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Choosing a Child Care Center

Center-based care takes place in a location staffed by caregivers. Center-based care has many names—child care center, preschool, nursery school, child development program, or learning center.

Center-based care also may have different sponsors, including churches, schools, colleges, universities, hospitals, social service agencies, Head Start, independent owners and businesses, and employers.

Answers to the following questions may help you in choosing a child care center:

  • Hours. What are the hours? What if you are late in picking up your child? How are vacations and holidays scheduled?

  • Fees and services. What is the cost? How are payments made? Are there other services available in addition to child care? Is there an extra cost?

  • Qualifications and training. What education, training, and experience does the child care provider(s) have? Is the child care provider certified in CPR?

  • Discipline. Is the caregiver(s) policy on discipline the same as yours? Center-based care should have a discipline policy.

  • Communication. How often does the child care provider give feedback about your child? Does the child care provider seem approachable?

  • Transportation. Are the proper car seats, booster seats, and seat belts used? Center-based care should have a transportation policy.

  • References. Does the caregiver have current references from parents you can contact?

  • Policies. The center should have a written policy for each of the following areas: health standards, illness, medication, nutrition, discipline, transportation, media, and outdoor play.

  • Licensing/accreditation. Is the center licensed or registered with the appropriate local government agencies? Are there any outstanding violations? Is the program currently accredited or in the process of becoming accredited?

  • Health professional. Is there a qualified health professional, such as a doctor or nurse, for the program? (The national standard recommends that center-based infant-toddler programs should be visited by a health professional at least once a month, and all other child care programs should be visited at least once every 3 months.)

  • Visiting policy. Can you visit the center before your child is enrolled? If your child is enrolled, can you visit the center anytime it is open? Can you see all the areas that your child will use? Are visitors screened or is their identification checked so that only approved adults can visit the center and pick up children?

  • Qualifications and training. What type of additional training have the staff had during the past year? Do outside experts provide training? How long have the staff worked at the center? How much experience do they have with children of your child's age?

  • Staffing. Are there enough trained adults available on a regular basis? What happens if staff are ill or on vacation? Are children supervised by sight and sound at all times, even when they are sleeping? Are children cared for in small groups? Are activities proper for their age group? Is there a daily schedule? Do the child-staff ratios and the size of groups of children fall within nationally recognized standards? For example, in a room with 4 children aged 13 to 35 months, there should be 1 trained caregiver. In a room with 5 to 8 children aged 13 to 35 months, there should be 2 trained caregivers. There should be no more than 8 children aged 13 to 35 months in a room. (See chart below.)


Maximum Child-Staff Ratio*

Maximum Group Size*

12 months



13-35 months












6- to 8-year-olds



9- to 12-year-olds



*As recommended by the AAP.

A Checklist To Help Rate Your Choice

"Is This the Right Place for My Child? 38 Research-Based Indicators of High-Quality Child Care" is a checklist put together by Child Care Aware of America (formerly the National Association of Child Care Resource & Referral Agencies [NACCRRA]) that you can use to evaluate child care programs. This checklist is available through the Child Care Aware of America Web site at and available through a link from the AAP's Healthy Child Care America Web site. All of the questions are based on research about what is important to your child's health, safety, and development.

Additional Resources:

Last Updated
Choosing Quality Child Care: What's Best for Your Family? (Copyright ? 2009 American Academy of Pediatrics, Updated 8/2012)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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