Choosing a child care center is one of the most important decisions that a working parent will make to help ensure the health, safety, and overall well being of their child while they must be away from them. Thousands of children are treated in emergency rooms for injuries sustained at child care centers or childcare homes each year in addition to those instances of abuse or neglect.  Sadly, some of those children will lose their lives.

There are precautions that can be taken to help ensure that a child will be properly cared for while a parent is at work. The first question a parent should ask is whether the childcare center or childcare home has an open door policy. If the answer is no, that provider should not be selected. Next, a parent should ask the potential provider whether they have been licensed by the state’s childcare licensing department to operate a childcare center or home and whether the certification is current.  

Check to see that staff has been trained on blood borne pathogens. With diseases like AIDS, Hepatitis B, etc., and

anti-biotic resistant strains of various infections, make sure childcare staff always wear plastic gloves when changing diapers and administering first aid, and that gloves and diapers are disposed of in a separate trash container labeled bodily fluids’. All trash cans should have plastic bags inside and locking lids. 

Parents should not be afraid to ask to see the license and most recent inspection date. Find out how many infants, toddlers, and older children they are licensed for and how many children are currently being cared for. Make sure staff has had a background check by the local police department and the state investigative agency.  Health and Human Service agencies and local police departments will usually submit a request for a background check on a parent’s behalf for a nominal fee. 

Parents should also find out if childcare staff has been trained on child abuse and neglect and the state reporting requirements for suspected child abuse. With an increasing number of incidents of domestic violence and kidnapping by non-custodial parents and other caregivers, parents should find out if doors are kept locked during the hours the center is open for operation and how the childcare provider ascertains that only approved persons are picking up a child and if they have a form that can be signed designating who can and cannot pick a child up?

Other training staff should have had is on positive discipline, nutrition, child development, how to prepare and store food, food allergies and food borne illnesses and the proper storage and handling of food, etc. Staff should have an annual re-certification on administering infant CPR, other CPR, choking, and the care of infants, toddlers and pre-school age children by the local American Red Cross, hospital, or other certified and qualified instructor. Make sure there is enough staff to care for the number of children in the center or private childcare home.

Take a walk through the childcare center or childcare home, including outdoor play areas, and the kitchen where food is prepared. Make sure cleaning supplies and other hazardous materials are stored in containers with tight fitting lids and that spray bottles are turned off and everything placed in a locked cabinet well out the reach of children, and that surfaces are clean. Many accidents in childcare centers occur when children accidentally come into contact with toxic materials because someone forgot to properly store cleaning supplies or failed to return them to a locked cabinet.

To ensure their child’s safety parents should make sure that tables are wiped down with warm soapy water after meals and that other cleaning materials that may be more toxic are only used to wipe down tables, cupboards, and bathrooms after the child care center or home is closed for the day and is followed up with a secondary wipe down with just hot water. Also look around and make sure electrical outlets that have safety covers in place to keep children from sticking things into the sockets and getting shocked.

Outdoor play areas should contain equipment that is of a proper height for younger children to minimize the danger of getting injured by a fall. Check to see that there is ample room between pieces of equipment, that the play area is completely enclosed with a locking gate and that there are no splinters, jagged wires, etc. children could get hurt on.

Find out if staff goes outside with the children to supervise and oversee their safety and wellbeing. If possible outdoor play areas should have a thick covering of wood chips or soft rubber matting under equipment to soften a fall. (The wood chips or rubber matting is helpful but not required as they can be an expensive purchase, especially for a private childcare home). Large childcare centers should keep playground equipment and things like trikes that are used by older children separated from equipment for children under five.

A fire and evacuation contingency plan, a floor plan and emergency contact numbers should be posted on a wall or a bulletin board where the can be easily seen if needed. Depending on the area of the country a parent lives in, providers should have a plan for tornadoes, floods, hurricanes, and other natural disasters. Ask staff if children are talked to about what to do if there is a fire on-site and if fire drills are scheduled regularly.

Find the location of fire extinguishers and look to see when they were filled last.  Parents may also want to make sure there is a smoke detector in every room and that the light is flashing to indicate that the detector is functional.  Child care centers should also have large exit signs posted above all exits.

How a childcare provider stores medication is also important for the health of all children.  Parents need to ask the provider how they store medication that has to be kept cold, if there is a first aid kit that includes ipecac, and if medication is kept in a locked cabinet or box and stored out of the reach of children. Ask to see the dates on first aid supplies and where the medication is stored.

In order to assure there will not be any risk from medications children have been prescribed, parents should try and schedule their child’s medicine to be administered at home. Of course, if a child has a medical condition like diabetes or asthma, this will not be possible. Make sure the childcare provider stores each child’s medication in a separate zip loc bag with the child’s name on the bag as an extra precaution. Parents should also look to see if a provider posts any allergies a child may have to a medication, food, etc. where other parents cannot see the names of the children while making sure that staff have easy access to the list. 

With the increase in unsafe toys and in light of the recent recalls of hundreds of toys made overseas because of lead paint, choking hazards, etc. a parent should ask the childcare provider if they have a current and updated list of recalled products as a visible reminder to not purchase potentially dangerous children’s toys and other products, including infant formula. If the provider does not have a list, parents can ask them to get one as a list can be downloaded and printed off the internet.

Safety gates should be placed tightly in front of stairs, kitchen and laundry doorways, basements, porches, utility areas, or other places that are open. Ensure that basement doors have safety locks that are high enough children cannot reach them and that there are child safety locks on cupboards, refrigerators, oven doors and microwaves. Check to make sure cords are not looped, so there is no potential for hanging.

For infants, childcare providers should have cribs with a certification safety seal, slats should be no more than two and three eighths inches apart and mattresses should fit snugly. Ask providers how infants are placed in a crib to sleep, making sure they are put down on their backs without pillows or comforters.

Once a childcare center or home has been selected and a child is in attendance, parents need to be sensitive to any changes in their child’s behavior.  If the child develops a fear of the provider, a staff person, or going to the childcare center parents should follow up by asking heir child questions and by scheduling a meeting with the center or home operator to discuss any concerns.  If a child continues to exhibit fear, cries or screams and clings to their parent or other caregiver, parents might want to consider finding another childcare home or center.

Parents can never do too much to make sure that their child, or the child of a friend or relative, will be cared for in a healthy and safe childcare environment. These guidelines will help in selecting the best provider and help a parent be less stressed at work. A checklist could be made to help with inspecting the childcare setting a child will exposed to.

As an early childhood education consultant I have, at times, had to inspect a childcare center or private childcare home. The guidelines set down in this article are things that I have looked at and received training for. When choosing a childcare provider a parent can never be too careful.

copyright 2009 by Jerrie DeRose