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Picking the Best Caregiver for Your Child Depends on Your Needs

Day Care: Some parents prefer a group setting, while others want a live-in nanny. In either case, look for a situation that's open, loving and safe, experts say.


Finding quality child care is more than just finding a baby-sitter--it's about establishing a responsive nurturing relationship between a caregiver and child. Optimally, it will be the kind of loving relationship that a child would receive at home with Mom and Dad.

Infant child care is particularly difficult to find. According to the National Center on Early Childhood, it is the No. 1 child care need nationwide.

Parents who enjoy employer on-site child care or have relatives who can watch children daily are in the minority. It is the hired caregivers--family child care homes, day-care centers, the woman next door who will take your child in addition to her own, nannies and au pairs--on whom we have come to rely.

If it takes a village to raise a child, then child care providers should become our most scrutinized, yet prized, citizens. But what should parents look for? That all depends on your needs.

* Child care centers provide licensed infant care in a group setting with a maximum ratio of four babies to one adult.

"It is the safest place for infants," says Anita Britt, director of the award-winning Children's Development Center at Childrens Hospital in Los Angeles. "In a center there is a system of checks and balances. Everybody is supervising everyone else."

Britt says California's standards for child care centers are very tough.

"Infant centers tend to give good baby care," she says.

Generally, child care centers start at $130 per 40-hour week. Waiting lists can be long.

* Licensed family child care homes are the most popular option for many reasons. They tend to be more economical--running between $85 and $125 a week. They often offer a more homey environment. They also offer more flexibility, a plus for parents who work nontraditional hours. State standards are less stringent here. Providers can care for up to six children, or up to 12 with an assistant and a larger setting.

* Licensed-exempt providers are allowed by the state to care for one other family's children in addition to their own. If they receive state subsidies or are hired through an employment agency, they are mandated to have a security clearance through the Trustline, a statewide criminal records and child abuse registry that checks in-home child care providers. But all parents have access to check if their provider has cleared the Trustline system.

Choosing a child care provider who is licensed by the state, while not always possible, is preferable, says Tammy Baker, director of family support services for Child and Family Service in Silver Lake. State licensing assures providers have taken 15 hours of health and safety training, including infant first aid and CPR. Licensing means the provider has submitted to a criminal background check with the state and the FBI, fingerprinting and has passed a tuberculosis test.

Day-care facilities and private homes are inspected by the state for health and safety as well. Baker reminds parents that licensing addresses only health and safety, not developmental training and experience on the part of the staff.

"In addition to licensing, parents can look for accreditation," says Catarina Tassara, resource and referral department manager for Connections for Children in West Los Angeles. "It shows that providers have taken an extra step."

Exempt care also includes caregivers who come to your home such as nannies and au pairs.

* Nannies live in or out of the home and usually also handle domestic duties as they relate to the children they care for. Weekly wages run from $300 to $600 a week for 40 to 60 hours of work. Nannies are considered employees, so parents must pay Social Security tax on their salary. Nanny wages depend largely on training and experience.

"People are usually looking for the consistency and convenience of having a caregiver in their home," says Mary O'Connor, president of the International Nanny Assn.

It is probably best to find a nanny through a placement agency, O'Connor says. Anyonecan put an ad in the paper and call themselves a nanny. Most agencies charge a fee of $800 to $5,000 for placement, but they also screen nannies for health, security and references in addition to assessing your family's needs.

* Au pairs are the only federally regulated live-in child care providers in the United States, says Susan Gross, director of program development for E.F. Au Pair in Cambridge, Mass.

These caregivers come from other countries for a year on a cultural exchange program. In exchange for room and board and a weekly stipend of about $140, they can provide up to 45 hours of child care a week, up to 10 hours a day.

Both au pair and host family are carefully screened. The host family pays the initial fees and cost of round-trip air fare for the au pair. Au pairs are between 18 and 26 years old and must have 32 hours of child safety and development training. Au pairs cannot be the primary caregiver for children under 3 months old and must have 200 hours of experience if they are caring for an infant.

Whatever your choice, experts say the optimal situation is an open, loving caregiver in a comfortable, clean and safe environment.



For more stories about taking care of that bundle of joy, see Monday's Health section.

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