
Illustration by Theresa O’Reilly
Maybe the walls are a cheerful yellow. Maybe the kids are laughing. Maybe the providers seem attentive. Maybe it’s just what you have been looking for in a child-care provider.
But there could be more to the place than meets the eye.
What else can you do to learn more about a facility? Check out its inspection reports. In the last year, the reports were made available online for the first time through the Missouri Department of Health & Senior Services’ website (health.mo.gov).
“The Show Me Child Care portal allows parents to review child-care facility inspections online,” says Ryan Hobart, spokesman for the department. “Parents can also contact the Section for Child Care Regulation and make appointments to review public files for child-care providers, which include inspection reports prior to 2012, background screenings, and substantiated complaints, as well as disciplinary actions taken related to the facility.”
The inspection reports list facilities’ violations, corrective actions taken, and how many children and staff members were present at the time of the inspection. Licensed facilities are inspected at least once a year for fire safety and sanitation, and general inspections take place at least twice a year (or more, if complaints are received or there is suspicion of noncompliance).
A sampling of violations from 2013 inspections includes problems you could see for yourself—such as chipping paint and inadequate fencing—as well as issues that wouldn’t meet the eye on a tour, such as not keeping children’s immunization records on file, not keeping care providers’ medical examinations and background checks on file, or having insufficient emergency-preparedness plans.
According to a Department of Health & Senior Services parent FAQ, “If there is a consistent pattern of noncompliance or areas that present a danger to the health, safety, and welfare of children, disciplinary action will be taken.”
Disciplinary action can start with a letter of warning to a facility about violations and ultimately extend to a court order to cease a child-care facility’s operations or to impose conditions that protect children in care from imminent danger. Facilities’ initial license requests and license renewals can be denied if the applicants don’t comply with the relevant statutes. Centers also can be put on probation, and licenses can be immediately suspended or revoked.
Child-care providers can care for up to four children who are unrelated to them in their home without a license. If a provider is found to be caring for more, referrals might be made to the local prosecuting attorney. “Last year, the Section for Child Care Regulation made 178 referrals of unlicensed child-care providers to prosecuting attorneys throughout the state, and 22 of those referrals were in the St. Louis area,” Hobart says.
A facility can manage to meet only the minimum requirements set forth by the Department of Health & Senior Services and still be licensed. On the other end of the spectrum, facilities can also be accredited by organizations such as the National Association for the Education of Young Children. L. Carol Scott, chief executive officer of Child Care Aware of Missouri, views this as a “mark of excellence.” Such facilities go way beyond the minimum requirements.
Currently, Missouri doesn’t have a system that would rate facilities that fall between those that barely meet minimum requirements and those that are accredited. In the absence of this type of rating system, Child Care Aware seeks to teach parents how to evaluate facilities on their own, looking at factors such as group size, adult-to-child ratios, and caregiver qualifications.
The U.S. Department of Health & Human Services is also proposing new regulations for 2015 that would apply to child-care providers who receive subsidies from the federal Child Care and Development Fund. According to a summary of the proposed changes, more than 500,000 providers serve about 1.6 million children through these funds. Of course, providers who accept such funding also care for children who are not funded that way, so as the department points out, these changes would benefit more than just those children who are federally funded.
The proposed national changes would dramatically alter child-care rules in Missouri, including requiring some form of quality-rating and improvement system for child-care providers. The proposed changes would also require a more comprehensive background check that would include a fingerprint check. Currently, Missouri conducts a background check before a potential provider becomes licensed and at the time of license renewal, which is every two years. The background check includes state criminal records and sex-offender and child-abuse registries, but unlike some other states’ background checks, it does not include a fingerprint check.
Naturally, there is more to good care-giving than meeting health, safety, and background standards. “The most important element of quality is the person who is caring for or educating the child,” Scott says. She recommends asking providers about their backgrounds—specifically, how much they have learned about child care and where they learned it.
Every caregiver in a licensed facility is required to complete 12 hours of state-approved training related to child care each year, in areas such as health, safety, nutrition, communication, and discipline. Inspection reports will note if staff members didn’t meet requirements, and the facility will be required to document completion of the necessary training. In 2011, the Missouri Department of Health & Senior Services started requiring at least one person who has age-appropriate CPR and first-aid training to be on-site at all times.
Child-care providers are teachers, Scott says, and once you acknowledge that, you must ask, “What are they teaching?” Are they teaching children to be good citizens? Are they preparing them for school? Are they reading to them?
“Having someone who is loving and caring is good, but it’s not enough,” she says.
What to Look For
Ask these questions when you are reviewing your options.
Do staff members have degrees related to child care? • How long have they worked in the field? • Are they certified in first aid or CPR? • Are chemicals and hazardous materials stored out of reach? • Is outdoor space fenced in? • How is food stored? • What is the facility’s maximum capacity? • How many adults are present every day? • How many children does each adult care for, and how does that vary by age? • Does the facility have thorough plans outlined for emergencies and disasters? • Are the staffers aware of food allergies and appropriate responses to children’s reactions? • How are injuries or illnesses handled? • Will older children be playing in the same area as younger children? • Does the facility offer age-specific activities? • How many kids are typically in each age group?
Source: Child Care Aware (childcareaware.org)