Bella Montessori

ARS § 36-883.05.C. C. The ratio of staff members to resting infants in the resting area must be at least one staff member to every four infants. A staff member in the resting area must be supervised for the first ninety days of employment to ensure the staff member's proper use of the floor bedding pursuant to this section. Any staff member in the resting area shall have current certification in cardiopulmonary resuscitation and first aid.

“Findings: Based on the Compliance Officer's observation, upon entering the Infant room the ratio in the resting area was 0:1 rather than 1:1 as required. An infant was observed asleep on their floor bedding with no staff present in the resting area.”

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 facility documentation and the Compliance Officer's observation, upon arrival in the 1/2's Classroom, the roster reflected 11, with 8 children present. In the Primary Classroom, the roster reflected 18, with 19 children present.”

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 staff statements and the Compliance Officers' observations, the health, safety and welfare of enrolled children was placed at risk of harm. On the playground, in the construction area, Child #1 was lying on the ground under a water table. A teacher noticed Child #1 under the table and walked over to them. When they got there, Child #1 had their pants and underwear pulled down. When the teacher asked what was going on, Child#1 said that Child #2 said, "Let's play a private game." Staff Statements: *Teacher asked, "What is the private game?" Child #2 response was "They pull their pants down so I can see." *I saw Child#1 under the table. Went to check on them and their pants were down.”

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

“Findings: Per Allegation: Based on staff statements and the Compliance Officers' observations, staff did not supervise children at all times. On the playground, in the construction area, Child#2 had asked Child #1 to play a "private game." Child #2 told Child #1 to pull down their pants and underwear. Child #1 went to the table and pulled down their pants and underwear. The teacher was over by the climbing structure. Staff Statements: *I saw Child #1 with their hands on their pants, still pulling them down. *Child #1 had their pants pulled down.”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on facility documentation and the Compliance Officers' observations, upon arrival on the playground the ratio was 2:19, rather than 3:19 as required with 2-year-old children present.”

ARS § 36-883.02.D. D. Employers of child care personnel shall make documented, good faith efforts to contact previous employers of child care personnel to obtain information or recommendations that may be relevant to an individual's fitness for employment in a child care facility.

“Findings: Based on facility documentation and the Compliance Officer's observations, it was determined that the files for Staff #4 (start date 10/30/2024) and Staff #5 (start date 02/12/2025) lacked dates of when 2 good faith efforts to contact previous employers occurred.”

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 Compliance Officer's observation, it was determined that the Mantoux skin test for Staff #3 (start date 06/03/2024) was read on 06/06/2024 rather than on or before the starting date of employment as required.”

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 facility documentation and the Compliance Officer's observations, it was determined that the licensee failed to validate the following staff members Fingerprint Clearance Card's prior to the staff member's start date as required: Staff #1: Start date 07/09/2024, card verified on 10/09/2024 Staff #2: Start date 10/14/2024, card verified on 10/29/2024 Staff #3: Start date 06/03/2024, card verified on 06/13/2024 Staff #4: Start date 10/30/2024, card verified on 11/05/2024 Staff #5: Start date 02/12/2025, card verified no date documented Staff #6: Start date 09/25/2024, card verified on 10/10/2024 The fingerprint clearance cards were verified to be valid through the DPS website at the time of the inspection.”

AAC R9-5-605.B.16. B. A licensee shall ensure that:16. The fire extinguisher required in subsection (A): a. Is serviced at least once every 12 months; and b. Has a tag attached to the fire extinguisher that specifies the date of the last servicing and the identification of the person who serviced the fire extinguisher; and

“Findings: Based on the Compliance Officer #1's observation, the Fire extinguishers service tags expired in April of 2024.”

AAC R9-5-605.B.6. B. A licensee shall ensure that: 6. Except for a room used only for an enrolled school-age child, each unused electrical outlet is covered with a safety plug cover or insert;

“Findings: Based on Compliance Officer #1's observation, in the Primary classroom, there were 2 outlets that lacked outlet covers on the West wall.”

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 Compliance Officer #1's observation, in the outdoor activity area, the following hazards were accessible to enrolled children: There was a broken slat with exposed nails on the wood wire spool in the construction center. There was a plastic bag filled with garbage on the basketball court.”

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 Compliance Officer #2's observations, Child #5's prescription medication lacked the pharmacy label and contained only half of the prescription.”

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 facility documentation and Compliance Officer #2’s observation, after a review of six medications, two lacked the following: There were no medication authorization forms for Child #5's two medications.”

AAC R9-5-504.5.b. A licensee providing child care services for 1-year-old and 2-year-old children shall:5. Ensure that: b A staff member serves food to an enrolled child in a feeding chair or at a table with a chair that allows the enrolled child to reach the food while sitting;

“Findings: Based on Compliance Officer #1's observation, in the Toddler classroom, an enrolled child was observed walking around the classroom eating crackers rather than sitting at a table as required.”

AAC R9-5-502.A.1. A. A licensee providing child care services for infants shall: 1. Provide a wall-enclosed room for infants that provides exits required by R9-5-601(1);

“Findings: Based on Compliance Officer #1's observation, upon entering Infant room 1, the door between Infant room 1 and Infant room 2 was open. Repeat deficiency, cited on 01/03/2024.”

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 Compliance Officer #1's observation, the Toddler classroom and Primary classroom's posted lesson plans were for April.”

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

“Findings: Based on Compliance Officer #1's observation, in Infant Room 2, a Staff member failed to supervise enrolled children at all times when the Staff member left Infant Room 2 and went into Infant Room 1, leaving 3 infants alone and unsupervised.”

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 Compliance Officer #1's observation, in the Toddler classroom, there was a cabinet door with a broken hinge in the diaper changing area. There was a 2-inch hole with exposed drywall on the wall by the second classroom door.”

AAC R9-5-404.A. A. A licensee shall ensure that at least the following staff-to-children ratios are maintained at all times when providing child care services to enrolled children: Age Group/Staff: Children - Infants/1:5 or 2:11; 1-year-old children/1:6 or 2:13; 2-year-old children/1:8; 3-year-old children/1:13; 4-year-old children/1:15; 5-year-old children not school-age/1:20; School-age children/1:20

“Findings: Based on Compliance Officer #1's observation, in Infant Room 2, a Staff member left the room and went into Infant Room 1. During the Staff members absence in Infant Room 2, the staff-to-child ratio was 0:3 rather than required 1:3 with infants present.”

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, 4 of 10 children’s Emergency Information and Immunization record cards lacked the following: Child #1 and Child #2: The name of the individual to contact in case of the child’s sudden illness or injury. Child #3: One of the required two emergency contact names and phone number. Child #4: The 2nd parent/guardian’s name, address, and phone number.”

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 Compliance Officer #2’s observations, one of three staff files lacked the following: Staff #1’s (start date 8/21/2023) DCS Central Registry affidavit was not signed before the staff member’s starting date on employment. The affidavit was signed on 9/11/2023.”

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 #1's observation, in the Toddler classroom, enrolled children's personal products lacked a first and last name as required. There were 3 ointments labeled with the child's first name only, and 4 ointments lacked a label with the child's name.”

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 Officers' observations, in the Ones classroom, there was a bowl and a cup on the diaper changing surface. In the Toddler Ones classroom, there was a thermos and a toy on the diaper changing surface.”

AAC R9-5-502.A.1. A. A licensee providing child care services for infants shall: 1. Provide a wall-enclosed room for infants that provides exits required by R9-5-601(1);

“Findings: Based on the Compliance Officers' observations, the door between the Infant room and Infant transition room was open and an enrolled infant was pushing a toy and crawling toward the door.”

AAC R9-5-605.B.9. B. A licensee shall ensure that: 9. Fans are mounted and inaccessible to an enrolled child;

“Per allegation findings: Based on the Compliance Officers' observation, in the Before and After school classroom, there was an unmounted fan by the doorway and accessible to enrolled children.”

AAC R9-5-605.B.6. B. A licensee shall ensure that: 6. Except for a room used only for an enrolled school-age child, each unused electrical outlet is covered with a safety plug cover or insert;

“Per allegation findings: Based on the Compliance Officers' observations, in the Toddler Ones room, an outlet under the mounted fan lacked a cover. In the Roadrunners classroom, there were 2 uncovered outlets above the cots on the south wall.”

AAC R9-5-503.D. D. A licensee shall ensure that a written diaper changing procedure is posted and implemented in each diaper changing area.

“Findings: Based on Compliance Officer #2's observation, the Ones classroom lacked a diaper changing procedure posted in the diaper changing area.”

AAC R9-5-512.A. A. A licensee shall maintain facility premises free of insects and vermin.

“Per allegation findings: Based on staff statements, in the outdoor activity area, Staff stated that "a roof rat ran up a pipe and onto the roof" during pick-up time and "traps were placed on the roof to catch it". Staff stated that "a rat was on the roof but was handled by maintenance people".”

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 Officers' observations, in the outdoor activity area, a ladder was leaning against a chain-link fence and accessible to enrolled children.”

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 facility documentation and Compliance Officer #2's observations, upon arrival in the following classrooms, the rosters did not accurately reflect the number of enrolled children present: In the Infant room, there were 8 enrolled children listed on the roster, but there were only 5 children present in the room. In the Infant transition room, there were 7 enrolled children listed on the roster, but there were only 4 children present in the room. In the Toddler ones classroom, there were 9 enrolled children listed on the roster, but there were only 5 children present in the room. In the Ones classroom, there were 9 enrolled children listed on the roster, but there were only 4 children present in the room. In the Roadrunner's classroom, there were 16 enrolled children listed on the roster, but there were 17 children present in the room.”