No one knows exactly how many children die in a child care setting every year — laws vary widely from state to state on whether providers in private centers, homes or ministries must be licensed, registered or require no regulation at all — and only 38 states require licensed child care facilities to report fatalities. “Families want their children to be safe in child care,” says Lynette Fraga, executive director at Child Care Aware of America, a nonprofit that advocates for quality child care nationwide and provides licensing, cost and local agency referral information to parents. “They reasonably assume that a child care license means the state has approved some minimum level of protection for children.”
Yet, in the CCA’s 2013 report ranking state child care center policies, it found the average score was a 92 out of 150 points — the equivalent of 61 percent. The report ranked day care centers in areas such as training, background check thoroughness, school readiness and health and safety requirements. The top 10 scoring states each earned a C, 21 states earned a D, and the remaining states failed. “There really is no model state,” Fraga says. “It’s simply unsatisfactory.” Similarly, in the CCA’s most recent report ranking state policies on home day cares, only one earned a B, three earned a C, four earned a D, and the remaining states failed.
In Kansas, the Patricks say they advocated for stricter child care laws along with Bryan and Kim Engleman, whose 13-month-old daughter, Lexie, died in 2004 in a Johnson County home day care. Lexie’s Law, passed in 2010, requires home providers to obtain a license, maintain a ratio of no more than 10 children per adult, and undergo regular home inspections. It also allows parents to check a provider’s licensing history, inspections and complaints online.
With so many variables in state laws, Alecia says parents absolutely must do their due diligence when selecting child care. “Do as much research as you can,” she says. “From the moment you find out you’re pregnant — start researching the laws. And always ask questions, questions, questions.”
The most important thing a parent can do is to search for a provider’s licensing and accreditation, says Linda Geigle, executive director of the National Association for Family Child Care, the only nationally recognized accreditation system specifically for home day cares. NAFCC-accredited home providers are licensed (if applicable), passed a thorough background check, earned CPR and first-aid certification, and received annual training, she says.
Founded in 1926, the National Association for the Education of Young Children is the gold standard for day care centers, preschools and prekindergartens. “It gives families and the public an extra tool to know that the programs have gone through an independent process to achieve standards of quality,” says Barbara Willer, NAEYC’s deputy executive director.
In a recent online poll of nearly 2,700 Angie’s List members, 63 percent of the respondents who said they used child care also said they checked licensing or accreditation before hiring their provider.
Maribeth Day, executive director of child development programs at highly rated Annandale United Methodist Church in Virginia, says NAEYC accreditation not only helps parents easily recognize a quality program, but also motivates staff. “We’re in a highly mobile area,” she says. “Families come and go, but they recognize NAEYC.”
Many states also have implemented their own version of the Quality Rating & Improvement System, a guide developed by the U.S. Department of Health and Human Services. A QRIS provider receives a rating after meeting various state-defined standards. “If you look at the states that have QRIS systems, and find child care centers that incorporate NAEYC accreditation, that’s the top level,” Willer says. And while some states exempt ministry-based centers from licensing regulations, NAEYC and QRIS require it.
Angie’s List member Mary Ann White of Barnhart, Mo., says accreditation mattered to her and she used the List to find a highly rated day care center for her 18-month-old son, Lucas. She says Creative Expressions Learning Center in Eureka, Mo., accommodates her irregular schedule — a key selling point. “Don’t settle. After you check their licensing and accreditation, make sure you have a good feel about the place,” says White, who pays $164 a week for three days of care.