Supp. 20-3 TITLE 9. HEALTH SERVICES CHAPTER 5. DEPARTMENT OF . - AZ SOS

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9 A.A.C. 5Supp. 20-3September 30, 2020Title 9TITLE 9. HEALTH SERVICESCHAPTER 5. DEPARTMENT OF HEALTH SERVICES - CHILD CARE FACILITIESThe table of contents on the first page contains quick links to the referenced page numbers in this Chapter. Refer to the notes at the end ofa Section to learn about the history of a rule as it was published in the Arizona Administrative Register.Sections, Parts, Exhibits, Tables or Appendices codified in this supplement. The list provided contains quick links to the updated rules.This Chapter contains corrections requested by the Department (Supp. 20-3).Section R9-5-101 had a non-substantive, typographical error in subsection R9-5-101(38) in reference to the statutory meaning ofElectronic Signature.Section R9-5-302 and its historical note were inadvertently removed and overwritten with rule text from R9-5-301; the Section andhistorical note have been restored as last amended and codified in Supp. 10-3.No rules were codified in this Chapter in Supp. 20-3.Questions about these rules? ddress:Telephone:Fax:E-mail:Thomas Salow, Branch ChiefDepartment of Health ServicesPublic Health Licensing Services150 N. 18th Ave., Suite 400Phoenix, AZ 85007-3248(602) 364-1935(602) 334-3808Thomas.Salow@azdhs.govStephanie Elzenga, Administrative CounselDepartment of Health ServicesOffice of Administrative Counsel and Rules150 N. 18th Ave., Suite 200Phoenix, AZ 85007(602) 542-1020(602) 364-1150Stephanie.Elzenga@azdhs.govThe release of this Chapter in Supp. 20-3 replaces Supp. 20-2, 1-41 pagesPlease note that the Chapter you are about to replace may have rules still in effect after the publication date of this supplement. Therefore,all superseded material should be retained in a separate binder and archived for future reference.i

PREFACEUnder Arizona law, the Department of State, Office of the Secretary of State (Office), accepts state agency rule filings and is the publisherof Arizona rules. The Office of the Secretary of State does not interpret or enforce rules in the Administrative Code. Questions about rulesshould be directed to the state agency responsible for the promulgation of the rule.Scott Cancelosi, DirectorADMINISTRATIVE RULES DIVISIONnote to make rules is often included at the beginning of a chapter.Other Arizona statutes may be referenced in rule under the A.R.S.acronym.RULESThe definition for a rule is provided for under A.R.S. § 41-1001.“‘Rule’ means an agency statement of general applicability thatimplements, interprets, or prescribes law or policy, or describesthe procedures or practice requirements of an agency.”SESSION LAW REFERENCESArizona Session Law references in a chapter can be found at theSecretary of State’s website, under Services- Legislative Filings.THE ADMINISTRATIVE CODEThe Arizona Administrative Code is where the official rules of thestate of Arizona are published. The Code is the official codification of rules that govern state agencies, boards, and commissions.EXEMPTIONS FROM THE APAIt is not uncommon for an agency to be exempt from the stepsoutlined in the rulemaking process as specified in the ArizonaAdministrative Procedures Act, also known as the APA (ArizonaRevised Statutes, Title 41, Chapter 6, Articles 1 through 10).Other agencies may be given an exemption to certain provisionsof the Act.The Code is separated by subject into titles. Titles are divided intochapters. A chapter includes state agency rules. Rules in chaptersare divided into Articles, then Sections. The “R” stands for “rule”with a sequential numbering and lettering outline separated intosubsections.An agency’s exemption is written in law by the Arizona StateLegislature or under a referendum or initiative passed into law byArizona voters.Rules are codified quarterly in the Code. Supplement releasedates are printed on the footers of each chapter.First Quarter: January 1 - March 31Second Quarter: April 1 - June 30Third Quarter: July 1 - September 30Fourth Quarter: October 1 - December 31For example, the first supplement for the first quarter of 2019 iscited as Supp. 19-1.When an agency files an exempt rulemaking package with ourOffice it specifies the law exemption in what is called the preamble of rulemaking. The preamble is published in the Registeronline at www.azsos.gov/rules, click on the Administrative Register link.Please note: The Office publishes by chapter, not by individualrule section. Therefore there might be only a few sections codified in each chapter released in a supplement. Historical notes atthe end of a section provide an effective date and informationwhen a rule was last updated.Editor’s notes at the beginning of a chapter provide informationabout rulemaking sections made by exempt rulemaking. Exemptrulemaking notes are also included in the historical note at the endof a rulemaking Section.The Office makes a distinction to certain exemptions becausesome rules are made without receiving input from stakeholders orthe public. Other exemptions may require an agency to proposeexempt rules at a public hearing.AUTHENTICATION OF PDF CODE CHAPTERSThe Office began to authenticate chapters of the AdministrativeCode in Supp. 18-1 to comply with A.R.S. § 41-1012(B) andA.R.S. § 5302(1), (2)(d) through (e), and (3)(d) through (e).EXEMPTIONS AND PAPER COLORAt one time the office published exempt rules on either blue orgreen paper. Blue meant the authority of the exemption was givenby the Legislature; green meant the authority was determined by acourt order. In 2001 the Office discontinued publishing rulesusing these paper colors.A certification verifies the authenticity of each Code chapterposted as it is released by the Office of the Secretary of State. Theauthenticated pdf of the Code includes an integrity mark with acertificate ID. Users should check the validity of the signature,especially if the pdf has been downloaded. If the digital signatureis invalid it means the document’s content has been compromised.PERSONAL USE/COMMERCIAL USEThis chapter is posted as a public courtesy online, and is forprivate use only. Those who wish to use the contents for resale orprofit should contact the Office about Commercial Use fees. Forinformation on commercial use fees review A.R.S. § 39-121.03and 1 A.A.C. 1, R1-1-113.HOW TO USE THE CODERules may be in effect before a supplement is released by theOffice. Therefore, the user should refer to issues of the ArizonaAdministrative Register for recent updates to rule Sections.ARIZONA REVISED STATUTE REFERENCESThe Arizona Revised Statutes (A.R.S.) are available online at theLegislature’s website, www.azleg.gov. An agency’s authorityRhonda Paschal, managing rules editor, assisted with the editingof this chapter.ii

signedArizona Digitallyby Arizonaof StateSecretary SecretaryDate: 2020.10.2011:05:23-07'00'of State9 A.A.C. 5Arizona Administrative CodeAdministrative Rules DivisionThe Arizona Secretary of State electronically publishes each A.A.C. Chapter with a digitalcertificate. The certificate-based signature displays the date and time the document was signedand can be validated in Adobe Acrobat Reader.TITLE 9. HEALTH SERVICESCHAPTER 5. DEPARTMENT OF HEALTH SERVICES - CHILD CARE FACILITIESChapter 5 consisting of Sections R9-5-101, R9-5-201 through R9-5-211, R9-5-301 through R9-5-308, R9-5-401 through R9-5-404, R95-501 through R9-5-222, R9-5-601 through R9-5-614 adopted effective December 12, 1986.Former Chapter 5 consisting of Sections R9-5-110 through R9-5-113, R9-5-211 through R9-5-218, R9-5-311 through R9-5-313, R9-5411 through R9-5-425 repealed effective December 12, 1986.Heading of Chapter permanently changed from “Department of Health Services - Day Care Centers” to “Department of Health Services - Child Care Facilities” effective October 4, 1990 (Supp. 90-4).Heading of Chapter changed by emergency action from “Department of Health Services - Day Care Centers” to “Department ofHealth Services - Child Care Facilities” effective July 9, 1990, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 90-3).ARTICLE 4. FACILITY STAFFARTICLE 1. GENERALSectionR9-5-101.R9-5-102.Definitions . 3Individuals to Act for Applicant or LicenseeRegarding Document, Fingerprinting, andDepartment-provided Training Requirements . 6ARTICLE 2. FACILITY LICENSUREArticle 2 consisting of Sections R9-5-201 through R9-5-211repealed; new Sections R9-5-201 through R9-5-209 adopted; andArticle heading amended effective October 17, 1997 (Supp. 97-4).SectionR9-5-201.R9-5-202.Table 1.Table 9-5-208.R9-5-209.R9-5-210.R9-5-211.Application for a License . 7Time-frames . 8Renumbered . 9Time-frames (in calendar days) . 9Fingerprinting and Central Registry Requirements. 9Child Care Service Classifications . 10Submission of Licensure Fees . 10Licensure Fees . 10Invalid License . 11Changes Affecting a License . 11Inspections; Investigations . 12Denial, Revocation, or Suspension of License . 12Repealed . 12ARTICLE 3. FACILITY General Licensee Responsibilities . 13Statement of Child Care Services . 13Posting of Notices . 14Enrollment of Children . 15Child Immunization Requirements . 15Admission and Release of Children; AttendanceRecords . 16Suspected or Alleged Child Abuse or Neglect . 16Insurance Requirements . 16Gas and Fire Inspections . 17Pesticides . 17September 30, ff Qualifications .17Staff Records and Reports .18Training Requirements .18Staff-to-Children Ratios .19ARTICLE 5. FACILITY PROGRAM AND EQUIPMENTChapter 5 consisting of Sections R9-5-501 through R9-5-222repealed; new Sections R9-5-501 through R9-5-518 and Table 1adopted; and heading amended effective October 17, 1997 -504.R9-5-505.R9-5-506.R9-5-507.Article 3 consisting of Sections R9-5-301 through R9-5-308repealed; new Sections R9-5-301 through R9-5-309 adopted; andArticle heading amended effective October 17, 1997 (Supp. 9-5-305.R9-5-306.Article 4 consisting of Sections R9-5-401 through R9-5-404repealed; new Sections R9-5-401 through R9-5-404 adopted; andArticle heading amended effective October 17, 1997 (Supp. 97-4).R9-5-508.Table 9.R9-5-520.R9-5-521.R9-5-522.Supp. 20-3General Child Care Program, Equipment, andHealth and Safety Standards .20Supplemental Standards for Infants .21Standards for Diaper Changing .23Supplemental Standards for 1-year-old and 2-yearold Children .23Supplemental Standards for 3-year-old, 4-year-old,and 5-year-old Children .24Supplemental Standards for School-age Children.24Supplemental Standards for Children with SpecialNeeds .24General Nutrition Standards .25Meal Pattern Requirements for Children .26General Food Service and Food HandlingStandards .26Discipline and Guidance .27Sleeping and Napping .27Cleaning and Sanitation .28Pets and Animals .28Accident and Emergency Procedures .29Illness and Infestation .29Medications .30Transportation .31Field Trips .32Repealed .32Repealed .32Repealed .32Repealed .32Page 1

9 A.A.C. 5Title 9Arizona Administrative CodeCHAPTER 5. DEPARTMENT OF HEALTH SERVICES - CHILD CARE FACILITIESTable 1.Repealed . 32ARTICLE 6. PHYSICAL PLANT OF A FACILITYArticle 6 consisting of Sections R9-5-601 through R9-5-614repealed; new Sections R9-5-601 through R9-5-607 adopted; andArticle heading amended effective October 17, 1997 (Supp. 10.R9-5-611.R9-5-612.R9-5-613.R9-5-614.General Physical Plant Standards . 32Facility Square Footage Requirements . 33Outdoor Activity Areas . 33Swimming Pools . 34Fire and Safety . 35Renumbered . 35Repealed . 35Repealed . 36Repealed . 36Repealed . 36Repealed . 36Repealed . 36Repealed . 36Repealed . 36ARTICLE 7. REPEALEDArticle 7, consisting of Sections R9-5-701 through R9-5-708,repealed by final rulemaking at 10 A.A.R. 1282, effective September1, 2004 (Supp. 04-1).SectionR9-5-701.R9-5-702.Table aledRepealedRepealedRepealed. 36. 36. 36. 36. 36. 37. 37. 37. 37ARTICLE 8. REPEALEDArticle 8, consisting of Sections R9-5-801 through R9-5-809,repealed by final rulemaking at 10 A.A.R. 1282, effective September1, 2004 (Supp. 04-1).Page ledRepealed.37.37.37.38.38.38.38.38.38ARTICLE 9. REPEALEDArticle 9, consisting of Sections R9-5-901 through R9-5-912,repealed by final rulemaking at 10 A.A.R. 1282, effective September1, 2004 (Supp. .40ARTICLE 10. REPEALEDArticle 10, consisting of Sections R9-5-1001 through R9-51006, repealed by final rulemaking at 10 A.A.R. 1282, effective September 1, 2004 (Supp. 04.R9-5-1005.R9-5-1006.Supp. ed.40.40.40.41.41.41September 30, 2020

Title 9Arizona Administrative Code9 A.A.C. 5CHAPTER 5. DEPARTMENT OF HEALTH SERVICES - CHILD CARE FACILITIESARTICLE 1. GENERALR9-5-101.DefinitionsIn addition to the definitions in A.R.S. § 36-881, the following definitions apply in this Chapter unless otherwise specified:1. “Abuse” has the same meaning as in A.R.S. § 8-201.2. “Accident” means an unexpected occurrence that:a. Causes injury to an enrolled child,b. Requires attention from a staff member, andc. May or may not be an emergency.3. “Accommodation school” has the same meaning as inA.R.S. § 15-101.4. “Accredited” means approved by the:a. New England Commission of Institution of HigherEducation,b. Middle States Commission of Higher Education,c. North Central the Higher Learning Commission,d. Northwest Commission on Colleges and Universities,e. Commission on Colleges, orf. Western Association of Schools and Colleges.5. “Activity” means an action planned by a licensee and performed by an enrolled child while supervised by a staffmember.6. “Activity area” means a specific indoor or outdoor spaceor room of a licensed facility that is designated by alicensee for use by an enrolled child for an activity.7. “Adaptive device” means equipment used to augment anindividual’s use of the individual’s arms, legs, sight, hearing, or other physical part or function.8. “Administrative completeness review time-frame” hasthe same meaning as in A.R.S. § 41-1072.9. “Adult” means an individual who is at least 18 years ofage.10. “Age-appropriate” means consistent with a child’s ageand age-related stage of physical growth and mentaldevelopment.11. “Agency” means any board, commission, department,office, or other administrative unit of the federal government, the state, or a political subdivision of the state.12. “Applicant” means a person or governmental agencyrequesting one of the following:a. A license, orb. Approval of a change affecting a license under R95-208.13. “Application” means the documents that an applicant isrequired to submit to the Department for licensure orapproval of a request for a change affecting a license.14. “Assistant teacher-caregiver” means a staff member whoaids a teacher-caregiver in planning, developing, or conducting child care activities.15. “Association” means a group of individuals other than acorporation, limited liability company, partnership, jointventure, or public school who has established a governingboard and bylaws to operate a facility.16. “Beverage” means a liquid for drinking, including water.17. “Business organization” has the same meaning as“entity” in A.R.S. § 10-140.18. “Calendar day” means each day, not including the day ofthe act, event, or default from which a designated periodof time begins to run, but including the last day of theperiod unless it is a Saturday, Sunday, or legal holiday, inwhich case the period runs until the end of the next daythat is not a Saturday, Sunday, or legal holiday.19. “Calendar week” means a seven-day period beginning onSunday at 12:00 a.m. and ending on Saturday at 11:59p.m.September 30, 2020Supp. 20-320. “C.C.P.” means Certified Childcare Professional, a credential awarded by the National Early Childhood Program Accreditation.21. “C.D.A.” means Child Development Associate, a credential awarded by the Council for Professional Recognition.22. “Change in ownership” means a transfer of controllinglegal or controlling equitable interest and authority in afacility resulting from a sale or merger of a facility.23. “Charter school” has the same meaning as in A.R.S. § 15101.24. “Child care experience” means an individual’s documented work with children in:a. A child care facility or a child care group home thatwas licensed, certified, or approved by a state in theUnited States or by one of the Uniformed Servicesof the United States;b. A public school, a charter school, a private school,or an accommodation school;c. A public or private educational institution authorized under the laws of another state where instruction was provided for any grade or combination ofgrades between pre-kindergarten and grade 12; ord. One of the following professional fields:i. Nursing,ii. Social work,iii. Psychology,iv. Child development, orv. A closely-related field.25. “Child care services” means the range of activities andprograms provided by a licensee to an enrolled child,including personal care, supervision, education, guidance, and transportation.26. “Child with special needs” means:a. A child with a health care provider’s diagnosis andrecord of a physical or mental condition that substantially limits the child in providing self-care orperforming manual tasks or any other major lifefunction such as walking, seeing, hearing, speaking,breathing, or learning;b. A child with a “developmental disability” as definedin A.R.S. § 36-551; orc. A “child with a disability” as defined in A.R.S. § 15761.27. “Clean” means to remove dirt or debris by methods suchas washing with soap and water, vacuuming, wiping,dusting, or sweeping.28. “Closely-related field” means any educational instructionor occupational experience pertaining to the growth,development, physical or mental care, or education ofchildren.29. “Communicable disease” has the same meaning as inA.A.C. R9-6-101.30. “Compensation” means money or other consideration,including goods, services, vouchers, time, government orpublic expenditures, government or public funding, oranother benefit, that is received as payment.31. “Corporal punishment” means any physical action usedto discipline a child that inflicts pain to the body of thechild, or that may result in physical injury to the child.32. “CPR” means cardiopulmonary resuscitation.33. “Credit hour” means an academic unit earned at anaccredited college or university:a. By attending a one-hour class session each calendarweek during a semester or equivalent shorter courseterm, orPage 3

9 A.A.C. 5Arizona Administrative CodeTitle 9CHAPTER 5. DEPARTMENT OF HEALTH SERVICES - CHILD CARE .47.48.49.50.51.52.Page 4Completing practical work for a course as determined by the accredited college or university.“Designated agent” means an individual who meets therequirements in A.R.S. § 36-889(D).“Developmentally-appropriate” means consistent with achild’s physical, emotional, social, cultural, and cognitivedevelopment, based on the child’s age and family background and the child’s personality, learning style, and pattern and timing of growth.“Discipline” means the on-going process of helping achild develop self-control and assume responsibility forthe child’s own actions.“Documentation” means information in written, photographic, electronic, or other permanent form.“Electronic signature” has the same meaning as in A.R.S.§ 41-351(4).“Emergency” means a potentially life-threatening occurrence involving an enrolled child or staff member thatrequires an immediate response or medical treatment.“Endanger” means to expose an individual to a situationwhere physical injury or mental injury to the individualmay occur.“Enrolled” means placed by a parent and accepted by alicensee for child care services.“Evening and nighttime care” means child care servicesprovided between the hours of 8:00 p.m. and 5:00 a.m.“Facility” has the same meaning as “child care facility” inA.R.S. § 36-881.“Facility director” means an individual who is designatedby a licensee as the individual responsible for the dailyonsite operation of a facility.“Facility premises” means property that is:a. Designated on an application for a license by theapplicant; andb. Licensed for child care services by the Departmentunder A.R.S. Title 36, Chapter 7.1, Article 1, andthis Chapter.“Fall zone” means the surface under and around a pieceof equipment onto which a child falling from or exitingfrom the equipment would be expected to land.“Field trip” means an activity planned by a staff memberfor an enrolled child:a. At a location or area that is not licensed for childcare services by the Department, orb. At a child care facility in which the child is notenrolled.“Final construction drawings” means facility plans thatinclude the architectural, structural, mechanical, electrical, fire protection, plumbing, and technical specifications of the physical plant and the facility premises andthat have been approved by local government for the construction, alteration, or addition of a facility.“Food” means a raw, cooked, or processed edible substance, ice, beverage, or ingredient used or intended foruse or for sale in whole or in part for human consumption, or chewing gum.“Food preparation” means processing food for humanconsumption by cooking or assembling the food, but doesnot include distributing prepackaged food or whole fruitsor vegetables.“Full-day care” means child care services provided forsix or more hours per day between the hours of 5:00 a.m.and 8:00 p.m.“Governmental agency” has the same meaning as inA.R.S. § 44-7002.Supp. 20-353. “Guidance” means the ongoing direction, counseling,teaching, or modeling of generally accepted social behavior through which a child learns to develop and maintainthe self-control, self-reliance, and self-esteem necessaryto assume responsibilities, make daily living decisions,and live according to generally accepted social behavior.54. “Hazard” means a source of endangerment.55. “Health care provider” means a physician, physicianassistant, or registered nurse practitioner.56. “High school equivalency diploma” means:a. A document issued by the State Board of Educationunder A.R.S. § 15-702 to an individual who passes ageneral educational development test or meets therequirements of A.R.S. § 15-702(B);b. A document issued by another state to an individualwho passes a general educational development testor meets the requirements of a state statute equivalent to A.R.S. § 15-702(B); orc. A document issued by another country to an individual who has completed that country’s equivalent of a12th grade education, as determined by the Department based upon information obtained from American or foreign consulates or embassies or othergovernmental agencies.57. “Hours of operation” means the specific time during aday for which a licensee is licensed to provide child careservices.58. “Illness” means physical manifestation or signs of sickness, such as pain, vomiting, rash, fever, discharge, ordiarrhea.59. “Immediate” or “immediately” means without restriction,delay, or hesitation.60. “Inaccessible” means:a. Out of an enrolled child’s reach, orb. Locked.61. “Infant” means:a. A child 12 months of age or younger, orb. A child 18 months of age or younger who is not yetwalking.62. “Infant care” means child care services provided to aninfant.63. “Infestation” means the presence of lice, pinworms, scabies, or other parasites.64. “Inspection” means:a. Examination of a facility by the Department todetermine compliance with A.R.S. Title 36, Chapter7.1, Article 1, and this Chapter;b. Review of facility documents, records, or reports bythe Department; orc. Examination of a facility by a local governmentalagency.65. “Lesson plan” means a written description of the activities scheduled in each activity area for a day.66. “License” means the written authorization issued by theDepartment to operate a facility in Arizona.67. “Licensed applicator” who complies with A.A.C. R3-8201(C).68. “Licensed capacity” means the maximum number ofenrolled children for whom a licensee is authorized by theDepartment to provide child care services in a facility or apart of a facility at

vices - Child Care Facilities" effective October 4, 1990 (Supp. 90-4). Heading of Chapter changed by emergency action from "Department of Health Services - Day Care Centers" to "Department of Health Services - Child Care Facilities" effective July 9, 1990, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 90-3). ARTICLE 1 .