Choosing a childcare provider for your infant or toddler is an extremely important decision. After you assess the childcare options available to you and narrow down the list potential providers, evaluate each provider to ensure your child receives the best quality of care. The best method of evaluation is observation. It is important to observe a provider in action before placing your child in their care. I recommend bringing your infant with you and observing for 30 minutes. Even after you enroll your child, take time to observe the workers when during drop-off and pick-up.
The caregiver ratio should be no greater than 4 to 1 for infants and 9 to 1 for toddlers less than 2. These ratios may change when caregivers take breaks or attend to housekeeping duties, but generally the ratio should be the same. For instance, at the beginning of the day the required number of caregivers should be in the room when you arrive for drop off.
Every childcare center should have a sink for hand washing in the infant/toddler room. This could be within the room itself or an adjoining bathroom (not down the hall). Caregivers need access to sinks for hand washing to prevent the spread of germs. If the sink is in an inconvenient location, it makes it less likely that the caregiver will wash when necessary. Make sure the employees wash their hands between diaper changes, feedings, and housekeeping duties. Childcare centers are required to use disinfecting sprays and the cheapest and most commonly used is bleach. In my experience as a sanitarian, most of the disinfecting solutions exceed a 200 parts per million concentration which is toxic.
Ideally, there should be at minimum of two changing tables for operation with six infants or more. The changing tables should have plastic changing pads which allow for easy cleaning and disinfection. Most state regulations require that the changing table should be disinfected after each use, most childcare centers change diapers in batches and this doesn’t get done. It is important to observe disinfection of the changing table. Rotavirus is rampant at childcare centers and the easiest route for spreading the virus is the changing table because the virus is carried in feces. If your child contracts the virus, your child will be excluded from daycare while they are symptomatic, which is typically 8 days. You will most likely contact the virus while caring for your child. What infuriates most parents about this situation is that you will miss work and still pay the provider for the days your child was sick with an illness contacted at the childcare center.
I highly advise parents to select a childcare center where their child has a designated crib because it can prevent the spread of viruses. It is sometimes best if you provide the crib sheets and blankets to ensure that they are washed with regular frequency. Also, be sure to wash the sheets and blankets after an illness or request to have them washed.
Every hard surface within an infant room should be washed and disinfected daily. This includes using a disinfecting spray or wipe and allowing the item to air dry. Plastic toys that are placed in a child’s mouth should be collected and sanitized. Highchairs need to cleaned and sanitized after use. The bottles and nipples you provide should be washed and sanitized after each use. A good question to ask during observation is, “How do you wash and sanitize the bottles?” If caregiver cannot answer this question it should raise a red flag. It is important to observe that the provider has a system in place for sanitation.
Most mothers think that their child will have a limitless amount of hugs and human contact in childcare
Fact: No one is going to hold your infant for eight hours a day. Most infants spend their days in swings, cribs, or bouncy seats.
Most mothers think that only the caregivers assigned to the infant room care for infants. Fact: Most employees within a childcare center spend some time in the infant room from the administrative staff to the cooks.
Most mothers think toddlers nap for two hours during the day.
Fact: In my experience, most toddlers are down for nap by 11:45 and do not get up until after 3 contrary to what their schedules say.
Some mothers think high turnover is a red flag that something is wrong at the facility.
Fact: A red flag would be the disappearance of the director. Directors of childcare centers meet stringent criteria in education, training, and experience. They are not easily replaced and the licensing of the center to tied to the director.