Certified Occupational Therapy Assistant (COTA/L)

Milestones Play Gym & Pediatric Therapy is seeking a Certified Occupational Therapy Assistant (COTA/L) to join our growing pediatric therapy practice in Fredericksburg, Virginia. We have an established pediatric OT caseload and active waitlist , allowing the right clinician to step into consistent hours without having to build a caseload from scratch.

Our primary opening is full-time with 32+ paid hours per week guaranteed , and we are also happy to consider candidates seeking a consistent part-time schedule. Why Join Milestones? $30–$35/hour W-2 , based on experience, qualifications, and responsibilities Flexible scheduling — establish your preferred working days and hours based on your availability, client needs, and clinic scheduling needs Guaranteed 32+ paid hours per week for full-time employees Approximately 75% clinical/program productivity Paid documentation, treatment planning, and indirect clinical time Established pediatric caseload and active waitlist Individual treatment sessions generally 45–60 minutes based on clinical need Paid designated holidays Health insurance options available Opportunities for additional hours, professional growth, and leadership as the practice expands A Schedule That Works for You We recognize that flexibility matters.

Clinicians may establish their preferred working days and hours based on availability, client demand, and clinic scheduling needs. Both daytime and evening hours are available, allowing clinicians meaningful flexibility in how they structure their weekly schedule. Full-time clinicians are guaranteed 32+ paid hours per week .

Consistent part-time schedules are also available. Clinician-Friendly Productivity Quality pediatric therapy requires time for more than direct treatment. This position is structured around an approximately 75% clinical/program productivity expectation . Productive time may include individual OT treatment, Integrated Therapy™ services, Developmental Groups, and other direct therapeutic or developmental programming.

The remaining paid work time is intentionally available for documentation, caregiver communication, treatment planning and preparation, collaboration/supervision, treatment-space setup and reset, and other necessary clinical responsibilities. Routine documentation and indirect clinical responsibilities are paid working time.

Clinicians are not expected to complete routine documentation outside of their scheduled workday. Productivity expectations take cancellations, caseload availability, and other circumstances outside of the clinician’s control into consideration. Our Approach Milestones is a child-led, play-based, sensory-rich, and movement-focused pediatric practice.

We believe meaningful therapy happens through play, relationships, movement, and children’s interests. Our environment provides clinicians with the opportunity to be creative while addressing each child’s individualized therapeutic goals. Our COTAs work closely with the supervising Occupational Therapist and interdisciplinary team while maintaining creativity and autonomy within their clinical day.

Responsibilities

Implement individualized occupational therapy plans of care under OTR supervision Provide 1:1 pediatric occupational therapy treatment Address sensory processing and regulation, fine and visual-motor development, motor planning, coordination, executive functioning, self-care, and functional participation Use play, movement, and children’s interests to create meaningful therapeutic experiences Participate in Integrated Therapy™ and Developmental Group programming as appropriate Complete timely and accurate documentation Communicate relevant session updates and strategies with caregivers Collaborate with the supervising Occupational Therapist and interdisciplinary team Prepare treatment materials and maintain safe, organized therapy environments Qualifications Required: Graduate of an accredited Occupational Therapy Assistant program Current Virginia Occupational Therapy Assistant license or eligibility to obtain Virginia licensure prior to employment Strong communication, organization, and documentation skills Ability to work collaboratively under Occupational Therapist supervision Ability to work safely and effectively in an active pediatric environment Preferred, but not required: Pediatric occupational therapy experience Experience supporting autistic and neurodivergent children Experience with sensory processing and regulation Comfort working in an active, movement-rich environment Creativity and ability to follow children’s interests while addressing therapeutic goals Interest in developmental programming and interdisciplinary care New graduates and clinicians transitioning into pediatrics are encouraged to apply.

Grow With Us Milestones is continuing to grow, and we’re looking for someone interested in growing with us. For the right clinician, future opportunities may include program development, staff mentorship, practice operations, leadership, and management responsibilities, along with opportunities for increased hours and compensation as the practice expands.

Who We’re Looking For We’re looking for a COTA who wants the stability of W-2 employment and an established caseload without sacrificing creativity and flexibility . If you’re looking for a pediatric setting with reasonable productivity expectations, paid documentation and planning time, flexibility in establishing your schedule, and the opportunity to grow professionally, we’d love to hear from you.

Salary $30 - $35 per hour