Questions to Help Assess the Quality and Safety of Childcare Centers

While there are many benefits of children attending childcare centers, the process of searching for a high quality and safe program can be stressful for parents. It can be particularly harrowing for parents with lower incomes and those with children who have special needs. In general, our country is lacking quality, affordable, and accessible childcare across the board.

Further, the high cost of quality childcare programs means that families with fewer economic resources may not have as many good options available to them. Similarly, there are not very many childcare centers trained and resourced to care for children with special needs. 

Parents often wonder how and when to begin the search for a suitable program. It’s never too soon to start looking, once you know that you need it. Centers often have long wait lists – especially for the higher quality programs. I recommend exploring as many centers as possible and spending at least 30 minutes there to see how the room operates and how the teachers interact with the children.

To assist you in your journey, here is a list of questions to ask the centers during your visit. This certainly isn’t an all-encompassing list, but it’s a place to start! If your child has special needs, please review both the first and second set of questions.

Questions to Assess Quality and Safety of Childcare Centers

1. What steps have you taken to keep children safe both indoors and outdoors? Safety is really the most important and basic thing when seeking childcare. Are the outlets covered? Are the toys developmentally appropriate to avoid choking hazards? Is the playground in good working condition?

2. What measures have you taken to prevent the spread of germs? Ask how often they wash toys, surfaces and hands. Is there a policy for hand washing when guests enter the room?

3. What accreditation and/or licensing does this center have? If you can afford an accredited program, this might be a good starting point. Ask your local accreditation organization for a list of the licensed programs in your area. In Cincinnati and Northern Kentucky, this program is called 4C. In the state of Ohio it’s called Ohio Child Care Resource and Referral Association (OCCRRA). If the center is accredited, it will have basic safety and health standards to uphold, as well as child-to-teacher ratios. Additionally, centers can work towards receiving a Step Up To Quality credential, with a rating of 1-5 (5 being the best). Ask them what their current rating is, and what they’re doing to improve it.

4. When am I allowed to visit? Childcare centers should allow you to stop by and visit your child any time. If they don’t, it’s probably a red flag.

5. How do you assess kids’ development? It’s important for kids to be learning and growing at a childcare center so that they’re ready to start preschool or kindergarten. Many higher quality programs will utilize a formal assessment, called ‘Ages and Stages’ to help them evaluate your child’s development. There is also a free app available through the CDC’s ‘Learn the Signs. Act Early’ Program, called the Milestone Tracker, which is a helpful tool to keep track of a child’s milestones.

6. What is the training and background of your staff? In addition to teaching qualifications, ask if their staff has been trained in CPR and First Aid. I would also ask how long the staff has worked there. High retention rates may indicate that teachers are treated well and given enough breaks to avoid burnout. 

7. Will my child have a primary caregiver? It is critically important for infants to attach and bond to a consistent caregiver. This builds trust, creates predictability and helps the baby feel more secure. For older children, it’s helpful to have a single point of contact and person responsible for their development and behavior.

8. How do you handle daily communication with families? It’s important for families to be aware of what happened during their kids’ time at daycare. Whether it be a daily sheet, an email, or an appointed person, this ensures continuity of care from childcare to home.

Though few and far between, there are some childcare centers that are equipped to care for children with special needs. During your visit, it’s important to be up front about your child’s needs and challenging behaviors. I reached out to my colleague, Stephanie Weber, PsyD, for additional questions to ask childcare centers. She is our training director for Leadership Education in Neurodevelopmental and related Disabilities (LEND).

 

Additional Questions to Ask When Seeking Childcare for A Child with Special Needs

1. What is the physical accessibility of your center? Is it ADA compliant? Will my child be able to play on the playground?

2. Do you have a nursing professional on staff? How are medications administered? Does your staff have experience with a catheter?

3. Are you trained to care for children who are not potty trained? Some childcare centers will not accept children who are not potty trained, so it’s important to ask this question up front.

4. What training has your staff had with a particular condition, such as Down syndrome, autism, or developmental or verbal delays? A couple of different organizations offer training for staff on these conditions, such as Step Up To Quality and OCCRRA. Cincinnati Children’s also does these types of trainings.

5. Is your center state or federally funded? If a childcare center receives funding from the government, it has to follow both state and federal standards. In particular, Head Start was created for children with low income families and for children with special needs, and does a good job training their staff.

When it comes down to it, there are so many different approaches to parenting. It’s important to look for a center that has goals and approaches that are similar to yours. For children to thrive, it takes a whole lot more than a checklist can show you. It’s about getting a vibe.

 

Julia Anixt, MD

About the Author: Julia Anixt, MD

Julia Anixt, MD, is the Director of the Kelly O'Leary Center for Autism Spectrum Disorders in the Division of Developmental and Behavioral Pediatrics.  She is a board-certified Developmental-Behavioral Pediatrician at Cincinnati Children's. Dr. Anixt specializes in the evaluation and treatment of autism, attention deficit / hyperactivity disorder (ADHD), and developmental concerns in children with congenital heart disease. She has two daughters who attended child care programs from infancy through preschool.

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