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Avoiding Day Care Nightmares


These activities are an important way your child will learn socialization skills -- that is, how to get along with other kids, says Kim Cavender, MSE, a child life specialist at Children's Medical Center of Dallas.

"A lot of times, people don't think about what experience the child will have, just that someone is there to watch them," Cavender says. "They assume that if someone is there, and it's safe and affordable, that's enough."

But it's not that easy. Parents need to visit the center several times, at different times of the day, to see how the staff interacts with the children, experts recommend. Once your child begins attending the facility, you should still expect unrestricted -- and unannounced -- visits.

"Find out if you can come in unexpectedly. If you can't, this is a big red flag," Cavender says. You should be allowed in all parts of the center, including the bathrooms, kitchen, nursery, and outside play area. In these areas, you should check for cleanliness, appropriateness of toys and playground equipment, and condition of playthings.

In addition, learn how many workers are available for each child. The American Academy of Pediatrics (AAP) recommends one staff member for every three kids up to 2 years old, and says a group of about six is ideal. These recommended numbers increase as the children age; at age 6, for instance, the AAP suggests a staff/child ratio of 10 to 1 in a group of 20.

But no matter what the ratio, Workman says it's best if a child has one staff member who is the primary caregiver.

"We want them to grow a bond," Workman says.

Davis says that it's important to find out if the center requires all children to have up-to-date immunizations. Most states require this, so be prepared to present a copy of your child's immunization records.

In addition, he says, find out what the center's policy is on sick children. The medical recommendations are that it's safe for a child to return to day care 24 hours after a fever is broken. And they need to stay home when they have diarrhea.

The cost of child care varies greatly depending on the region of the country, the services provided, whether the facility is accredited, and the age of your child. The NAEYC estimates that costs range from $4,000 to $10,000 a year; some top-of-the-shelf programs can be more expensive than a private college. The average: $286 a month, according to the 1997 National Survey of Families from the Department of Health and Human Services.

WebMD's sources say you also should check the following when choosing a day care facility:

  • Is the diaper-changing area separate from the play and kitchen areas?
  • Are hand-washing facilities available for the children and the staff in diaper areas, kitchens, and bathrooms?
  • What are the hours of operation?
  • Has the place ever been involved in a Child Protective Services investigation?
  • How long has each staff member worked there?
  • How long has the primary caregiver for your child worked with that age group?
  • How often is cleaning done?
  • Are electrical outlets covered and/or grounded to prevent electrocution if a child tries to stick something in them?
  • Are they all trained in CPR and first aid?
  • Is the outdoor play area fenced?
  • What is served for meals and snacks? Be sure to explain any specific dietary requests to the caregiver.
  • Find out whether they have options for part-time care, such as two days a week rather than five.

Most of all, Workman says, "I encourage people to pay attention to your gut feeling. How do you feel there? How are you treated? How do you think your child will fit in?" If you don't feel comfortable, she says, chances are your child won't either.


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