years of age or older and provides the licensee with documentation of one of the following: a. Current and continuous enrollment in high school or a high school equivalency class; b. High school or high school equivalency diploma; c. Enrollment in vocational rehabilitation, as defined in A.R.S. § 23-501; d. Employment as a teacher-caregiver aide for 12 months; or e. Service as a volunteer in a child care facility for 12 months;

“Findings: Based on facility documentation and the Compliance Officer's observation, it was determined that staff #1 was an assistant teacher-caregiver in the classroom. Staff #1 was not qualified as an assistant teacher-caregiver because the staff file lacked documentation of a high school diploma or high school equivalency diploma.”

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

“Findings: Based on the Compliance Officer’s observation, the health, safety, and welfare of enrolled children were placed at risk of harm. In the Butterfly classroom, one enrolled child was sleeping with a blanket covering their face.”

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, in the Cuddlebug's 1 classroom, there was an unlabeled container of wipes. In the Cuddlebug's 2 classroom, there were two containers of wipes with a first name only and one container of Desitin with a first name only.”