1. A. A licensee shall not permit an enrolled child to attend a facility until the facility receives:

   1. 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:

      1. a. Provided by a health care provider, or
      2. 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. 2. An exemption affidavit for the enrolled child provided by the enrolled child’s parent that contains a statement, signed by the enrolled child’s:

      1. a. 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
      2. b. Parent, that the enrolled child is being raised in a religion whose teachings are in opposition to immunization; or
2. B. If an enrolled child has not had immunizations and is either homeless, as in “homeless children and youths” according to 42 USC 11434a, who is referred by DCS or Tribal Child Protective Services, initial doses should be administered within 30-calendar days, unless the enrolled child has a religious or medical exemption, as specified in subsections (A)(1) and (2). A child who is experiencing homelessness or who is referred by DCS or Tribal Child Protective Services is permitted to enroll in the program while required documentation is obtained
3. C. 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, required in R9-5-304(B).
4. D. A licensee shall ensure that a staff member updates an enrolled child’s written immunization record required in subsection (A)(1)(a) each time the enrolled child’s parent provides the licensee with a written statement from the enrolled child’s health care provider that the enrolled child has received an age-appropriate immunization required by 9 A.A.C. 6, Article 7.

5. E. If an enrolled child’s immunization record indicates that the enrolled child has not received an age-appropriate immunization required by 9 A.A.C. 6, Article 7, a licensee shall ensure that a staff member:

   1. 1. Notifies the enrolled child’s parent in writing that the enrolled child may attend the facility for not more than 15 calendar days after the date of the notification unless the enrolled child’s parent complies with the immunization requirements in 9 A.A.C. 6, Article 7; and
   2. 2. Documents on the enrolled child’s Emergency, Information, and Immunization Record the date on which the enrolled child’s parent is notified of an immunization required by the Department.
6. F. A licensee shall not allow an enrolled child who lacks proof of immunity against a disease listed in A.A.C. R9-6-702 to attend the child care facility between the start and end of an outbreak of the disease at the facility.
7. G. If a parent of an enrolled child, excluded from a child care facility because of the lack of documented immunity to a disease during an outbreak of the disease at the child care facility, submits any of the documents in A.A.C. R9-6-704 as proof of the enrolled child’s immunity to the disease, a licensee shall allow the enrolled child to attend the child care facility during the outbreak of the disease.

Historical Note

New Section made by final rulemaking at 31 A.A.R. 2015 (June 27, 2025), effective August 3, 2025 (Supp. 25-2).