Indicated Child Neglect. Neglect with No Mental Injury. Except as provided in §A(2) of this regulation, the local department may make a finding of indicated child neglect when there is credible evidence, which has not been satisfactorily refuted, that the following four elements were present during the alleged neglect: A failure to provide proper care and attention; A child victim; A parent or caregiver of the alleged victim responsible for the alleged neglect; and Circumstances including the nature, extent, or cause of the alleged neglect indicating that the alleged victim’s health or welfare was harmed or was at substantial risk of harm. Neglect — Mental Injury. The local department may make a finding of indicated child neglect with mental injury if there is credible evidence, which has not been satisfactorily refuted, that the following four elements were present during the alleged neglect with mental injury: A mental injury caused by a failure to provide proper care and attention regardless of whether there was an intent to harm the child and characterized by an observable, identifiable, substantial impairment to the child's mental or psychological ability to function, which may be shown by the need for specific psychiatric, psychological, or social work intervention; A victim who was a child; A parent or caregiver of the alleged victim responsible for the alleged child neglect with mental injury; and Circumstances including the nature and extent of the failure to provide proper care and attention indicating that the child's health or welfare was harmed or was at substantial risk of harm. Unsubstantiated Child Neglect. A local department may make a finding of unsubstantiated child neglect if there is insufficient evidence to support a finding of indicated or ruled out. A local department may base its finding of unsubstantiated child neglect on insufficient evidence: Supporting one or more elements of indicated child neglect; or Refuting one or more elements of indicated child neglect. A local department may find insufficient evidence supporting a finding of indicated child neglect for reasons including but not limited to: The lack of a credible account by the alleged victim or witness; The failure of the alleged maltreator to completely and credibly refute the allegations; A lack of access to the alleged victim or alleged maltreator despite reasonable efforts to obtain access; or An inability to obtain relevant facts regarding the alleged child neglect despite reasonable efforts. Ruled Out Child Neglect. A local department shall make a finding that child neglect is ruled out if the local department finds that child neglect did not occur. The local department may base a finding of ruled out on: A lack of credible evidence supporting one or more elements of indicated child neglect; or The credible refutation of one or more of the elements of indicated child neglect. If the alleged maltreator was a child and not the parent of the alleged victim, the local department may consider the factors in Regulation .10D of this chapter to determine the appropriate finding.