More and more, research tells us that our children’s healthy development depends on safe and positive experiences during the first few years of life. If you are a parent who works or attends school or training during these early years, choosing quality child care is one of the most important decisions you will ever make for your child.

To help you make the right choice for your child, researchers have identified 13 research-based guidelines to think about when choosing a child care program.

You might want to visit several different child care programs, either centers or family child care homes, before you decide which one is best for your family. Call each child care program and schedule an appointment for your visit. Once you are there, stay for at least an hour to watch activities, check the surroundings, and ask questions. Research shows that if a program follows these guidelines, it is more likely to be a safe and healthy place for your child. Your state or county may have other guidelines to help ensure health and safety in child care programs.

Considering these guidelines can help you find a place where you feel comfortable leaving your child.

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1. Supervision

  • Are children supervised at all times, even when they are sleeping?
  • How do the caregivers discipline children? (Hint: Discipline should be positive, clear, consistent, and fair.)

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2. Hand Washing and Diapering

  • Do all caregivers and children wash their hands often, especially before eating and after using the bathroom or changing diapers?
  • Is the place where diapers are changed clean?
  • Do caregivers always keep a hand on the child while diapering?
  • Do caregivers remove the soiled diaper without dirtying any surface not already in contact with stool or urine?
  • Do caregivers clean and sanitize the surface after finishing the changing process? (Hands should be scrubbed with soap and warm running water for at least 20 seconds and then rinsed and dried. The water faucet should be turned off with a paper towel.)

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3. Director Qualifications

  • Does the director of a child care center have a bachelor’s degree in a child-related field?
  • Has the director worked in child care for at least two years?
  • Does the director understand what children need to grow and learn?

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4. Lead Teacher Qualifications

  • Does the lead teacher in a child care center have a bachelor’s degree in a child-related field?
  • Has the teacher worked in child care for at least one year?
  • Does the teacher give children lessons and toys that are right for their ages?

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5. Adult to Child Ratio and Group Size

  • How many children are being cared for in the child care program or classroom? This is called group size.
  • How many caregivers are there? Your child will get more attention if each caregiver has fewer children to care for. This is called the adult to child ratio. The younger the children are, the more caregivers there should be. (For example, one family home caregiver should only take care of two infants.) The adult to child ratio and group size will depend on the age of your child and the age of the other children in their group.

Ratio and Group Size Best Practices for Child Care Centers*

Age Group

Maximum Ratio Maximum Group Size

Infants (0-12 months)

3-4 per caregiver

8 per group

13-23 months 4 per caregiver

8 per group


4-6 per caregiver

12 per group

3-year-olds 7-9 per caregiver

18 per group

4- and 5-year-olds

8-10 per caregiver

20 per group

6-to 8-year-olds

10 per caregiver

20 per group

9- to 12-year-olds 12 per caregiver

24 per group

*Ratio and Group Size Best Practices for Child Care Centers compiled using NAEYC Teacher-Child Ratios within Group Size chart and Caring for Our Children National Health and Safety Performance Standards Guidelines for Early Care and Education Programs, 3rd Edition: Standard

Ratio Best Practices for Small Family Child Care Homes* (with one caregiver)

FCC Group Size Scenario

# of Children Under 2

# of Children Over 2

Scenario #1 If there are 0 children under 2 years old,

there may be 1-6 children over 2 years old.

Scenario #2

If there is 1 child under 2 years old,

there may be 1-3 children over 2 years old.

Scenario #3 If there are 2 children under 2 years old,

there should be 0 additional children in care.

*Ratio Best Practices for Small Family Child Care Homes compiled using Caring for Our Children National Health and Safety Performance Standards Guidelines for Early Care and Education Programs, 3rd Edition: Standard

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6. Immunizations

  • Is your child up-to-date on all of the required immunizations?
  • Does the child care program have records proving that the other children in care are up-to-date on all their required immunizations?

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7. Toxic Substances

  • Are toxic substances like cleaning supplies and pest killers kept away from children?
  • Has the building been checked for dangerous substances like radon, lead and asbestos?
  • Is poison control information posted?

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8. Emergency Plan

  • Does the child care program have an emergency plan if a child is injured, sick, or lost?
  • Does the child care program have first-aid kits?
  • Does the child care program have information about who to contact in an emergency?

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9. Fire/Emergency Drills

  • Does the child care program have a plan in case of a disaster like a fire, tornado, flood, blizzard, or earthquake?
  • Does the child care program do practice drills once every month?

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10. Child Abuse

  • Can caregivers be seen by others at all times so a child is never alone with one caregiver?
  • Have all caregivers undergone comprehensive background checks?
  • Have the caregivers been trained on how to prevent child abuse, how to recognize signs of child abuse, and how to report suspected child abuse?

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11. Medications

  • Does the child care program keep medication out of the reach of children?
  • Are the caregivers trained and the medications labeled to make sure the right child gets the right amount of the right medication at the right time?

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12. Staff Training/First Aid

  • Have caregivers been trained on how to keep children healthy and safe from injury and illness?
  • Do they know how to do first aid and rescue breathing?
  • Have they been trained to understand and meet the needs of children of different ages?
  • Are all child care staff, volunteers, and substitutes trained on and implementing infant back sleeping and safe sleep policies to reduce the risk of SIDS (Sudden Infant Death Syndrome, crib death)? (When infants are sleeping, are they on their backs with no pillows, quilts, stuffed toys, or other soft bedding in the crib with them?)

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13. Playgrounds

  • Is the playground regularly inspected for safety?
  • Is the playground surrounded by a fence?
  • If there is a sandbox, is it clean?
  • Are the soil and playground surfaces checked often for dangerous substances and hazards?
  • Is equipment the right size and type for the age of children who use it?

In addition to the 13 research-based indicators above, the following questions are also helpful to ask as you evaluate potential child care programs.


  • Do the caregivers/teachers seem to really like children?
  • Do the caregivers/teachers get down on each child’s level to speak with the child?
  • Are children greeted when they arrive?
  • Are children’s needs quickly met even when things get busy?
  • Are the caregivers/teachers involved in continuing education programs?
  • Does the program keep up with children’s changing interests?
  • Will the caregivers/teachers always be ready to answer your questions?
  • Will the caregivers/teachers tell you what your child is doing every day?
  • Are parents’ ideas welcomed? Are there ways for you to get involved?
  • Do the caregivers/teachers and children enjoy being together?
  • Have the caregivers participated in early childhood development classes?


  • Is the atmosphere bright and pleasant?
  • Is there a fenced-in outdoor play area with a variety of safe equipment? Can the caregivers/teachers see the entire playground at all times?
  • Are there different areas for resting, quiet play and active play? Is there enough space for the children in all of these areas?

Safe Infant Sleep Practices

  • Are all infants put to sleep on their backs?
  • During rest time, are the children where the adults can see and hear them? Do the adults check on children frequently when they are sleeping?
  • Are all child care staff, volunteers and substitutes trained on infant back sleeping and current safe sleep policies to reduce the risk of Sudden Infant Death Syndrome (SIDS)?
  • Do all infants have their own designated sleep space that is the same every day?
  • Do the infant sleep spaces consist of a firm sleep surface, such as a mattress in a crib or play yard covered by a fitted sheet, with no other bedding?
  • Are the infant sleep spaces kept free of soft objects, toys, crib bumpers and loose bedding?
  • Are safe infant sleep practices posted in the infant sleeping area as a reminder to all staff, volunteers and substitutes?


  • Is there a daily balance of play time, story time, activity time and nap time?
  • Are the activities right for each age group?
  • Are there enough toys and learning materials for the number of children?
  • Are toys clean, safe and within reach of the children?

In General

  • Do you agree with the discipline practices?
  • Do you hear the sounds of happy children?
  • Are children comforted when needed?
  • Is the program licensed or regulated?
  • Are surprise visits by parents encouraged?
  • Will your child be happy there?

Portions of this page produced by:
National Resource Center for Health and Safety in Child Care and Early Education (1-800-598-5437)
University Of Colorado Health Sciences Center at Fitzsimons
Campus Mail Stop F541, PO Box 6508, Aurora, CO 80045 – 0508

Portions of this page supported by:
U.S. Department of Health and Human Services
Office of the Assistant Secretary for Planning and Evaluation and Maternal and Child Health Bureau
Health Resources and Services Administration