Day Care: Choosing a Good Center


What should I look for in a day care center?

Whether you are considering a commercial day care center or one in someone’s home, you should check it out carefully. Ask questions of the staff. Talk to parents of other children at the day care center. Look over the center carefully. This handout gives you a list of questions to get started.

Ask about the child to staff ratio.

  • How many children are there for each staff member? The fewer children each staff member is responsible for, the better. The American Academy of Pediatrics recommends a ratio of one staff person for 3 to 5 small children and one staff member for 7 to 10 older children.
  • Are the younger and older children separated? Separating the older and younger children helps reduce the number of infections that are passed around.

Ask about the center’s policies.

  • What are the center’s policies on discipline and other important issues?
  • Are the policies in writing? Ask for a copy.

Ask how the center cares for sick children.

  • How is medicine given?
  • How are parents told about illness among the children?
  • When must children stay home because of illness?
  • Does the center have a “sick room” for children with minor illnesses?
  • Is there a nurse or doctor to help with medical care?
  • Are children required to have vaccinations before coming to day care?
  • Is a physical exam required before admission?
  • Does the day care center keep a record of health-related problems, such as illnesses, injuries and accidents, for each child?

Ask about staff training.

  • What are the training requirements for staff members?
  • Are all staff members certified in basic first aid?
  • Are all staff members trained in child development?
  • Are all staff members trained in identification of abused children?
  • Are all staff members trained in preventing illness and injury?
  • Does the center have rules about careful and frequent hand-washing? This is key to reduce the spread of illness among the children. All staff members must wash their hands each time they diaper a child and before fixing meals or snacks.

Check building and playground safety.

  • Are poison control phone numbers and ambulance phone numbers clearly posted?
  • Does the playground have impact-absorbing surfaces, such as wood chips, under the swings and slides?
  • Are young children able to get to high places?
  • Are the children protected from strangers?
  • Are fire drills held at least every month?
  • Are there smoke alarms throughout the building?
  • Does the center use space heaters? If so, are they being used properly?
  • Are safety gates used in areas for small children?
  • Are electric outlets covered?
  • Are sharp corners of furniture covered?
  • Are the toys kept clean? Washable toys should be washed every day with a disinfectant cleaner, such as Lysol or a solution of water and bleach.
  • Does the day care staff regularly clean all surfaces with disinfectant?

What can I do to keep day care safe for my child?

  • Visit with the staff at the day care center. Go to meetings for family members and learn about the concerns of staff and other parents.
  • Suggest educational programs for parents and staff members. Helpful topics include child development, first aid, dental care, skin cancer prevention, general safety and recognizing abuse.
  • Help with cleaning and repairs at the daycare center. Many centers appreciate parents helping out as playground supervisors.
  • Ask your child every day about what happened at day care.

What are some signs that would tell me if there are problems?

  • The staff fails to answer your questions and address your concerns.
  • There is no way for parents to be involved in the day-care practices.
  • Your child tells you about problems or is not happy with his or her day care experience.
  • Unexplained accidents happen more than once.
  • The staff changes often.
  • The management can’t offer you a written copy of the day-care policies.
  • Other parents tell you about problems or concerns with the day care center.

If you suspect there are problems, contact the agency in your state that governs day care centers. (You can find the number in the phone book.)


Written by editorial staff. American Academy of Family Physicians