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Health Today: Keep your kids safe; know your child care provider

by Lisa Pfitzer, MD, Division of Pediatric Forensic Medicine, Department of Pediatrics last modified Apr 11, 2011 03:22 PM

(Editor's Note: When Jake Brent was just four months old, University of Louisville pediatrics child abuse specialists found that he had been repeatedly abused by his babysitter.

Their investigation also revealed that several other children in that daycare had been abused. You can see that story in the sidebar video. In recognition of Child Abuse Prevention month, Health Today tapped into the expertise of Lisa Pfitzer for tips parents can use when choosing a daycare center for their children.)

Most parents eventually will confront the process of choosing a caregiver for their child. There are myriad choices regarding child care — everything from nationally accredited daycare programs to a helpful neighbor or relative. Each child care site decision requires special consideration.

While there are no right answers when it comes to choosing a daycare, it is still important for parents to do their homework. As a child abuse pediatrician, I know that only a small percentage of abuse and neglect actually occurs in daycare. Still, every child deserves reliable, safe care, so parents must make a point of understanding how their daycare is regulated and who is caring for their children.

Commercial Child Care

Providers who operate commercial child care centers must be licensed by the state according to specific criteria, based on their size and place of operation. The state divides licensed child care programs into two types: four or more children in a non-residential setting and 7–12 children in the provider’s home.

Criteria include building inspection, criminal and child abuse and neglect background checks, annual continuing education requirements, availability of staff trained in first aid and CPR, specific staff-to-child ratios based on the age of the youngest child and adequate supervision of each child in care.

Some commercial daycares pursue national accreditation. National accreditation by an organization such as the National Association for the Education of Young Children (NAEYC) indicates that high standards have been met.

In-Home Providers

Child care providers must be certified by the state if they provide in-home care for six unrelated (and up to four related) children. A state surveyor checks the home annually. The provider must have first aid, CPR and nine hours of child development training per year. Certified in-home providers may not care for more than six children younger than 6 years old, or more than four children under 12 months old.

Exempt Providers

In-home care providers who care for three or fewer children, in addition to related children, are legally exempt from Kentucky’s child care regulations.

Is this the daycare for you?

Two Kentucky organizations can help you through the process of evaluating daycares. STARS for KIDS NOW is a voluntary quality rating system of Kentucky child care programs. It ranks child care centers and provides incentives to child care providers who meet these goals.

Community Coordinated Child Care (4-C), a child care resource and referral agency, provides a directory of state-reviewed programs. Be sure to interview providers, keeping these tips in mind:

  • Who will watch your child? Are there substitute caregivers and are these caregivers qualified?
  • What type of discipline will be used if the child misbehaves?
  • For formal child care programs:
    • No person under the age of 18 should provide care to your child without adult supervision.
    • A daily report, including accident reports, should be provided.
    • Inquire about site surveillance via the Internet.
    • Certificates and licenses should be visibly posted.

After you have chosen a daycare, feel free to drop by unexpectedly to see your child and surrounding environment. Do not return your child to a program where safety is in question.

Promptly report any concerns you encounter:

  • Kentucky Abuse Hotline 1-877-KYSAFE1
  • Indiana Abuse Hotline 1-800-800-555

The University of Louisville Department of Pediatrics, in partnership with Kosair Children’s Hospital, is the only statewide medical referral resource for child maltreatment assessments. The pediatric forensic medicine team serves a liaison between the hospital team and community partners such as law enforcement, Child Protective Services and the Department of Justice.

UofL Pediatrics has offices in downtown and south Louisville where children, birth to 18 years old, receive the full range of primary care services. Evening hours are available at UofL Pediatrics-C & Y, 555 S. Floyd St., and UofL Pediatrics-Broadway, 230 E. Broadway. At UofL Pediatrics-Stonestreet, doctors are available evenings and Saturday morning, 9702 Stonestreet Rd., Suite 100.

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