When you start to look for child care, you may wish to contact a group such as Child Care Aware by phone at 1-800-424-2246 or online at This group can provide resources on high-quality child care and tell you if there is a local Child Care Resource and Referral agency in your community. All types of child care may be listed through this agency.

Once you receive a list of caregivers in your area, review written material that these caregivers make available, then call them. Ask questions on the phone to help you select those that you want to visit. Whatever type of child care you choose — in-home, family or center-based — consider the following factors as you begin your search:

· Location — How far is the child care from home? From your work? Is this convenient for both parents? Can either parent get there quickly in an emergency?

· Hours — What hours of care are available? What happens if you are late in picking up your child? How are vacations and holidays scheduled?

· Licensing/accreditation — Is the facility or home licensed or registered with the appropriate local government agencies? Are there any outstanding violations? Is the program currently accredited; if so, by what organization?

· Inspections/consultations — Is there a qualified health professional, such as a doctor or nurse, who serves as a consultant for the child care program? (The national standard is that center-based infant-toddler programs should be visited by a health professional at least monthly, and all other child-care programs should be visited at least quarterly.)

· Visiting policy — Are you welcome to visit during normal operating hours before and after enrolling your child? Can you see all the areas that your child will use?

· Caregiver experience and training — What education, training and experience do the caregiver or center director and staff have? What type of training has the staff had during the past year? Do outside experts provide training?

· Adequate staffing — Are there enough trained adults available to children on a regular basis? Are there enough caregivers to fill in if one is ill or on vacation? Do the child-staff ratios and the size of the groups of children fall within the nationally recognized standards below?


Child-Staff Ratio

*Maximum Group Size*

Birth-12 months



13-30 months



31-35 months












9-12 year olds



*As recommended by the AAP.

· Health standards — What is the policy regarding sick children? Is a health assessment required before children enroll? Have caregivers and others who may spend time with your child been checked by a doctor to be sure that they are healthy?

· Quality of program — Are children cared for in small groups? Are activities proper for the children's level of development? Is there a daily schedule? Are there daily opportunities for indoor and outdoor play? Is television viewing permitted and, if so, what is watched and for how long?

· Policies — Check the center's policies. Are the policies in writing? What is the discipline policy? Do the children go on any outings? If they travel by car, van or bus are the proper child safety seats, booster seats and seat belts used?

· Consistency — Are the program's policies on meals, discipline, and issues such as toilet training the same as yours? How long have the caregivers who will take care of your child worked at the facility with children of your child's age? Will your child be able to have a stable relationship with one caring adult for at least one year?

· Backup plans — What happens if your child is sick or when the caregiver is not available or the child care program is closed?

· Fees and services — What is the cost for child care and/or optional services? How are payments collected? Are there other services available in addition to child care? Is safe transportation available daily and/or for trips?

· References — Ask for references and contact information from several parents who are currently using the program, as well as at least one parent whose child was in the program during the past year but is now too old to receive care at the facility.

· Communication — Can you talk with the caregiver on a regular basis? You will need to spend time with your child and the caregiver every day, both before you leave and when you return.

Another aspect of child care to consider is how sick children are handled. Children sometimes get sick or are injured while in child care. Keep this in mind when choosing child care. Plan ahead with your caregiver so that you both know what to expect and are prepared. Make sure that your caregiver can always reach you. Confirm a plan for emergency care in advance.

Many times children are allowed to stay with their caregiver as long as they do not have a fever and can participate in most of the activities. If the child needs extra rest, there must be a place to lie down and still be observed.

Sometimes children need medications while they are at child care. Both prescription and over-the-counter medications should have a pharmacy label with the child's name, dosage and expiration date. The caregiver should have the parent's written permission to give the medication to the child and know how to safely give the medication and properly record each dose.

It is ultimately your responsibility to ensure that your child receives the best care. When problems occur, your caregiver should be able and willing to work through the situation with you. If at any time problems persist and you suspect your child's health or safety is in question, you will need to find other child care for your child right away.

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