Midlothian Kids Academy

8VAC20-780-60-A Complaint related: No

“Based on the review of one child’s record (C1), and interviews with staff members (S2 and S3), the agency failed to maintain information in the child’s record as required. Evidence: The record of C1 did not contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. In an exit interview on 6/04/24, S2 and S3 acknowledged that there was one emergency contact listed in the file of C1.”

8VAC20-780-80-B-2 Complaint related: No

“Based on a record review and a staff interview, the center failed to inform the department’s representative of any injury that occurs at the center that requires outside medical care. Evidence: A child (C1) was taken to the hospital on 5/24/24 after being at the center all day due to concerns about the child’s diaper rash. In interviews with two staff members (S2 and S3) on 6/04/24, S2 and S3 acknowledged that they were aware that the child received outside medical care and that no incident report was sent.”

8VAC20-780-130-A Complaint related: No

“Based on the review of one child’s record (C1), and interviews with staff members (S2 and S3), the agency failed to obtain immunizations for a child as required. Evidence: The first day of attendance for C1 was 9/11/23. The immunizations in the record for C1 were dated 10/27/23. In exit interviews on 6/04/24, S2 and S3 acknowledged that the immunizations in the record for C1 were not received before the child started attending the center.”

8VAC20-780-140-A Complaint related: No

“Based on the review of two children’s records (C1 and C2), and interviews with staff members (S2 and S3), the agency failed to obtain two children’s physical examinations as required. Evidence: The first day of attendance for C1 was 9/11/23. The physical examination in the record for C1 was dated 10/27/23. The physical examination was not completed within 30 days after the first day of attendance. The first day of attendance for C2 was 2/08/24. There was no physical examination in the record for C2. In exit interviews on 6/04/24, S2 and S3 acknowledged that the physical examination in the record for C1 was not completed within the required timeframe and that there was no physical examination for C2.”

8VAC20-780-60-A Complaint related: No

“Based on the review of one child’s record (C1), and interviews with staff members (S2 and S3), the agency failed to maintain information in the child’s record as required. Evidence: The record of C1 did not contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. In an exit interview on 6/04/24, S2 and S3 acknowledged that there was one emergency contact listed in the file of C1.”

8VAC20-780-80-B-2 Complaint related: No

“Based on a record review and a staff interview, the center failed to inform the department’s representative of any injury that occurs at the center that requires outside medical care. Evidence: A child (C1) was taken to the hospital on 5/24/24 after being at the center all day due to concerns about the child’s diaper rash. In interviews with two staff members (S2 and S3) on 6/04/24, S2 and S3 acknowledged that they were aware that the child received outside medical care and that no incident report was sent.”

8VAC20-780-130-A Complaint related: No

“Based on the review of one child’s record (C1), and interviews with staff members (S2 and S3), the agency failed to obtain immunizations for a child as required. Evidence: The first day of attendance for C1 was 9/11/23. The immunizations in the record for C1 were dated 10/27/23. In exit interviews on 6/04/24, S2 and S3 acknowledged that the immunizations in the record for C1 were not received before the child started attending the center.”

8VAC20-780-140-A Complaint related: No

“Based on the review of two children’s records (C1 and C2), and interviews with staff members (S2 and S3), the agency failed to obtain two children’s physical examinations as required. Evidence: The first day of attendance for C1 was 9/11/23. The physical examination in the record for C1 was dated 10/27/23. The physical examination was not completed within 30 days after the first day of attendance. The first day of attendance for C2 was 2/08/24. There was no physical examination in the record for C2. In exit interviews on 6/04/24, S2 and S3 acknowledged that the physical examination in the record for C1 was not completed within the required timeframe and that there was no physical examination for C2.”

8VAC20-780-70 Complaint related: No

“Based on interview and record review, the center failed to keep staff records as required. Evidence: In an interview, S2 reported that she was promoted from an aide to a teacher in February of 2024. The record of S2 does not document 24 hours of training related to the care of children between August of 2023 and March 2024 as required. There was documentation of one hour of training on 8/17/23 and documentation of 2 hours of training on 9/25/23. S3 stated that they provide training every month and that they will gather the documentation for the file.”

8VAC20-780-410-1 Complaint related: Yes

“Based on staff interviews and review of video footage, a staff member roughly handled a child. Evidence: Video footage documented an incident on 5/08/24 in which a staff member (S1) grabbed a child’s ankle (C1) to stop the child from leaning back in her chair. C1 (age 3 years 5 months) fell backwards in her chair and fell out of the chair onto the floor. Staff (S3, S4, and S5) acknowledged in interviews that S1 handled the child roughly. S1 was terminated from employment the next day.”

8VAC20-780-400-A Complaint related: Yes

“Based on staff interviews and review of video footage, a staff member did not provide needed help and comfort to a child after the child tipped over backwards in her chair and fell out of the chair onto the floor. Evidence: Video footage documented an incident on 5/08/24 in which a staff member (S1) grabbed a child’s ankle (C1) to stop the child from leaning back in her chair. C1 (age 3 years 5 months) fell backwards in her chair and fell out of the chair onto the floor. S1 picked up the chair to set it upright then walked away without providing needed help or comfort to C1. Staff (S3, S4, and S5) acknowledged in interviews that S1 did not provide help and comfort to the child after she fell. S1 was terminated from employment the next day.”

8VAC20-780-80-B Complaint related: Yes

“Based on a record review and a staff interview, the center failed to ensure that any suspected incident of child abuse and neglect shall be reported in accordance with ?63.2-1509. Evidence: An anonymous complaint was received on 5/09/24 regarding an incident that took place on 5/08/24 alleging that a staff member roughly handled a child (C1) and failed to provide needed help and comfort to the child (C1). A self report was received from the center on 5/10/24 reporting a staff member’s neglect regarding the same incident. In an interview on 5/10/24, the Director acknowledged that they did not contact the local department of Social Services as required.”

8VAC20-780-550-P Complaint related: No

“Based on the review of a child's record (Child #1) and an interview with a center representative (CR #1), the agency failed to include required elements in the written record of children’s serious and minor injuries. Evidence: Child #1 was injured during an activity at the center on 4/2/2024. The injury report for Child #1 did not include: the names of all staff that were present, the outside medical treatment received, the time that the parent was notified, and any future action to prevent recurrence of the injury. In an exit interview on 4/15/24, CR #1 acknowledged that the elements listed above were not included in the injury report.”

8VAC20-780-80-B-2 Complaint related: No

“Based on the review of a child's record (Child #1) and an interview with a center representative (CR #1), the agency failed to inform the department's representative within 2 business days of the injury to the child that required outside medical attention. Evidence: In an interview on 4/15/24, CR #1 confirmed that Child #1 needed outside medical treatment for the injury received on 4/02/24. In an exit interview on 4/15/24, CR #1 acknowledged that the department's representative was not notified.”

8VAC20-780-60-A

“Based on review of five children's records, the facility failed to have required information in each child's file. Evidence: Child 2, Child 3, Child 6, and Child 8 did not have documentation of the name and phone number of the child's physician.”

8VAC20-780-130-A

“Based on review of ten children’s records, the facility failed to have the immunization record for each child before the child can attend the center. Evidence: Child 3 (date of enrollment 9/26/2022) did not have documentation of an immunization record.”

8VAC20-780-140-A

“Based on review of ten children’s records, the facility failed to have a physical examination for each child within 30 days of attendance. Evidence: Child 3 (date of enrollment 9/26/2022), Child 5 (date of enrollment 7/5/2022), Child 6 (date of enrollment 1/3/2023), and Child 8 (date of enrollment 9/18/2023) did not have documentation of a physical.”

8VAC20-780-570-B

“Based on observation, the center did not ensure that bottles were not used while children are in their designated sleeping location. Evidence: In the toddler classroom, two children were observed on their cots with bottles.”

8VAC20-780-510-P

“Based on review of four medications, the facility failed to notify parents that that the medication must be picked up within 14 days of the authorization expiring or that a new authorization should be completed. Evidence: Child A's medication authorization expired 3/08/2024, and Child C's medication authorization expired 2/15/2024. The authorizations had not been renewed and the medications were not returned or destroyed as required. The medication was on site.”

8VAC20-780-160-A

“Based on review of 9 staff records, the center failed to obtain documentation of a negative tuberculosis (TB) screening or test for each staff at the time of employment and prior to coming in contact with children. Staff 1 (date of employment 8/17/2023) had a TB test on 8/30/2023, Staff 2 (date of employment 7/31/2023) had a TB test on 8/1/2023, Staff 3 (date of employment 9/08/2023) had a TB test on 9/18/2023, and Staff 4 (date of employment 7/24/2023) had a TB test on 3/08/2022, Staff 5 (date of employment 1/02/2024) had a TB test 11/21/2023, .”

8VAC20-780-440-L

“Based on observation, the facility failed to prevent the use of pillows for children under two years of age. Evidence: In toddler room, there were two children under the age of two years that were using pillows while on their cots.”

8VAC20-780-380-A-2

“Based on observation and staff interview, the failed to limit the designated rest period to no more than two hours per day. On 3/08/2024, the toddler and twos classrooms, the children were on cots for rest at 11:30 a.m. and remained on cots until 2:30 p.m. Staff confirmed that the children had rest time for 3 hours.”

8VAC20-780-60-A

“Based on review of five children's records, the facility failed to have required information in each child's file. Evidence: Child 2, Child 3, Child 6, and Child 8 did not have documentation of the name and phone number of the child's physician.”

8VAC20-780-130-A

“Based on review of ten children’s records, the facility failed to have the immunization record for each child before the child can attend the center. Evidence: Child 3 (date of enrollment 9/26/2022) did not have documentation of an immunization record.”

8VAC20-780-140-A

“Based on review of ten children’s records, the facility failed to have a physical examination for each child within 30 days of attendance. Evidence: Child 3 (date of enrollment 9/26/2022), Child 5 (date of enrollment 7/5/2022), Child 6 (date of enrollment 1/3/2023), and Child 8 (date of enrollment 9/18/2023) did not have documentation of a physical.”

8VAC20-780-570-B

“Based on observation, the center did not ensure that bottles were not used while children are in their designated sleeping location. Evidence: In the toddler classroom, two children were observed on their cots with bottles.”

8VAC20-780-510-P

“Based on review of four medications, the facility failed to notify parents that that the medication must be picked up within 14 days of the authorization expiring or that a new authorization should be completed. Evidence: Child A's medication authorization expired 3/08/2024, and Child C's medication authorization expired 2/15/2024. The authorizations had not been renewed and the medications were not returned or destroyed as required. The medication was on site.”

8VAC20-780-160-A

“Based on review of 9 staff records, the center failed to obtain documentation of a negative tuberculosis (TB) screening or test for each staff at the time of employment and prior to coming in contact with children. Staff 1 (date of employment 8/17/2023) had a TB test on 8/30/2023, Staff 2 (date of employment 7/31/2023) had a TB test on 8/1/2023, Staff 3 (date of employment 9/08/2023) had a TB test on 9/18/2023, and Staff 4 (date of employment 7/24/2023) had a TB test on 3/08/2022, Staff 5 (date of employment 1/02/2024) had a TB test 11/21/2023, .”

8VAC20-780-440-L

“Based on observation, the facility failed to prevent the use of pillows for children under two years of age. Evidence: In toddler room, there were two children under the age of two years that were using pillows while on their cots.”

8VAC20-780-380-A-2

“Based on observation and staff interview, the failed to limit the designated rest period to no more than two hours per day. On 3/08/2024, the toddler and twos classrooms, the children were on cots for rest at 11:30 a.m. and remained on cots until 2:30 p.m. Staff confirmed that the children had rest time for 3 hours.”

8VAC20-780-280-B Complaint related: No

“Based on observation, the center failed to ensure hazardous substances such as cleaning material, insecticides, and pesticides were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. A bottle of home defense insect killer was observed being used to prop the center director’s office door open. 2. During the inspection a child was observed in the center director’s office.”

22.1-289.035-B-4

“Based on record review and interview, the center failed to obtain a child abuse and neglect search from any state in which the individual has resided in the preceding five years. Evidence: 1.The record for Staff #7 (date of hire: 3/6/23) documented a sworn disclosure statement, indicating having resided outside of the state of Virginia within the preceding five years. 2.There was not an out of state child abuse and neglect search documented in the record for Staff #7 and no additional information was provided. 3. During an interview, with the center director, it was acknowledged that the record did not document the search results for Staff #7.”

22.1-289.036-A

“Based on review of two applicant/agent background checks, the center failed to ensure a sworn disclosure statement was completed every five years. Evidence: 1. The most recent sworn disclosure statement documented for applicant/agent (A) A#1, is dated 1/1/2017. 2. The most recent sworn disclosure statement documented for applicant/agent (A) A#2, was dated 1/26/2017. 3. During an interview, the center director acknowledged the sworn disclosure statements for the applicants/agents were not completed every 5 years.”

8VAC20-770-60-B

“Based on review of eleven staff records, the center failed to ensure that the sworn disclosure statement was signed prior to employment. Evidence: 1. Staff #4?s date of hire was 6/19/2023. The sworn disclosure statement was signed on 6/21/2023.”

8VAC20-770-60-C-2

“Based on review of eleven staff records and interview, the center failed to ensure a search of the central registry was completed for each staff by the end of the 30th day of employment. Evidence: 1. Staff #1 (date of employment 5/25/2022) did not have a completed search of the central registry documented in the record. 2. No additional information was provided and the director acknowledged the central registry search was not completed. 3. Staff #6 (date of employment 4/3/2023) did not have a completed search of the central registry documented in the record. 4. The center director forwarded emails from the Office of Background Investigations (OBI) on 6/29/2023. One email is dated 6/2/23 and documents, that portability was not available and Staff #6 was not found. 5. An additional email, dated 6/6/2023 from OBI, documents an error on the request submitted and advised the center, that a request must be resubmitted. 6. The center did not provide any additional information regarding the request for the central registry search.”

8VAC20-780-160-A

“Based on review of eleven staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis screening at the time of employment and before coming into contact with children. Evidence: 1. The record for staff #11 (date of hire: 1/23/23) documented a tuberculosis screening dated 4/13/2023.”

8VAC20-780-270-A

“270-A Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. One bathroom located in the Pre-K room had 2 chipped paint areas on the wall. 2. The center director observed and acknowledged the chipped paint areas.”

8VAC20-780-500-B

“Based on observation, the center did not ensure soiled diapers are disposed of in a storage system that is either foot-operated or used in such a way that neither the staff member’s hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: 1.The foot-operated diaper trash can in infant room #100 was observed as not operable with the foot-operated step. The lid required manual lifting. 2. A teacher in the room was observed lifting the lid with her hand to dispose of a diaper.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was refrigerated, dated and labeled with the child's name. Evidence: The refrigerators in the infant rooms contained infant bottles with no dates.”

8VAC20-780-140-A

“Based on review of 10 child records, the center failed to ensure that each child had a physical examination by or under the direction of a physician before attendance or within 30 days after attendance. Evidence: At the time of review, there was no physical examination in the record of Child #6. Child #6 had a documented first date of attendance of 11/29/21.”

8VAC20-790-600-F

“Based on review of staff records, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department. Evidence: The record for Staff #1 (date of hire: 5/25/2022) contained documentation of the Virginia Annual Health and Safety Update Course dated 5/25/2022.”

22.1-289.035-B-4

“Based on record review and interview, the center failed to obtain a child abuse and neglect search from any state in which the individual has resided in the preceding five years. Evidence: 1.The record for Staff #7 (date of hire: 3/6/23) documented a sworn disclosure statement, indicating having resided outside of the state of Virginia within the preceding five years. 2.There was not an out of state child abuse and neglect search documented in the record for Staff #7 and no additional information was provided. 3. During an interview, with the center director, it was acknowledged that the record did not document the search results for Staff #7.”

22.1-289.036-A

“Based on review of two applicant/agent background checks, the center failed to ensure a sworn disclosure statement was completed every five years. Evidence: 1. The most recent sworn disclosure statement documented for applicant/agent (A) A#1, is dated 1/1/2017. 2. The most recent sworn disclosure statement documented for applicant/agent (A) A#2, was dated 1/26/2017. 3. During an interview, the center director acknowledged the sworn disclosure statements for the applicants/agents were not completed every 5 years.”

8VAC20-770-60-B

“Based on review of eleven staff records, the center failed to ensure that the sworn disclosure statement was signed prior to employment. Evidence: 1. Staff #4?s date of hire was 6/19/2023. The sworn disclosure statement was signed on 6/21/2023.”

8VAC20-770-60-C-2

“Based on review of eleven staff records and interview, the center failed to ensure a search of the central registry was completed for each staff by the end of the 30th day of employment. Evidence: 1. Staff #1 (date of employment 5/25/2022) did not have a completed search of the central registry documented in the record. 2. No additional information was provided and the director acknowledged the central registry search was not completed. 3. Staff #6 (date of employment 4/3/2023) did not have a completed search of the central registry documented in the record. 4. The center director forwarded emails from the Office of Background Investigations (OBI) on 6/29/2023. One email is dated 6/2/23 and documents, that portability was not available and Staff #6 was not found. 5. An additional email, dated 6/6/2023 from OBI, documents an error on the request submitted and advised the center, that a request must be resubmitted. 6. The center did not provide any additional information regarding the request for the central registry search.”

8VAC20-780-160-A

“Based on review of eleven staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis screening at the time of employment and before coming into contact with children. Evidence: 1. The record for staff #11 (date of hire: 1/23/23) documented a tuberculosis screening dated 4/13/2023.”

8VAC20-780-270-A

“270-A Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. One bathroom located in the Pre-K room had 2 chipped paint areas on the wall. 2. The center director observed and acknowledged the chipped paint areas.”

8VAC20-780-500-B

“Based on observation, the center did not ensure soiled diapers are disposed of in a storage system that is either foot-operated or used in such a way that neither the staff member’s hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: 1.The foot-operated diaper trash can in infant room #100 was observed as not operable with the foot-operated step. The lid required manual lifting. 2. A teacher in the room was observed lifting the lid with her hand to dispose of a diaper.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was refrigerated, dated and labeled with the child's name. Evidence: The refrigerators in the infant rooms contained infant bottles with no dates.”

8VAC20-780-140-A

“Based on review of 10 child records, the center failed to ensure that each child had a physical examination by or under the direction of a physician before attendance or within 30 days after attendance. Evidence: At the time of review, there was no physical examination in the record of Child #6. Child #6 had a documented first date of attendance of 11/29/21.”

8VAC20-790-600-F

“Based on review of staff records, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department. Evidence: The record for Staff #1 (date of hire: 5/25/2022) contained documentation of the Virginia Annual Health and Safety Update Course dated 5/25/2022.”

8VAC20-780-510-B

“Based on review of seven medications for six children, the facility failed to have written authorization from the parent to administer medication. Evidence: The parent did not provide written authorization for the facility to administer medication to Child A or Child B.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: the landscape fabric on the toddler playground was exposed and ripped, causing a tripping hazard.”

8VAC20-770-60-C-2

“Based on review of ten staff files, the facility failed to have documentation of a completed search of the central registry ( CPS check) on file for each staff within the first 30 days of employment. Evidence: 1. Staff 2 (date of employment 9/28/2022) did not have a completed search of the central registry until 2/10/2023. Staff 2 (date of employment 10/31/2022) did not have a completed search of the central registry until 2/1/2023. 2. Staff 5 (date of employment 5/25/2022) and Staff 10 (date of employment 7/26/20222 did not have documentation of a search of the central registry on file. There was no documentation of having submitted the search of the central registry within 7 days of employment as required.”

22.1-289.035-B-2

“Based on review of ten staff files, the facility failed to obtain a national fingerprint background check for two staff prior to employment as required. Evidence: Staff 2 (date of employment 9/28/2022) did not receive fingerprint results until 11/15/2022. Staff 3 (date of employment 10/31/2022) did not have fingerprint results until 2/1/2023. Center management confirmed the staff worked without results.”

8VAC20-780-510-E

“Based on review of seven medications, the center failed to follow procedures to prevent an outdated medication to be on-site. Evidence: The emergency medication for Child D expired 10/06/2022.”

8VAC20-780-510-B

“Based on review of seven medications for six children, the facility failed to have written authorization from the parent to administer medication. Evidence: The parent did not provide written authorization for the facility to administer medication to Child A or Child B.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: the landscape fabric on the toddler playground was exposed and ripped, causing a tripping hazard.”

8VAC20-770-60-C-2

“Based on review of ten staff files, the facility failed to have documentation of a completed search of the central registry ( CPS check) on file for each staff within the first 30 days of employment. Evidence: 1. Staff 2 (date of employment 9/28/2022) did not have a completed search of the central registry until 2/10/2023. Staff 2 (date of employment 10/31/2022) did not have a completed search of the central registry until 2/1/2023. 2. Staff 5 (date of employment 5/25/2022) and Staff 10 (date of employment 7/26/20222 did not have documentation of a search of the central registry on file. There was no documentation of having submitted the search of the central registry within 7 days of employment as required.”

22.1-289.035-B-2

“Based on review of ten staff files, the facility failed to obtain a national fingerprint background check for two staff prior to employment as required. Evidence: Staff 2 (date of employment 9/28/2022) did not receive fingerprint results until 11/15/2022. Staff 3 (date of employment 10/31/2022) did not have fingerprint results until 2/1/2023. Center management confirmed the staff worked without results.”

8VAC20-780-510-E

“Based on review of seven medications, the center failed to follow procedures to prevent an outdated medication to be on-site. Evidence: The emergency medication for Child D expired 10/06/2022.”

8VAC20-770-60-C-2

“Based on review of seven staff files, the facility failed to have a completed search of the central registry ( CPS check) within 30 days of employment. Evidence: Staff 2 (date of hire 5/2/2022) and Staff 7 (date of hire 9/27/2021) did not have documentation of a completed search of the central registry ( CPS check).”

8VAC20-780-510-B

“Based on review of medications, the facility failed to have current authorization from the parent to administer medication. Evidence: The parent did not provide written authorization for two medications for Child 3. The medication authorization for one of Child 7's medications expired in 12/2021.”

8VAC20-780-140-A

“Based on review of six children's files, the facility failed to obtain documentation of a physical for each child within 30 days of enrollment. Evidence: Child D (date of enrollment 3/7/2022) did not have a physical on file.”

8VAC20-770-60-C-2

“Based on review of seven staff files, the facility failed to have a completed search of the central registry ( CPS check) within 30 days of employment. Evidence: Staff 2 (date of hire 5/2/2022) and Staff 7 (date of hire 9/27/2021) did not have documentation of a completed search of the central registry ( CPS check).”

8VAC20-780-510-B

“Based on review of medications, the facility failed to have current authorization from the parent to administer medication. Evidence: The parent did not provide written authorization for two medications for Child 3. The medication authorization for one of Child 7's medications expired in 12/2021.”

8VAC20-780-140-A

“Based on review of six children's files, the facility failed to obtain documentation of a physical for each child within 30 days of enrollment. Evidence: Child D (date of enrollment 3/7/2022) did not have a physical on file.”

22VAC40-185-400-B Complaint related: Yes

“Based on review of a video recording and staff interviews, the facility failed to ensure that all behavioral guidance is constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. Evidence: on September 9, 2021, a video of Room 250 starts with 2 year old Child 1 seen sitting on the floor crying. Several other children are seated at the table having water play. Child 1 gets up from the floor and approaches a child sitting in a chair at the table. Staff 1 uses her arm to move Child 1 away from the seated child. A few seconds later, Child 1, still crying, approaches the seated child again, pulling on the other child’s shirt. Staff 2 again uses her arm to move Child 1 away from the seated child, taking no other action to try to redirect the child’s behavior, and instead just continues with the water play activity with the other children. Child 1 sits on the floor crying without receiving behavioral guidance to redirect her behavior.”