From the April 2015 issue

Choosing Child Care

When faced with the choice, what do parents pick for child care? Nanny? Center-based facility? In part II of our child care series, we offer some guidance.

When expecting her first child in 2012, Andi Welch of Lyon Township wanted to weigh all of her options for child care – but wasn’t sure where to begin. A co-worker recommended Welch take advantage of the concierge service available free to all employees of their company. Among other things, the service could provide a list of child care centers and group child care homes in her area. That list proved a great starting point, as did the other tips the service sent her way.

“I remember reading some ‘child care 101’ type article they sent me,” Welch recalls. “Among the steps suggested was one recommending parents check out each child care center’s licensing report – a step I don’t know that I would have otherwise taken.”

Welch and her husband visited three child care centers near their home and immediately ruled out one based solely on cost. The next two they visited. While Welch liked both, one stood out. After a tour of this facility, Welch looked up the center’s licensing reports. She was surprised to see that a child had died while in the center’s care. She asked the center director about the incident and was reassured to learn that the child’s existing medical condition was at play. Still, she was uneasy. While making up her mind, Welch’s mother- and father-in-law expressed interest in watching their grandchild a few days a week. Welch would then need to line up care for only the other two days of the week.

From there, Welch set up a profile on Care.com and eventually found a nanny to cover her daughter’s care for the remainder of the week. The setup works well, and Welch is especially happy that her now two daughters are getting care in their own house with Welch just down the hall working from her home office.

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“I like that if I hear something, I can come out and join in the fun,” she says.

Welch’s girls are among the 457,700 Michigan children under age 6 who were in need of care during 2014, according to Child Care Aware (CCA), a nonprofit national advocacy organization that serves as the central hub for the more than 600 state and local child care resource and referral (CCRR) agencies nationwide. Her experience is not unlike thousands of other local parents looking to line up quality, affordable child care.

The stakes are high in choosing a place or person to ensure the safety of your child. And yet the resources can seem slim to help make the choice. Here, we offer some guidance in making the best child care choice for your family.

Doing your homework

Michelle Noth McCready, CCA’s Deputy Chief of Policy, recommends parents begin their search by reaching out to their local CCRR. Families can find their local agency by entering their ZIP code in the red “Free Child Care Search” box on the CCA website childcareaware.org – or by calling its hotline at 800-424-2246.

Michigan’s CCRR agencies can help families identify some of the state’s more than 4,429 licensed child care centers, 3,762 licensed family child care homes and 1,904 licensed group child care homes (as of March 2015). Family child care homes are based in someone’s home where up to six children (including the caregiver’s own children) can be in care. Group child care homes offer a similar setup but the number of children in care can range from seven to 12.

“Licensing is very different for home settings than center-based settings,” says Colleen Nelson, child care program consultant for the Michigan Department of Human Services (DHS) Bureau of Children and Adult Licensing. “There are more licensing requirements for a center. For example, they need to have had an environmental health inspection, and they must have a program director with relevant education and qualifications.”

That experience includes a degree from an accredited university or college and verification of the number of hours of experience the program director has had working with children. Alternatively, an individual running a licensed home day care must have a minimum of only a GED or high school diploma.

Inspections are part of the licensing application and renewal for group homes and centers. Inspections are also part of the registration process for family child care homes. However, the timeline is different for each setting. It’s during these inspections, which typically happen at a day and time unknown in advance by the care provider, that any licensing violations are noted by the state.

“When we cite a violation, the provider is required to do a corrective action plan,” Nelson notes. “The provider must outline the timeline for correcting the violation and who will be addressing it. Depending on how many violations a provider has, we’ll conduct a follow-up inspection.”

Should a provider accrue multiple violations or have a significant violation affecting the health and safety of the children, it may be put on a provisional license – and providers may be required to take additional training.

“We can recommend revocation of a license or refuse to renew it,” Nelson says. “Either the provider agrees or we’ll close them down. The vast majority of providers, though, are following the rules and are in compliance. The number of licenses we revoke in a year is not significant; typically less than 100.”

Parents can view a licensed provider’s most recent two licensing reports by clicking on the “Licensed Provider Look-up” link on the DHS child care website (in the right column, under “Online Services”). Here, they can also view a list of providers whose licenses have been revoked.

All licensed child care providers also are required to have a licensing notebook that contains all of their licensing reports and any corrective action plans created following a licensing violation. Providers are required to have this available to parents during regular business hours.

“When a family enrolls their child for care, providers are required to notify parents of the availability of the notebook,” Nelson says. “It has been in effect since May 2010.”

While a licensing report can provide important information that can influence a family’s child care decision, Nelson points out that it’s common for most providers to have at least a few licensing violations.

“One violation shouldn’t be an ‘Oh, My God, I can’t go there,'” she notes. “Go see the facility, observe the interaction with the kids. Take note of the quality of care.”

Visiting care providers

Reviewing a provider’s licensing report should be just one piece of the search process, says Dawn Carene, director at Beautiful Savior Early Learning Center in Bloomfield Hills. She recommends parents tour five different facilities.

“I say shop around,” she explains. “I tell parents the tour should take about an hour. If you truly sit and observe and ask questions, you’ll get the whole feel of whether this is the place for your child.”

As for key things to take note of, Carene says parents should not be hit by a strong pH smell of urine as soon as they step foot in the facility.

“The smell should either be neutral, or you might smell a wisp of a bowel movement as you walk into a classroom,” she notes. “That’s normal especially in the infant and toddler rooms.”

Beyond that, she recommends parents take note of each classroom and its goings on. Observe: “Is the classroom bright and sunny? Are the staff smiling and happy? Are kids screaming lying on the floor throwing tantrums with snot bubbles pouring out of their nose? Is the classroom equipment updated?”

Of particular importance, Carene encourages parents to observe the ratio of caregivers to children.

“Are there two teachers in an infant room with six kids?” she says. “The state allows a one-to-four ratio. When you walk into the baby room and there are six infants and two teachers, when the tour is done an hour later, you should go back and observe that there are still two teachers in that room.”

In her book Child Care Today, noted British child developmental psychologist Penelope Leach makes the case for low caregiver-to-child ratio.

“A central fact about child care, as widely known as it is widely ignored, is that what matters most to children’s current happiness and ongoing development is warm and intimate personal relationships with their caregivers,” she notes. “Having more children to care for does not automatically preclude a caregiver from such relationships, but it certainly makes them less likely. The lower the ratio of children to adults, especially in the first three years, the more likely it is that the quality of care will be high.”

Unfortunately, during her tours of some local day care centers, Carene has observed serious violations of ratio.

“When you walk into each room, check to see that all of the kids are being attended to,” she advises. “In the infant room, are they being held? Are nine darlings in swings and no teacher is to be found? Unfortunately, I have seen this at centers I’ve visited.

“Also observe the organization of the classroom,” she continues. “If there are two teachers in a preschool room, one should be on crowd control watching whatever is going on with the children. Then you have your lead teacher facilitating centers and working with the kids. You don’t want to see the teachers propped up against the counter having tea and watching the kids play. Unfortunately, I’ve also seen this at other centers.”

Carene’s tips are crucial components of what experts agree typify quality child care.

“There are a number of basic parameters indicative of high-quality care,” CCA’s McCready notes. “When evaluating options, look at the setting and environment. Look at the health and safety standards. Is the equipment safe? Is the environment age appropriate?

“Make sure caregivers are trained in basic first aid and CPR. Ask them what training they require of their staff or assistants. Is the provider properly equipped in the event of an emergency? Have they completed background checks on all caregivers?”

McCready says a comprehensive background check would include a state-level check that would pull up any criminal record. She also recommends an FBI fingerprint check and a check of the Child Protective Services registry (each state has its own). Michigan’s Child Abuse and Neglect Central Registry includes names of individuals for whom evidence exists that they have neglected or abused a child. Information on how to check this registry is available on the Michigan DHS website. Lastly, McCready recommends a check of the sex offender registry.

“All checks are important to have completed to ensure no offenses,” she says.

McCready also indicates it’s important for parents to ask a potential caregiver about their program’s turnover.

“Ask a potential provider how long they and their staff or assistants have been there,” she suggests. “This is important for continuity of care – another indicator of quality.”

Center-based benefits

Sara Cibor of Rochester Hills shared a nanny with her sister for the care of her own infant daughter and her niece until her daughter was 18 months old and the nanny decided to move on. Cibor visited Care.com Care.com to begin a new nanny search but felt uneasy about it from the start.

“I couldn’t imagine how we’d find someone without a (direct) reference,” she recalls. “It felt uncomfortable to me.”

It was then that Cibor and her husband began looking into center-based care. A web search generated a list of centers near her home and the school she teaches at.

“There were definitely a lot of options,” she says. “But many centers were already full. It was bit overwhelming.”

Cibor and her husband identified a few centers in their area, completed phone interviews and scheduled tours.

“I did experience some uneasiness at a few of them,” she recalls. “Some didn’t smell clean. One place was super-high energy. Kids were everywhere. It was loud. It seemed to me there were a lot of kids in not a huge space. At another center, the outdoor space had no grassy area for play.”

Soon after, Cibor found Beautiful Savior, chatted with Carene and felt the center could be the right fit.

“We did a tour, and we were pleased with what we saw,” she recalls. “It was calm. Everyone was super friendly. All of the staff had been there for a while.”

Now more than a year after Cibor first enrolled her then-2 1/2-year-old daughter and 4-month-old son, she has no regrets about her decision.

“It’s nice for our kids to be around other kids their age doing age-appropriate activities,” she says. “Back when we were contemplating what to do about care, we thought it would be more difficult for a nanny to take our daughter places when there would also be a newborn in the mix. At day care, both of my kids are having fun with their peers while learning from teachers with backgrounds in early education.”

It is this socialization that makes day care especially appealing to many families, Carene notes.

“Kids are not going to have the same level of socialization at home with a nanny as they are going to have at day care,” she says. “Day care is also usually less expensive.”

One disadvantage, though, that Carene is quick to point out is the frequency of illness.

“You can get sick no matter where you are,” she says. “But in close quarters like we are and with parents bringing their kids to school but disguising them with Motrin for six hours, of course, it exposes other children to the illness. It’s ongoing. We can never get away from it.”

Carene’s experience mirrors findings from the largest study of the effects of child care conducted over 15 years by the National Institute of Child Health and Development (NICHD). The study found that center-based and large-group care settings are linked to more ear infections and upper-respiratory and stomach illnesses during the first three years of a child’s life.

On the plus side, it revealed that children ages 6 months and older who had more experience in child care centers showed somewhat better cognitive and language development through age 3 and somewhat better pre-academic skills involving letters and numbers at age 4 1/2 than children with less center-based child care experiences.

Still, the study found that center-based and large-group settings are associated with more problem behavior just before and just after a child enters school.

Pros and cons of day care aside, researchers associated with the NICHD study are quick to point out that family influence and dynamics are more strongly and consistently linked to child development outcomes than child care choices for children up to age 4 1/2. Those include parents’ education, family income, two-parent family compared to single-parent family, mother’s psychological adjustment and sensitivity, and the social and cognitive quality of the home environment.

These findings should give parents peace in knowing that there is no wrong choice in child care. If they take some time doing research in the specific places or people they are considering for their child care option, ensuring to the best of their ability that it is a quality setting or arrangement, their kids will be just fine.

Illustration by Melanie Demmer

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