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Avoiding Day Care Nightmares


WebMD Health News

Feb. 7, 2001 -- OK, you have a child -- and you have a job. You don't, however, have a friend or relative who can take care of the little angel, and hiring a nanny or governess is not in the stars. The next step, then, is to find a suitable day care center or babysitter in a private home. But where do you start looking?

First, you should know that no national standards exist for licensing or monitoring facilities that look after children. States generally handle that, and most of them require licenses for centers that take in more than 12 children. They also require background checks for the caregivers -- not only in day care centers, but also for people caring for three or more children in their homes.

"In a licensed setting someone visits, inspects, and writes a report on the center," says Sherry Workman, executive director of The National Association of Child Care Professionals. The state keeps these annual inspection reports on file, and parents can ask for a copy.

A good standard to go by in choosing a day care facility, Workman tells WebMD, is whether or not it is accredited by a professional organization such as hers. Other accrediting agencies are the National Association for the Education of Young Children (NAEYC) and the National Child Care Association. All these groups require centers to meet certain criteria and evaluate them regularly to make sure they do. Ask your day care center director if the facility is accredited.

No matter whether the care takes place in a home, a church, or a commercial center, Workman says, parents should ask for references and details of the caregivers' training and the director's credentials. In Texas, for instance, caregivers are required to have 20 hours of education per year and to know CPR and first aid.

Workman and other experts say it's not enough for someone to be with your child; the caregiver needs to offer the children activities and toys that are age-appropriate.

"You should look at the play area. If the children are 2 or 3 years old and there are a lot of toys around that can easily be swallowed, this is probably not the place for you," says Kirk Davis, MD, a pediatrician in Fort Worth, Texas.

It's also important for children to be challenged and stimulated mentally. This is especially true for infants and toddlers, because they are developing rapidly physically, mentally, and psychologically.

A measure of how well a child care facility handles this is whether youngsters are allowed to pursue activities they enjoy. Workman calls this "child-centered care" rather than teacher-centered. In other words, the children shouldn't all be forced to do the same activity at the same time for the convenience of the teacher.

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