Part detective, part health inspector and all loving parent — that’s how it feels when you’re choosing a day care provider. Entrusting your child to someone else takes more than a leap of faith. It’s about vetting backgrounds, bringing checklists, looking around, asking questions and not assuming that licensure guarantees quality. Below, experts — including a parent who learned through hard experience — help you sort out the process.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
All child care is not created equal, says Michelle McCready, chief of policy with Child Care Aware of America. To choose quality, safe and affordable day child care, she says, “We encourage parents to have a strong process in place.” Start early, she suggests: During pregnancy is not too soon to begin looking at child care options. States and communities have varying availability, and some centers have waiting lists.
Making a call to local experts is the next step. On Child Care Aware’s website, plug in your ZIP code to find the child care agency serving your area. This free resource is “a great hidden secret” that many parents aren’t aware of, McCready says.
“They can walk you through the facts about child care and provide a list of child care options in your area that meet your needs,” she says, whether you’re looking for a family provider, a center or after-school care. You can also ask about child care subsidies, area licensing requirements and how to get information about complaints and licensing violations.
Check Records
Licensure and a mother’s due diligence weren’t enough to save Qualé Johnson, who died Sept. 25, 2008, during his second day in day care. This week, LéVaughn Westbrook, his mother, testified at a U.S. Senate committee hearing on the implementation of a child care improvement law that she and many others have fought for since.
The Child Care and Development Block Grant Act (CCDBG) of 2014 made sweeping changes to health, safety and educational requirements for child care providers and boosted funding for day care subsidies and staff education. It also increased transparency and parental access to information on individual providers.
Because of CCDBG, states must open and offer easy electronic access to records including monitoring and inspection reports on individual providers; statistics on deaths, serious injuries and substantiated child abuse in child care settings; and licensing requirements, monitoring procedures, criminal background checks processes and criminal offenses that bar people from being child care providers.
Safeguards such as these might have prevented her infant son’s death, Westbrook believes. Now a social worker and mother of two in Fairfax, Virginia, she lost 2 1/2-month-old Qualé after dropping him off with his family day care provider in DeKalb County, Georgia.
Back then, even though Westbrook did all the right things, such as seeking licensed day care, visiting the provider in advance, interviewing the provider and watching how she interacted with other children, the tragedy still occurred. Even now, uncertainty remains around the circumstances of her son’s death, which are detailed in an October 2009 follow-up story in the Flint Journal.
Inadequate supervision by the provider, failure to abide by safe-sleep requirements and a lack of CPR and first aid certification were eventually uncovered after Westbrook kept insisting on answers. But she had no way of knowing about previous complaints against the provider or whether she or others in the home had a criminal background or were listed on a sex offender registry.
Today, as a parent seeking child care, much of this information is at your fingertips. Before visiting a provider, click on your state to go through an online search for individual quality ratings, inspection reports and information on required background checks.
Quality rankings and accreditation listings are more tools to help you find the best day care. The National Association for the Education of Young Children helps parents find high-quality child care programs that meet its standards.
Visit With Purpose
An in-person visit will give you a better sense if a program will work for you, McCready says. You’re the eyes and ears on day-to-day activities such as sleep, eating and play. You may even want to come back another time or two.
Pay attention to adult-to-child ratio. And ask: How many children are there for each adult? Day-care checklists give appropriate ratios depending on a child’s age. Parents for Safe Child Care provides a checklist for choosing quality child care. (A variety of checklists are available online.)
During the visit, ask about the caregiver’s qualifications, training and early child education. Find out about first aid and safety: Is there a CPR-certified person on staff? “For infant care, specifically, are they trained in safe sleep practices and infant CPR?” McCready adds.
And a very basic question: Who has access to the child? “We strongly promote anybody who’s taking care of the child, or potentially could be left alone with the child, should have a comprehensive background check,” she says.
[See: How to Promote Safe Sleep for Your Infant.]
Safe sleep is the top issue for infants in day care, says Dr. Danette Glassy, a primary care pediatrician at Mercer Island Pediatrics near Seattle. “Have the caregivers taken a training in safe sleep?” she asks. “Are the cribs the newest models and not recalled by the Consumer Product Safety Commission? Are [infants] always in sight, even while they’re asleep?”
Safety alone isn’t enough. Infants need emotional and social support from providers to thrive. “If they’re not really loving and responsive and creating good relationships with the babies, that sets them off on a trajectory that’s not healthy down the road,” Glassy says.
Toddlers bring on another dimension of safety concerns. “What can they get into?” is the question, Glassy says. Parents should observe how providers store medicines and chemicals, and look for trouble spots where kids could climb and fall. Also, she says, “Is the outdoor equipment developmentally appropriate to young, exploring bodies, as opposed to the 4- and 5-year-olds?”
[See: The 5 Latest Poison Control Threats Kids Face.]
Day care food is another important area, so ask providers what they’re feeding babies, toddlers and preschoolers. “Is it developmentally appropriate?” Glassy says. “Does it follow current guidelines on what we know is healthy nutrition?”
Cleaning, sanitizing, disinfecting and hand-washing are important components of day care safety, especially for infants. A baby under 6 weeks old with a high fever will almost certainly be hospitalized, Glassy says, even if the likely culprit is a cold.
Worst-case scenarios for day care-related infections include meningitis, bacterial pneumonia and whooping cough, Glassy says. So you need to know whether all caregivers are fully immunized, she says. And it’s OK to ask about other kids at the day care. “You bet,” she says. “Your child is at risk if there are many children in that setting who aren’t fully immunized.” Infants under 6 months old who have not completed vaccinations and still can’t receive a flu shot rely on others around them for protection.
Listen to Your Heart
After you’ve done your due diligence, you’re ready to make your decision. And that includes going with your heart. “Parents should trust their instinct,” Glassy says. “They know. They should trust that little inner voice.”
Once you’ve selected the best provider for your family’s needs, McCready says, make sure to build a strong connection and maintain it. That, she says, means “ensuring that you’re staying involved with that provider, and those communication channels are open.”
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Seeking Safe Day Care for Your Child originally appeared on usnews.com
