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Family Life

Making Child Care Choices Count for Your Family

For more and more parents, making the child care decision is not a simple choice. Along with weighing your child’s needs, there are three main types of child care to think about. There is no simple formula for choosing the right child care provider for your child. However, learning as much as you can about your options can help you decide what is best for your family.

What Type for Your Child?

There are three basic types of child care:

  • In-home care: A caregiver comes into your home and supervises your child there.

  • Family child care: Child caregivers provide their service out of their own homes.

  • Center-based care: Child care organizations feature structured activities and programs, as well as a trained staff.

Choosing the right option for your family comes down to thinking about the pros and cons of each type.

In-Home Care

For some families, the most convenient option is having the caregiver come to your own home. In some cases, caregivers may even live in the family home. The advantages to this approach include the potential for your child to receive more individual attention, limited exposure to seasonal ailments such as colds and the flu, and your child’s comfort level with a familiar place.

There are challenges to having an inhome caregiver, however. For starters, skilled in-home providers are not easy to find. If you do find one, realize that both the caregiver and child need clear rules about what your expectations are. These rules should include how to discipline the child in your absence; how much TV time (if any) is OK; what activities you want your child to take part in (reading, playtime, etc.); and when it’s OK to take your child on an outing.

An in-home caregiver should be willing to provide a complete daily schedule and report of your child’s activities, and to make use of positive, effective methods of discipline. Even so, it’s not easy to know for sure what your child’s caregiver is doing when you’re not there. That’s why frequent, unannounced visits from friends or family members are a good idea.

Keep in mind that you’ll need to have a backup plan in place for those times when your child’s caregiver is sick, needs personal time, or is on vacation.

Family Child Care

Some child care providers work out of their own homes, often supervising other children alongside their own. These family child care providers are usually not as convenient for parents as in-home care. But they can sometimes provide a more focused, home-like environment than center-based care and are usually easier to find than in-home caregivers.

If you are thinking about a family child care situation, there are some questions you will want to ask:

  • What are the caregiver’s policies and qualifications? Is he or she licensed or registered with the state, or accredited by a recognized child care organization?

  • What kind of program does the caregiver provide, and what condition is the caregiver’s home in?

  • Are there other children, teens, or adults in the home besides the caregiver? If so, who are they, what are their backgrounds, and how will they be involved in the care of your child?

The American Academy of Pediatrics recommends that a family child care business have no more than six children per adult caregiver (including the caregiver’s own children), with no more than two of those children younger than 2 years old. However, be aware that state regulations often allow for more children per caregiver. Also, make sure that you have a backup plan. If your caregiver is sick or unavailable, or in case of emergencies, you’ll need a fallback option since usually only one adult is providing the care. Ask the provider if he or she belongs to a local network that can provide support if needed.

Center-Based Care

Child care centers are widely available. Some are independently owned, while others are sponsored by churches, employers, schools, or government agencies or programs, such as Head Start. Whether it’s called a child care center, preschool, nursery school, learning center, or something similar, it serves the same basic function: providing care for children at a central location.

Regardless of who sponsors it or what it is called, a child care center should be licensed and inspected on a regular basis for health, safety, cleanliness, staffing, and program content. Many states license child care centers, but these regulations set only the minimum standards for operating — and some types of child care operation may be exempt under the law. Either way, be sure that what the center offers meets not only the state’s standards but also your expectations for appropriate care for your child.

As with family-based care, written policies and safety guidelines should be available for your review.

What You Need to Consider

A good place to start your search for a quality child care option is to contact a reliable information resource, such as Child Care Aware (1-800-424-2246). This organization can provide helpful information and contacts to steer you toward locally available child care in your community.

Get a list of child care providers in your community, then call them and ask for information about who they are and what they offer. As you review those materials, write down the questions you want to ask them when you call them back.

Here are a few things you want to think about in choosing a child care provider:

  • Location: Is the provider near your home or workplace? Can a parent get there quickly in case of emergency?

  • Hours: When is the operation open to parents? What is their policy regarding parents who are late picking up their children?

  • Licensing and accreditation: Is the facility licensed with the state, or accredited by a recognized professional child care association?

  • Inspections and consultations: Does the program have a qualified health professional such as a doctor or a nurse who serves as consultant? Keep in mind that the national standard is for centerbased child care facilities to be visited by a health professional at least monthly, with all others to receive quarterly visits.

  • Policies: Does the provider welcome parent visits during normal operating hours, including after enrollment? Can you inspect the areas your child will use? What is the sick child policy? Are the center’s policies available in writing, and are they consistent with your own?

  • Staff: What is the caregiver’s educational and professional background? Has he or she received any outside training from qualified experts in the past year? Is CPR/First Aid training required of the staff? How many trained adults are available for the children there? Are there enough staff members per number of children, and is the staffing sufficient to cover absences?

  • Availability: Does the center keep reasonable hours, given your schedule? Do you have access to the caregiver during the day or by phone on a regular basis?

Once you’ve narrowed your list down, visit the providers you’re considering and notice how they operate. Note any concerns you have about:

  • How children are treated

  • How clean the facilities are

  • Whether the food seems to be nutritious and well prepared

  • How safe the rooms are

  • How much space is available for activities

  • Whether the children and caregiver(s) there seem happy

  • Any other such measures of quality child care

With some very worthwhile homework, you can rest assured that you’ve made the right child care decision for your child and your family.

This article was featured in Healthy Children Magazine. To view the full issue, click here.

Last Updated
Healthy Children Magazine, Summer 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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