Child care

Quality child care encourages children to feel good about themselves, teaches them how to get along with others, and helps them discover more about the world around them.

To find the best form of child care for you and your child -- such as a child care center, home-based caregiver or individual caregiver in your own home -- trust your feelings, instincts and judgment. Start by gathering as much information as you can. Think about your needs, as well as your child's. Ask other parents about their experiences.

Here are some general guidelines to help you make the best decision.


Child care centers
Licensing: Is the child care center licensed? Licensing requires the center to meet certain environmental, safety and sanitary levels. Remember that licensing doesn't guarantee high quality. It only establishes the basis for a safe environment.

Accreditation: Has the child care center received accreditation from the National Academy of Early Childhood Programs, a division of the National Association for the Education of Young Children?

Health and safety standards: Is indoor space clean and child-safe? Is there sufficient ventilation? Are the rooms aired out each day to decrease airborne germs? Is the outdoor recreation area safe?

During sleep, are infants placed on their backs and under constant supervision?

Are there plenty of sinks with soap and hot water? Do the staff members wash their hands after each diaper change and wiping a child's nose?

Is it clear when your child would be expected to stay home due to illness? Are there separate areas for children who get sick during the day to wait for their parents? Does the child care center have a consulting health professional on call? Is proof of immunization required to enroll, and do they review for booster shots?

Is the building fire-safe? Is there a working fire alarm? What about sprinklers? In the event of a fire, is there a simple escape route? What plan is in place for other emergency situations, such as injury or a natural disaster? Do the staff members have training in first aid and basic life support?

Qualifications: Some licensing authorities demand set levels of staff training. This is helpful, but you still need to evaluate the staff for yourself. Does the director have a degree in early childhood education? The rest of the staff should have experience in caring for children. How are assistants screened, and what sort of training is required? Do they check references, backgrounds and appropriate elements of the health status of potential employees?

Staff-to-child ratio: Consult the chart below for staff-to-child ratios approved by the American Public Health Association and the American Academy of Pediatrics. Your state's regulations may differ from the numbers presented here. In fact, most states permit a much higher ratio, which may not ensure a safe environment or quality care.

Size: Is there an adequate amount of space for each child? For safety and sanitary reasons, infants should be in a separate room. Are the diaper changing and toilet areas removed from the play and eating areas?

Atmosphere: Is the atmosphere enriching? Are there age-appropriate toys, books, games and exposure to stimulating activities? Do the staff members take the children on outings, such as strolls to the park?

Do the staff members have time to interact with each child beyond meeting basic needs, such as feeding and changing diapers? Do the children seem content, clean, well cared for and comfortable with the staff members? Are the staff members friendly? Do they treat each child as a unique individual?

Staff members should show equal concern or fondness for clingy children as well as happy, outgoing children. Staff members should greet older children by name and engage them in conversation.

Structure: Is there a planned routine that includes some free time every day? This is especially important for toddlers.

Nutrition: Are nutritious hot meals served? Is there a menu? Who plans the meals? Is a nutritionist involved? Are food safety guidelines enforced to avoid food-borne illness and prevent choking or allergic reactions?

Personal visit: If permitted, visit unannounced near the middle or end of the day to see how well the child care center meets your expectations. Due to potential disruption and security concerns, some facilities don't encourage this practice from prospective parents. Prearranged visits may be almost as good. Make sure you're comfortable with the center's policy.

Find out if parents can be involved in making decisions on how the child care center is operated. If so, volunteer to be on the board or help in other ways.


Family or home-based child care
Licensing: Is the in-home facility licensed? Licensing requires the facility to meet certain environmental, safety and sanitary levels. Remember that licensing doesn't guarantee quality, however. It only establishes the basis for a safe environment.

Accreditation: Has the in-home facility received accreditation from the National Association for Family Child Care?

Health and safety standards: Is indoor space clean, child-safe and fire-safe? Is there a working fire alarm? What about sprinklers? In the event of a fire, is there a simple escape route? What plan is in place for other emergency situations, such as injury or a natural disaster? Is the outdoor recreation area safe? What are the caregiver's handwashing practices? What is the policy for sick children? During sleep, are infants placed on their backs and under constant supervision?

Qualifications: Look for child care experience and training. Does the caregiver have any training in early childhood education? In first aid and basic life support? The caregiver should be self-confident, loving and comfortable with children. The caregiver should nourish social skills and positive behaviors, as well as set boundaries on negative ones.

Child care philosophy: Does the caregiver share your child-rearing philosophies? Discuss topics of importance to you, such as nutrition, weaning, discipline and potty training.

References: Obtain references from the caregiver, and check them yourself. Don't rely on written references only. Speak with parents of children currently receiving care in the home, as well as parents who have moved on to other child care arrangements. Ask for a full list of past and current children, not just selected ones.

Caregiver-to-child ratio: Consult the chart below for caregiver-to-child ratios approved by the American Public Health Association and the American Academy of Pediatrics. Your state's regulations may differ from the numbers presented here. In fact, most states permit a much higher ratio, which may not ensure a safe environment or quality care.

Remember to include in the ratio any of the caregiver's own preschool-age children who are home part-time or full-time. If any of the caregiver's adolescent or adult children will be around on a regular basis, ask about them.

Atmosphere: Are there any animals in the house? Will they be around the children? Are the animals' immunizations up-to-date?

Does the caregiver maintain the home or work on other personal tasks while children are there? If so, the quality of care your child receives may be adversely affected.

Does the caregiver offer age-appropriate toys, books, games and exposure to stimulating activities? What about television? Up to one hour of age-appropriate programming per day is typically considered reasonable, as long as the shows have been chosen with discretion.

Nutrition: Are nutritious hot meals served? Is there a menu? Who plans the meals? Are foods from the four basic food groups included? What about snacks? Does the caregiver follow food safety standards?

Availability: What happens if the caregiver or one of his or her own children is sick? Is a backup plan in place?

Transportation: If the caregiver will be driving your child anywhere, make sure he or she has appropriate safety equipment.

Insurance: Does the caregiver have insurance? Does it cover injury to anyone while in his or her care?

Personal visit: Visit the in-home facility when all the children will be there. If the caregiver is opposed to this, carefully consider whether your child should be placed there.


In-home caregivers
Reason for wanting the job: Conduct a personal interview. Ask the applicant if this would be considered a temporary job. What is his or her commitment to working with children? Does he or she want the job because nothing else is available?

Qualifications: Look for child care experience and training. Does the applicant have any training in early childhood education? In first aid and basic life support? The applicant should be self-confident, loving and comfortable with children. The applicant should be able to nourish social skills and positive behaviors, as well as set boundaries on negative ones.

References: Obtain references from the applicant. Check them yourself, and talk to previous employers and teachers, clergy or other qualified individuals. Don't rely solely on written references or references from the caregiver's family or friends.

Availability: How many hours is the applicant willing to commit? What about overtime? Does the caregiver have the ability to stay if you have an emergency? What is his or her long-term commitment to the job? Is he or she willing to remain with your family as long as necessary? Are there other factors that may influence the person's availability?

Child care philosophy: Does the applicant share your child-rearing philosophies? Discuss topics of importance to you, such as nutrition, weaning, discipline and potty training.

Transportation: Does the applicant have his or her own transportation and a valid driver's license? If he or she will be driving your child, make sure appropriate safety equipment is available.

Other considerations: Did the applicant arrive to the interview on time? Were your personalities compatible? Could you freely communicate with each other? How comfortable was the applicant with your child and vice versa?


Helpful hints
For more information on child care options, talk with friends, neighbors and co-workers. They may provide helpful suggestions or recommendations. You can also contact local child care associations or child care referral services.
You may also want to contact local government or law enforcement agencies to check criminal or sexual offender lists. Local chambers of commerce and the Better Business Bureau may offer information on a specific child care provider as well. In addition, many states maintain sexual offender registries, and the federal government sponsors a national sex offender registry. Even doing an online search for a person's name can provide useful information to help you make an informed decision regarding your child's care.

Age Maximum group size Staff-to-child ratio
0 to 12 months 6 1:3
13 to 30 months 8 1:4
31 to 35 months 10 1:5
3 years 14 1:7
4 to 5 years 16 1:8
6 to 8 years 20 1:10
9 to 12 years 24 1:12