An Overview of Quality Child Care

After a long and overwhelming process, you have finally found a nanny or daycare center that you feel comfortable with and fits your family's needs! How do you know that they really are doing a good job though? Learn how to evaluate your decision and assess the quality of a child care center or provider.

Daycare Centers

Several studies found that quality child care programs have certain characteristics in common. Quality indicators measure the conditions that generally foster a safe, nurturing, and stimulating environment for children.

Health & Safety

  •  Locked cabinets for cleaning supplies and other toxic materials
  •  Easily accessible, visible first-aid kits and posted emergency numbers
  •  Covered electrical outlets (with protective caps)
  •  Security gates at the top and bottom of stairs
  •  Window guards on all windows except designated fire exits
  •  Smoke alarms and fire extinguishers
  •  Enclosed outside play areas and soft surfaces under all equipment
  •  Emergency evacuation plans
  • Non-toxic materials children can play with 
  • Individual cribs for infant sleep (and placing babies on their backs to sleep)
  • Individuals cots for toddler sleep
  • Clean sleeping areas that are clear of potential distractions and hazards


  • Policies to ensure a child's parent, guardian, or other approved adult picks them up
  • Policies for keeping track of children during transition to the playground or another classroom
  • Evacuation plans (in case of an emergency) that is practiced with children
  • Child-to-staff ratio of 3:1 in a center caring for infants, 4:1 for 2-year-olds, and 7:1 for 3-year-olds

Licensing & Teacher Training

  • A staff member with certified pediatric first-aid training is always present with each group of children. 
  • Care center is licensed and regularly inspected for health and cleanliness


  • Providers implement cleanliness and health standards for themselves, surfaces, and toys
  • Precautions are taken to prevent cross-contamination for children with food allergies
  • Kitchen area is clean
  • Teachers and children regularly wash hands

Quality of Providers

  • Positive teacher/child interactions
  • Greets your child in the morning with a warm welcome
  • Caregiver is attuned to your child's needs
  • Caregiver talks to children at their eye level
  • Caregiver is responsive and able to read child's cues
  • Age-appropriate activities 


  • Parents are welcome to observe, discuss policies, make suggestions, and volunteer in the classroom
  • Close communication between parents and staff 
  • Staff discusses highlights in children’s daily experiences with parents


The following list can help you evaluate a potential nanny candidate or the nanny you already.

  • Your child lights up when their nanny walks in the door or can't stop talking about all the wonderful things their nanny says and does
  • Suggests creative solutions to problems and works with parents/guardians to provide the best possible child care
  • Punctual
  • Stays connected
  • Child's room is clean and so is your child
  • Infrequent accidents
  • Lots of energy and patience
  • Considers safety first and foremost
  • Communicates with parents
  • Reliable, responsible, self-motivated, and organized

Is the Quality of Child Care Regulated?

It is important to learn about different licensing requirements for various types of child care providers. Almost all daycare centers, whether it is a traditional center or in-home, are required to meet state licensing regulations for health and safety to operate—but some do without it. 

Ideally, a daycare center will be accredited by the National Association for the Education of Young Children (NAEYC). A license, however, is not a guarantee of quality care. 

You should ask any potential child care provider to show you credentials and call your local social services department to double-check. Having a license shows that your provider takes professional pride in their work.

Some home daycares have been accredited by the National Association for Family Child Care. More are being added regularly, but the accreditation process can take almost a year and costs several hundred dollars.

The National Association for Family Child Care has strict standards and a center must receive an in-person visit before it becomes accredited. Getting this is a definite sign of quality!

If an individual (such as a nanny) is coming into your home, there is no licensing requirement. Providers of drop-in child care, such as child care in health clubs, churches, recreational center programs, or before or after school care operate by school districts and do not need licenses.

Testing the Quality of a Child Care Center/Provider

Before you choose a daycare or other care provider, you can get a sense of the quality offered by taking a tour, stopping by unannounced, or speaking to other parents who send their child to the center or use/have used the same care provider.


Once your child is attending a daycare, you can get a sense of its quality in a few ways:

  • Stopping by unannounced during the day, not just at set drop-off and pick-up times
  • If your child is talking, asking them specific questions about the safety of the daycare or about their activities to find out if they are age-appropriate
  • Assessing if your child dreads going to daycare or is excited in the morning to see their friends and caregivers
  • For a baby, making sure they are clean and happy when you pick them up


Before you hire a nanny, you should speak to referrals, do a trial where you can observe them interacting with your child while you are home, and ask interview questions to gauge how they would perform and react in specific situations.

Once you hire a nanny, pay attention to their interactions with your child. Is your child happy to see them or does he or she seem scared, worried, or hesitant?

If working from home is an option, you may choose to listen in on what goes on. You can also come home early without notifying the nanny. Some parents even set up a nanny cam to watch what goes on while they are away.

Paying Attention

Your child's verbal and non-verbal behavior may be the best signifier of a bad child care situation.

Look out for these signs which may signal that your child is unhappy at daycare or with the nanny:

  • Cries before daycare or when the nanny arrives
  • Scared or reluctant to go to daycare
  • Refuses to eat
  • Nightmares or trouble falling asleep
  • Frequent cuts or bruises
  • Changes in temperament
  • Frequent infections or illness

It is important to note that some separation anxiety is normal. If your child is sad to leave you and go with the child care provider, that is not a direct connection to the quality of the provider.

If your child repeatedly cries and refuses to go with a child care provider, look out for signs that indicate the match is not a good one.

Signs That Quality Is Slipping

As parents, we know when a situation is not a good fit for our kids. If you have a bad feeling, trust your gut and change your childcare situation if necessary.

Here are some things to be on the lookout for when evaluating the quality of your child care situation.


  • Unsafe environment
  • Unhealthy environment
  • Non-stimulating environment
  • No emotional support from caregivers
  • Too many children and not enough teachers
  • Activities that do not promote mental, physical, social and emotional growth
  • State licensing requirements are not followed
  • Lack of open communication


  • Your child seems afraid or has increased anxiety around the nanny
  • Nanny is secretive about the daily routine
  • Requests are not followed
  • Your parenting is often critiqued
  • Tardiness
  • Your child often looks unkempt and dirty
  • Frequent injuries to your child
  • Stories don't add up or there is lying and concealing
  • Your child is consistently hungry and tired
  • Changes in nanny behavior or communication

Improving Quality of Care

Even parents who are generally happy with their nanny or daycare have complaints or areas they wish would improve from time to time. It is important to discuss areas of concern as they come up so you do not build up resentment or start creating a list of complaints in your head.

Communication Is Key

Open communication with childcare providers is the key to a good relationship. It's your responsibility as the parent to communicate the house rules and what is acceptable on the job. Maybe your nanny gave your child candy and you don't want them to do so. Base when to address the situation on how serious it is.

Try to have the conversation without the child in earshot so it can be handled privately. Explain the situation and work with your nanny to make sure it doesn't happen again. Create a log book where you both put in notes or other important information about the day.

It's important for caregivers to be consistent with your child's sleeping, eating, and discipline routines. Discuss your expectations with your child care provider and work together as a team.

Schedule Meetings

Set up longer more formal meetings with your childcare provider as needed. Make sure you can talk to your provider without your child hearing. Parents should come to the meetings with an agenda and use the time to talk about concerns.

With everyone's busy schedules, sometimes parents have very little face time with nannies other than a few minutes at the beginning and end of the day. It is important to set aside time to communicate any issues or questions.

Taking Action

If you have tried to repair your child care situation and you still feel it is not working, it is time to rethink the situation. If this is the case, consider that you might be:

  • Afraid of the effect that changing the child care situation will have on your children
  • Worried about finding another nanny
  • Concerned about the disruption in yours or your child's life and routine that may ensue
  • Feeling guilty about putting the nanny out of a job

While having mixed feelings is normal, no parent should stick with a child care situation if they feel their children are not happy or not properly looked after.

Before pulling your child from daycare or firing your nanny, consider your options.

  • Use a nanny-finding website, such as or
  • Look for a nanny share with a family who already employs a nanny
  • Have you or your partner take some time off from work
  • Ask a relative to help out
  • See if any local daycares can take your child right now
  • Start a new nanny search
  • Look for drop-in child care options
  • Ask your company about employee-sponsored back-up daycare
3 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Alkon A, Rose R, Hazard K, Moser D. National Health and Safety Standards: Family Child Care Homes Compared With Child Care CentersJournal of Pediatric Health Care. 2021;35(1):5-15. doi:10.1016/j.pedhc.2020.03.004

  2. U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Care (OCC). Child Care & Licensing Regulations.

  3. Child Welfare Information Gateway. What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms.

By Jill Ceder, LMSW, JD
Jill Ceder, LMSW, JD is a psychotherapist working with women, children, adolescents, couples and families.