Table of Contents | Previous | Next |
Chapter Four: The Family Child Care Home
This chapter describes the family child care homes themselves. It begins with a description of the schedule for care and policies about issues such as care for sick children. Next, the chapter describes the number and characteristics of children in the homes. The chapter concludes with a description of the physical environment--the adequacy and comfort of the space used by children; the safety of the homes, both in terms of physical safety and of health concerns; and the resources and materials available to children. Information for the chapter was drawn from interviews with providers and observations in the homes.
Schedule of Care
Annual Schedule
Family child care homes typically operate year-round and offer more flexible hours of operation than most child care centers. In the family child care homes in this sample, care was provided, on average, for 50 weeks (Exhibit 4-1). Nearly half (45%) provided care for 52 weeks a year, and close to one-quarter of homes (23%) provided care for all but one or two weeks. Most other homes (30%) offered care for at least 11 months, with about a month off during the year. A small number of providers (2%) were closed for nearly three months over the summer. (These homes provided primarily before- and after-school care, and parents made other arrangements during the summer and other school vacations.)Homes that provided care for related children were more likely to take care of children year- round. Over half (56%) of these homes provided care 52 weeks a year, compared with 36 percent of homes caring only for unrelated children.
Daily Schedule
In addition to providing care year-round, the family child care homes in the study provided care beyond the standard hours that a center would typically operate. On average, the homes provided care for 13 hours a day (Exhibit 4-1). Only a small number of homes (3%) provided care for less than 8 hours a day, and approximately half provided care 12 hours a day. Five percent of the homes provided care round the clock.
Care During Non-Standard Hours
Many of the parents in the study worked during non-standard hours or had irregular schedules, and many homes were able to accommodate these schedules. More than half (55%) of the homes provided care during weekend hours, and a similar proportion (54%) were willing to provide off-hours care and accommodate irregular schedules. In addition, most (78%) of the providers made special arrangements for early drop-off or late pick-up at the parent’s request. Just over one-third charged parents extra for this latter arrangement (Exhibit 4.1).
| Some/All Children Related to Provider | No Children Related to Provider | All Family Child Care Providers | ||
|---|---|---|---|---|
| Average # weeks open in a year | 51.4 | 50.6 | 50.3 | |
| Homes open 52 weeks a year (%) | 55.6 | 35.8 | 44.7 | |
| Average # hours of care each day | 13.3 | 12.7 | 13.0 | |
| Makes special arrangements for: (%) | For early/late pick-up/drop-off | 63.8 | 82.6 | 77.7 |
| For weekend care | 75.2 | 47.6 | 54.5 | |
| For off-hours care | 10.4 | 8.8 | 9.2 | |
| For irregular/varied schedules | 8.1 | 13.0 | 11.8 | |
| Both off-hours and varied | 66.5 | 49.0 | 53.5 | |
| Neither | 15.1 | 29.1 | 25.5 | |
| Charges extra for early/late pick-up or drop-off (%) | 15.4 | 40.2 | 34.9 | |
| Sample size | 161 | 481 | 642 | |
| Source: Provider Interview |
Care Arrangements When Children are Sick
Working parents are faced with a problem when children are sick. Most centers and many family child care homes will not allow a parent to bring a sick child to the center or home and will ask parents to come and pick up a child who falls sick while in care. Providers were asked about arrangements when a child is sick, when they themselves are sick, and in an emergency. Almost half (45%) of the homes in the study would allow a parent to leave a feverish child in care, and more than half (53%) would care for a child who had a severe cough. Less than one-third (28%) were willing to have parents leave a child with a rash (Exhibit 4-2).
Providers who cared for related children were more willing to take care of feverish children than providers who cared for unrelated children only (65% vs. 37%) and more than twice as likely to care for a child with a rash (54% vs. 19%). In both cases, the providers were willing to do this because they were caring for siblings or cousins, with no unrelated children present, and probably assumed that siblings or cousins would already have been exposed.
In all types of homes, most providers (85%) were willing to administer prescription medicines to a child, and even more (91%) were willing to administer over-the-counter drugs when necessary (Exhibit 4-2).
Arrangements When the Provider is Sick
The assumption is often made that a family child care home arrangement will be disrupted if the provider is sick; the providers in the study suggested otherwise. Only 27 percent of all caregivers said that they did not provide or arrange for care when sick, and this proportion was similar across all types of homes. Providers either found someone to cover for them when they were sick (40%), or continued to provide care when they were sick (23%). Responses varied little across different types of homes and providers (Exhibit 4-2).
Emergency Procedures
Almost all providers had procedures in place for medical or household emergencies. Most (88%) had a list of doctors’ phone numbers for all children, medical release forms for all children in case emergency medical care was needed (90%), and a plan in case a child in care needed emergency medical care (97%). In addition, nearly all providers had a list of persons to whom a child could be released (Exhibit 4-2).
Turnover and Replacement of Children in Care
The child population in these homes was quite stable. Sixty-three percent of providers reported that in the previous three-month period no children left care; most of these providers also reported that no new children entered the home in the same period. In 15 percent of homes, a single child left during the three-month period, and was replaced by another child. Just over 20 percent of homes experienced substantial turnover, with two or more children leaving in a three-month period. Half of the providers reported that they had had to turn a child away because they had no slots available, in the prior three-month period.
| Some/All Children Related to Provider % | No Children Related to Provider % | All Family Child Care Homes % | |||
|---|---|---|---|---|---|
| When Child is Sick | Allow parents to leave child with: | Feverish appearance | 65.3 | 37.6 | 44.8 |
| Cough | 66.7 | 47.9 | 52.8 | ||
| Rash | 53.6 | 18.9 | 27.8 | ||
| Administer medicines to child: | Over-the-counter medicines | 88.3 | 84.4 | 85.4a | |
| Prescription medicines | 95.3 | 88.0 | 90.9b | ||
| Sick children are separatedc | 58.6 | 72.4 | 69.1d | ||
| When Provider is Sick | No care provided | 28.4 | 26.3 | 26.8 | |
| Provider finds another caregiver | 34.8 | 42.0 | 40.1 | ||
| Provides care anyway | 25.6 | 22.6 | 23.4 | ||
| Never gets sick | 11.0 | 8.0 | 8.8 | ||
| Emergency Procedures | Keeps phone number of child’s doctor for all children | 77.8 | 91.5 | 87.9e | |
| Has medical release for each child | 70.2 | 94.5 | 89.8f | ||
| Has plan for obtaining emergency medical care | 93.6 | 98.6 | 97.3 | ||
| Has list of persons child can be released to | 89.4 | 97.8 | 95.6 | ||
| Has evacuation plan in case of fire | 92.4 | 98.6 | 97.0 | ||
| Sample size | 171 | 492 | 663 | ||
| a An additional 5% of providers administer over-the-counter medications “sometimes.” b An additional 5% of providers administer prescription medications “sometimes.” c Separated routinely, put in a separate room. d An additional 12% “sometimes” put sick child in separate room. e An additional 2% have doctor’s phone number for “some but not all children.” f An additional 2% have a medical release for “some but not all children.” Source: Provider Interview |
Fees and Payments for Child Care
Across all types of homes, the average weekly fee charged for child care was $84.78 (at the first interview, conducted between 2000 and 2002). This included some children who paid nothing. When these children are excluded, the average weekly fee was $89.00. The average weekly fee charged for relative care was $54.00, versus $95.00 for care in homes with no related children. (The comparable fees, excluding children who paid nothing) were $97.00 for non-relative care and $63.00 for care in homes with related children.
The majority of providers varied their fees, depending on a range of factors (Exhibit 4-3). More than 40% of providers charged more for children who were in care part-time versus full-time, charged a different amount for a second or subsequent child from the same family, or charged different fees for children of different ages. A third of providers took family income into account when setting fees. Other factors cited by more than 20 percent of providers as reasons for varying parent fees were: the relationship of the parent to the provider and whether an agency was paying for the care.
Variation in fees charged was slightly different for providers caring for related children and providers with no related children. Providers with related children varied their fees less frequently overall, and were less likely to charge different fees depending on the number of children from the same family, for children of different ages, or for the hours the child was in care.
| Some/All Children Related to Provider % | No Children Related to Provider % | All Family Child Care Homes % | |||
|---|---|---|---|---|---|
| Provider does not vary fees | 33.1 | 17.8 | 21.8 | ||
| Reasons for varying fees: | Number of children from same family | 27.0 | 49.7 | 44.1 | |
| Family income | 32.1 | 33.3 | 33.0 | ||
| Relationship of provider to family | 30.2 | 20.5 | 22.9 | ||
| Hours/week child is in care | 34.6 | 47.7 | 44.4 | ||
| Child’s age | 32.7 | 51.3 | 46.8 | ||
| Child is not yet toilet trained | 23.9 | 16.0 | 17.9 | ||
| Child has handicap | 15.7 | 13.2 | 13.8 | ||
| Outside agency is paying for care | 20.4 | 32.6 | 29.7 | ||
| Late pick-up | 0.6 | 1.0 | 0.9 | ||
| Special services are provided for child: | Diapers | 17.0 | 7.6 | 9.9 | |
| Meals | 23.3 | 8.8 | 12.4 | ||
| Transportation | 23.3 | 14.9 | 17.0 | ||
| Sample size | 182 | 491 | 673 | ||
| Source: Provider Interview |
Paying for Care
The majority of homes in the study were providing care for at least one child whose care was subsidized, at the time of the first interview1 and, on average, more than half (58%) of the children in the homes were receiving subsidies. (Exhibit 4-4). Subsidy payments covered 89 percent of the cost of care (i.e., fees charged). For more than half of the children whose care was subsidized, subsidies covered the entire cost of their care2, i.e., parents paid no additional fee. In homes with related children, those parents who did pay an amount in addition to the subsidy, paid about half as much as parents who received no subsidy ($21.73 vs. $44.64). In homes with no related children, the difference in parent payments was much greater; parents who made payments in addition to the subsidy paid less than $20 weekly, compared with parents who paid the entire fee, who paid, on average, $77.54 weekly.
| All/Some Children Related to Provider % | No Children Related to Provider % | All Family Child Care Homes % | |
|---|---|---|---|
| Providers with at least one subsidized child | 62.3 | 88.3 | 81.6 |
| Percentage of children in home receiving subsidies | 53.0 | 60.3 | 58.4 |
| Percentage of costs covered by subsidiesa | 85.2 | 89.7 | 88.9 |
| Proportion of children for whom subsidies covered 100% of cost of care. | 46.8 | 55.1 | 53.9 |
| Proportion of provider child care income from subsidies | 55.8 | 59.8 | 58.8 |
| Proportion of provider child care income from parent fees | 44.2 | 40.2 | 41.2 |
| Average weekly parent payment (no subsidy) | $44.64 | $77.54 | $72.27 |
| Average weekly parent payment (with subsidy) | $21.73 | $18.97 | $19.42 |
| Sample size | 167 | 491 | 658 |
| a Including only homes with at least one subsidized child Source: Provider Interview |
The majority of providers received payment from an agency for at least one child in their care (Exhibit 4-5). For most homes, the agencies paid the providers directly. Thirty percent of providers identified problems with the subsidy system. Problems were much more likely to be cited by providers with no related children, and delay in payments was the most common complaint.
| Percentage of Providers by Type of Home | All/Some Children Related to Provider % | No Children Related to Provider % | All Family Child Care Homes % | ||
|---|---|---|---|---|---|
| Provider receives all/part of fees from agencies | 65.4 | 86.9 | 81.6 | ||
| Agency pays provider directly | 82.1 | 57.5 | 62.3 | ||
| Agency pays provider for vouchers | 13.2 | 42.1 | 36.4 | ||
| Agency pays parent in cash | 4.7 | 0.0 | 0.1 | ||
| Any problems with subsidies | 7.8 | 34.5 | 29.8 | ||
| Delays in payments | 71.4 | 47.2 | 48.3 | ||
| Inadequate amount of payment | 57.1 | 17.4 | 19.2 | ||
| Too much paperwork | 14.3 | 4.2 | 4.6 | ||
| Agencies make mistakes/are unhelpful | 0.0 | 2.8 | 2.6 | ||
| Parents don’t pay the co-pay | 0.0 | 6.2 | 6.0 | ||
| Parents leave without notice | 0.0 | 1.4 | 1.3 | ||
| Subsidized children are more needy | 0.0 | 2.8 | 2.6 | ||
| Sample size | 103 | 433 | 536 | ||
| Source: Provider Interview |
Children Enrolled in Homes
Number of Children
The number of children enrolled in the family child care homes ranged from a single child to 30 children,3 with an average of six children across all homes (Exhibit 4-6). Three-quarters of the homes had 8 or fewer children enrolled. Providers reported that they could care for slightly more children (capacity for seven children, on average, versus the six reported as currently enrolled). Homes in which children were related to the caregiver were substantially smaller, with an average of 2.7 children and a range of from one to ten children, compared with homes with no related children with an average of 7.2 children and a range of 1 to 30 enrolled. The number of children actually observed to be present in the home at any one time ranged from a single child to thirteen children, with an average of three children.
| Some Children Related to Provider | No Children Related to Provider | All Family Child Care Homes | ||||
|---|---|---|---|---|---|---|
| Mean | Range | Mean | Range | Mean | Range | |
| Number of children | 2.7 | 1-10 | 7.2 | 1-30 | 6.0 | 1-30 |
| Sample size | ||||||
| Source: Family Child Care Home Observation: Roster |
Ages of Children
Almost half (45%) of the homes provided care for children in all age groups--infants, toddlers, preschool children and school-age children (Exhibit 4-7). Conversely, only a fifth of homes provided care for a single age group. The majority of homes (78%) provided care for infants but, in most homes, infants were cared for with older children. Homes in which children were related to the provider were more likely to serve a single age group (Exhibit 4-7).
| All/Some Related Children % |
No Related Children % |
All Homes % |
||
|---|---|---|---|---|
| Single Age Group | All infants/toddlers | 9.1 | 4.0 | 5.3 |
| All preschoolers | 0.0 | 0.0 | 0.0 | |
| All school-age children | 25.7 | 5.5 | 10.7 | |
| Mixed Ages | Infants/toddlers and preschoolers | 21.1 | 15.6 | 17.1 |
| Infants/toddlers and school-age | 29.7 | 64.4 | 55.4 | |
| Preschoolers and school-age | 14.3 | 10.5 | 11.5 | |
| All three age groupsa | 2.0 | 0.1 | 0.1 | |
| Sample size | 182 | 491 | 673 | |
| a Includes homes with at least one infant or toddler, one preschooler and one school-age child.. Source: Family Child Care Home Observation: Roster |
Subsidized Children
Fifty-eight percent of the children in the family child care homes received a child care subsidy and most of the homes in the sample (82%) had at least one child enrolled who received a subsidy. Homes providing care to unrelated children were more likely to receive subsidy payments for at least one child than homes with related children (Exhibit 4-8).
| All/Some Children Related to Provider % | No Children Related to Provider % |
All Family Child Care Homes % |
|
|---|---|---|---|
| Any subsidized children | 62.3 | 88.3 | 81.6 |
| Provider’s own child | 34.0 | 61.0 | 53.7 |
| Special needs children | 10.3 | 19.0 | 16.8 |
| Sample size | 182 | 491 | 673 |
| Source: Provider Interview |
Related Children
Two kinds of related children are found in family child care homes. One type consists of children related to the provider but who do not live with the provider, most often grandchildren or (less frequently) nieces/nephews. The second type consists of children living with the provider, typically her own children. In about a quarter of family child care homes (26%), the provider took care of her own children during at least some of the hours she cared for other children.4 Providers who cared for their own young children were somewhat less likely to care for other related children and more likely to care for unrelated children, as indicated by the fact that the provider’s child was present in 61 percent of homes with no related children versus 34 percent of homes with related children (Exhibit 4-8).
Children with Special Needs.5
Seventeen percent of the homes had at least one child with special needs enrolled. Providers with only unrelated children were more likely to care for a special needs child (19 percent of homes), compared with homes with related children (10 percent).
Child/Adult Ratio in Family Child Care Homes
Adults in Homes
The majority of family child care homes (74%) had a single adult provider. The remaining homes had a provider or assistant. In homes with an assistant, the assistant was present most of the day. In addition to assistants, adult family members of the provider were also present. Adult family members were observed in almost 30 percent of the homes during day-time hours.The type of adult present in the home was related to the type of home (Exhibit 4-9). Formal assistants were less common in relative care, possibly because these homes tended to be smaller. Conversely, members of the provider’s family were more likely to be present in homes providing relative care.
| All/Some Children Related to Provider % | No Children Related to Provider % | All Family Child Care Homes % | |
|---|---|---|---|
| Assistant(s) | 20.4 | 31.2 | 26.4 |
| Adult member(s) of provider’s familya | 37.8 | 26.6 | 29.6 |
| Unrelated adult(s)b | 8.4 | 6.4 | 7.8 |
| Parent(s) of children in home | 28.1 | 20.8 | 23.2 |
| Sample size | 182 | 491 | 673 |
| a Adult family members defined as household members age 16 years and older. b Includes neighbors, friends; does not include parents of children in care. Source: Family Child Care Home Observation: Snapshot |
Ratio of Number of Children Enrolled to Adults
Based on the number of children that providers reported as their enrollment, and the presence of any assistants in the home, the average child-to-staff ratio was 1 adult to 4.8 children, with a range from 1 child to one adult up to 22 children to 1 adult6. The average ratio varied by the type of home. Homes providing relative care had fewer children per provider, on average (2.6 per provider) compared with homes with no related children (5.5 children per provider).Ethnicity of Children and Providers
In two-thirds of the family child care homes in the sample, all of the children in the home shared the same ethnic/racial background. Forty-two percent of homes cared for only Black, non-Hispanic children, another 14 percent cared for only White, non-Hispanic children, and 11 percent cared for only Hispanic children (Exhibit 4-10). There was also a match between the ethnicity/race of the provider and that of the children in care, especially for Black providers. The majority of Black providers (73%) had homes where all children in care were Black. The majority of both Hispanic and White providers cared for children from different ethnic groups. On average, a higher proportion of homes in which all or some children were related to the provider enrolled children from only one ethnic group--87 percent, compared with 58 percent of homes in which no children were related to the provider.
| White Non-Hispanic Providers % |
Black Non-Hispanic Providers % |
Hispanic Providers % | Providers of Other Ethnic Groupsa % | All Homes % | ||
|---|---|---|---|---|---|---|
| All Children Same Ethnic Group | All children White, non-Hispanic | 35.4 | 1.3 | 15.3 | 5.1 | 14.3 |
| All children Black, non-Hispanic | 3.2 | 73.1 | 14.8 | 4.5 | 42.3 | |
| All children Hispanic | 1.3 | 3.4 | 0.9 | 67.0 | 10.6 | |
| Children from Different Ethnic Groups | Mixed ethnic groups | 60.1 | 22.2 | 69.0 | 23.4 | 32.8 |
| Sample size | 188 | 333 | 114 | 38 | 673 | |
| a Includes Asian, American Indian, Alaska native, Native Hawaiian, other Pacific Islander Source: Provider Interview |
The Home as a Physical Environment
Space in Homes
Virtually all of the family child care homes—89 percent—used some shared space for child care. That is, child care was provided in parts of the home that were also used by the provider’s own family. In 56 percent of homes, all of the space that was used for child care was shared with the family, while, in another 33 percent of the homes, some space was shared space, and some space was dedicated space for child care only (e.g., a basement playroom). On average, family child care homes used 4.4 rooms of the house (counting the bathroom) for child care. Eight percent of homes used only one or two rooms for children, 44 percent used three or four rooms, and nearly half used five or more rooms.The number of rooms available for children was not strongly related to the number of children in care. The number of rooms available for child care actually decreased slightly as the number of children cared for increased. Homes with only one or two children had, on average, five rooms for the children to use. Homes with three to five children had 4.7 rooms, on average, and larger homes (either 6 to 8 children or more than 8 children) had four rooms.
This pattern reflects the fact that the homes with one or two children tended to be the grandmother’s (or less frequently the aunt’s) home and the related child or children she cared for had free run of the home, as they would if she were not providing child care. By contrast, homes with more children tended to belong to providers who were not caring for related children, who were more likely to be licensed or otherwise regulated, and who therefore needed to set aside some space dedicated to and appropriate for child care. Even if they are not subject to regulation, such providers are likely to want to reduce wear and tear on household furniture, preserve privacy for other family members and, possibly, maintain a small amount of dedicated space for tax purposes.
Space in the family child care homes was rated as generally adequate for children’s needs, with comfortable and adequate indoor space for play and learning activities, space for active play, places where children could play or work in peace, and a safe and unrestricted environment for very young children (Exhibit 4-11). The average score across all ten items in this domain was high—2.6 out of 3.0, where 3 indicates that the home consistently meets standards. On all six aspects of space, the majority of homes received the highest rating.
| Environmental Conditions | Rarely/Never % | Sometimes % | Consistently % | |
|---|---|---|---|---|
| Space | Average = 2.7 out of 3 | |||
| Children can use what they can reach | 6.0 | 18.9 | 75.1 | |
| Enough space, not cramped | 6.9 | 22.3 | 70.8 | |
| Comfortable, cozy space availablea | 12.1 | NA | 87.9 | |
| Space to work, play without interferenceb | 8.0 | 22.5 | 69.5 | |
| Area for active play | 9.2 | 20.5 | 70.2 | |
| Space for children learning to walk | 2.1 | 24.6 | 73.2 | |
| Comfort | Average = 2.6 out of 3 | |||
| Lighting was sufficiently bright | 2.0 | 19.3 | 78.7 | |
| Setting does not smell | 5.3 | NA | 94.7 | |
| Comfortable level of background noise | 0.8 | 12.1 | 87.1 | |
| Television was off | 40.4 | 32.0 | 27.6 | |
| Space and comfort | Average = 2.6 out of 3 | |||
| Sample size (n = 637 homes) | ||||
| a Item coded as “No” or “Yes,” with no code for “Sometimes.” b Older children can use materials without interference from younger children. Source: Family Child Care Home Observation: Snapshot |
Similarly, for the ratings on environmental comfort, the overall rating was high—2.6 out of 3. On three of the four items, the majority of homes were rated at the highest level. There were a substantial number of homes with a low rating on only one aspect of the environment --the amount of time that the television was on. In 40 percent of the homes, the television was never or rarely off during the observation.
The adequacy of the space and comfort in the family child care homes varied by type of home: Homes where no children were related to the provider had significantly higher ratings on space and comfort, compared with the homes where all or some children were related to the provider (Exhibit 4-12).
| Environmental Conditions | A | B | Significant Difference by Type of Home | |
|---|---|---|---|---|
| All/Some Children Related to Provider | No Children Related to Provider |
All Family Child Care Homes | ||
| Mean | Mean | Mean | P valuea | |
| Space | 2.6 | 2.7 | 2.7 | B>A** |
| Comfort | 2.5 | 2.6 | 2.6 | B>A*** |
| Total: Space and comfort | 2.5 | 2.7 | 2.6 | B>A*** |
| Sample size | 173 | 464 | 637 |
| a Significance levels: * = p < .05, ** = p < .01, *** = p <.001; ns=not statistically significant Source: Family Child Care Home Observation: Snapshot |
Materials and Resources in Homes
Given that children are in these care arrangements for many hours, it is important to have sufficient amounts of developmentally-appropriate materials for indoor and outdoor play. Family child care homes often face the additional challenge of having materials for children of widely-differing ages.
Indoor Play Materials
The average score for indoor play materials was 2.2 out of 3, where 1 = few, 2 = some, and 3 = adequate (Exhibit 4-13). Less than half of the homes had adequate developmentally-appropriate indoor play materials for the age groups enrolled in the home (Exhibit 4-13). Most of the homes did not have an adequate number of books available to children. Although the majority of homes had some books accessible to children, less than half of homes had at least ten books appropriate for each age group cared for in the home. Just over 60 percent of the homes had adequate materials to encourage dramatic and language play, and less than 60 percent had basic art materials available to children.The adequacy of play materials varied by the type of home. Although there was not a significant difference for indoor play materials, homes with no related children had significantly higher ratings on outdoor play materials (Exhibit 4-14).
| Rarely % | Sometimes % | Consistently % | |||
|---|---|---|---|---|---|
| Indoor materials | Average = 2.2 out of 3 | ||||
| Sufficient developmentally-appropriate indoor toys/materials for age groups in home:a |
Infants | 32.1 | 23.7 | 44.2 | |
| Toddlers | 37.2 | 22.7 | 40.2 | ||
| Preschoolers | 37.6 | 23.0 | 38.5 | ||
| School-age | 37.0 | 28.3 | 34.7 | ||
| Household items used in learning/play | 66.0 | NA | 34.0 | ||
| 10+ appropriate books for each age | 22.0 | 29.8 | 48.2 | ||
| Some books accessible to all children | 12.0 | 22.2 | 65.9 | ||
| Materials for language/dramatic play | 12.6 | 24.5 | 62.9 | ||
| Basic art materials | 19.8 | 23.6 | 56.7 | ||
| Outdoor materials | Average = 2.7 out of 3 | ||||
| Sufficient developmentally appropriate outdoor toys/materials for age groups in home | 8.6 | 15.9 | 74.5 | ||
| Sample size (n=637homes) | |||||
| a Rated only if any children of that age enrolled. Infants = birth - 11 months, toddlers = 12 - 35 months, preschool = 36 - 59 months, school-age = 60 months and older. Source: Family Child Care Home Observation: Environment Checklist |
| Play Materials | A | B | All Family Child Care Homes | Significant Difference by Type of Home |
|---|---|---|---|---|
| All/Some Children Related to Provider | No Children Related to Provider | |||
| Mean | Mean | Mean | P valuea | |
| Total: Indoor materials | 2.1 | 2.2 | 2.2 | ns |
| Outdoor play materials | 2.5 | 2.7 | 2.7 | B > A** |
| Sample size | 166 | 491 | 637 |
| a Significance levels: * = p < .05, ** = p < .01, *** = p <.001; ns=not statistically significant Source: Family Child Care Home Observation: Environment Checklist |
Health and Safety in Homes
Indoor Health and Safety
The family child care homes in the study were, on average, safe and healthy places for children (Exhibit 4-15). The overall score for indoor health and safety was 2.8, which indicates there was consistent evidence of good health practices, as defined by national pediatricians’ groups (e.g., the American Academy of Pediatrics). None of the areas of indoor health and safety received an average score lower than 2.6. At the same time, some of the individual items suggest areas of potential concern. Over half of the homes had electrical outlets that were not safely covered, and over half had doors on bedrooms and bathrooms used by the children that could be locked from the inside. In a quarter of homes, providers did not use universal health precautions when dealing with blood; and, between 17 and 20 percent of the homes did not follow consistent health practices for children’s hand-washing.
Ten critical safety issues in homes were singled out for attention in the observations and ratings as posing particular dangers for children. Although the majority of homes had at least one of these dangers present, only one danger was consistently observed across the sample of homes: failure to have fire evacuation procedures posted (Exhibit 4-16). However, it could be argued that, in family child care, where there is typically only one adult present, there is no need to have a written, posted fire evacuation plan, as long as the provider knows what she was going to do in case of fire. However, if there are other adults present in the home at the time of a fire, including parents, other members of the provider’s family or neighbors, then it would be important for them to know how to evacuate the children. Two other dangers were present in at least 20 percent of the homes--unsafe items kept in unlocked cabinets and an insufficient number of fire extinguishers to meet safety guidelines.
| Components of Indoor Health and Safety | Rarely/Never % | Sometimes % | Consistently % | |
|---|---|---|---|---|
| Safety of Furnishings and Equipment | Average = 2.8 out of 3 | |||
| Equipment in good repair | 1.0 | 14.6 | 84.4 | |
| Windows safety guarded | 4.9 | 6.1 | 89.0 | |
| Any toy chest is safe | 0.5 | naa | 99.5 | |
| Soft cushioning under climbing structures | 1.2 | na | 98.8 | |
| No infant walkers | 7.6 | na | 92.4 | |
| Safe use of wood stove, space heater, fireplace | 1.4 | na | 98.6 | |
| Portable space heaters not used for heating | 2.0 | na | 98.0 | |
| Hot items out of children’s reach | 2.8 | na | 97.2 | |
| No latex balloons | 1.9 | na | 98.1 | |
| Small objects out of reach of children < 3 years | 10.3 | na | 89.7 | |
| Electric fans safely covered or inaccessible | 2.5 | na | 97.5 | |
| Electrical outlets covered when not in use | 53.7 | na | 46.3 | |
| Exits and Stairs | Average = 2.6 out of 3 | |||
| Two exits on each floor used by children | 22.0 | na | 78.0 | |
| Indoor stairs closed off at top and bottom | 19.7 | na | 80.3 | |
| Exits usable and unobstructed | 4.5 | na | 95.5 | |
| Bathroom, bedroom doors cannot be locked | 55.4 | na | 44.6 | |
| Stairs with 3+ steps have safe railings | 1.7 | 4.4 | 93.9 | |
| Pets | Average = 2.9 out of 3 | |||
| Accessible pets in good health/even-tempered | 3.1 | na | 97.0 | |
| Litter boxes, food dishes, pet toys out of reach | 10.3 | na | 89.7 | |
| Food Preparation and Toileting | Average = 2.7 out of 3 | |||
| Food handled in sanitary manner | 0.9 | 7.8 | 91.3 | |
| Meals, snacks are nutritious | 2.4 | 12.9 | 84.7 | |
| Meals, snacks sufficient in quantity | 1.4 | 6.8 | 91.8 | |
| Cooking appliances used safety | 1.6 | 6.6 | 91.8 | |
| Dishwashing is sanitary | 1.0 | 6.1 | 93.0 | |
| High chairs are safe | 2.4 | na | 97.6 | |
| Children sit down to eat meals | 4.8 | 10.4 | 84.8 | |
| Children helped to learn to feed themselves | 2.8 | 11.2 | 86.0 | |
| Children held during bottle-feeding | 14.2 | 27.8 | 58.0 | |
| Adults wash hands before preparing food, eating | 7.3 | 16.9 | 75.8 | |
| Children wash hands before/after eating/toileting | 16.9 | 20.5 | 62.7 | |
| Universal health precautions if handling blood | 28.6 | na | 71.4 | |
| Hands washed with soap, gels; individual towels | 20.0 | 21.3 | 58.6 | |
| Children safe and secure at sink | 12.0 | 12.1 | 75.3 | |
| Sink used for food preparation only/disinfected | 5.0 | 5.0 | 90.0 | |
| Diapering/toileting separate from food areas | 4.0 | na | 96.0 | |
| Children kept safe on changing table | 2.6 | na | 97.4 | |
| Diaper containers are kept covered, out of reach | 7.4 | na | 92.6 | |
| Diapers checked at least every 1.5 hours | 12.0 | 38.8 | 49.3 | |
| Naps | Average = 2.8 out of 3 | |||
| No bottles while children lying down | 15.1 | na | 84.9 | |
| Safe sleeping arrangements for babies | 6.0 | 15.5 | 78.5 | |
| Cribs meet safety standards | 0.5 | 2.3 | 97.3 | |
Sample size (n=637 homes) |
||||
| a Some items on the rating scale are coded as only “Rarely” or “Consistently,” with no code for “Sometimes.” Source: Family Child Care Home Observation: Environment Checklist |
| Dangerous Situations | Present in Home % |
|---|---|
| Gun(s) in home | 1.7 |
| Unsafe items in lower kitchen cupboards | 19.3 |
| Insufficient smoke detectors | 8.9 |
| Insufficient fire extinguishers | 26.5 |
| No posted fire evacuation procedures | 64.7 |
| Inadequate first aid kit | 6.6 |
| Drugs, prescriptions in reach of children | 2.1 |
| Smoking in children’s presence | 8.7 |
| Matches, lighters in reach of children | 2.5 |
| Poisonous, dangerous substances | 10.6 |
| Sample size (n = 637 homes) | |
| Source: Family Child Care Home Observation: Snapshot |
There were differences in indoor health and safety by type of home. All aspects of indoor health and safety practices with the exception of care of pets, differed by type of home (Exhibit 4-17). In all areas, homes with no related children had higher ratings on health and safety practices, compared with homes with all or some related children. The proportion of homes with any of the dangerous situations present was significantly higher for homes with related children, compared with homes with only unrelated children (Exhibit 4-18). Whereas 83 percent of the homes with related children had at least one dangerous situation, the comparable percentage for homes with no related children was 57 percent. In fact, with the exception of drugs within reach of children, all of the dangerous conditions were present in a higher proportion of the homes with related children.
| Components of Indoor Health and Safety | A | B | All Family Child Care Homes | Significant Difference by Type of Home | |
|---|---|---|---|---|---|
| All/Some Children Related to Provider | No Children Related to Provider |
||||
| Mean | Mean | Mean | P valuea | ||
| Safe indoor equipment | 2.8 | 2.9 | 2.8 | B>A*** | |
| Safe doors and exits | 2.5 | 2.6 | 2.6 | B>A*** | |
| Healthy practices with pets | 2.8 | 2.9 | 2.9 | ns | |
| Healthy food/toileting | 2.6 | 2.8 | 2.7 | B>A*** | |
| Safe nap practices | 2.7 | 2.8 | 2.8 | B>A*** | |
| Summary | Total: Indoor health/safety | 2.7 | 2.8 | 2.8 | B>A*** |
| Sample size | 165 | 492 | 637 | ||
| a Significance levels: * = p < .05, ** = p < .01, *** = p <.001; ns=not statistically significant Source: Family Child Care Home Observation: Environment Checklist |
| Dangerous Situations | A | B | All Family Child Care Homes % | Significant Difference by Type of Home | |
|---|---|---|---|---|---|
| All/Some Children Related to Provider % | No Children Related to Provider % |
||||
| P valuea | |||||
| Gun(s) in home | 3.3 | 1.2 | 1.7 | B > A** | |
| Unsafe items in lower kitchen cupboards | 34.9 | 13.7 | 19.3 | B > A*** | |
| Insufficient smoke detectors | 24.0 | 3.3 | 8.9 | B > A*** | |
| Insufficient fire extinguishers | 61.2 | 13.7 | 26.5 | B > A*** | |
| No posted fire evacuation procedures | 95.4 | 53.6 | 64.7 | B > A*** | |
| Inadequate first aid kit | 23.4 | 0.9 | 6.6 | B > A*** | |
| Drugs, prescriptions in reach of children | 3.5 | 1.5 | 2.1 | ns | |
| Smoking in children’s presence | 4.4 | 20.5 | 8.7 | A > B*** | |
| Matches, lighters in reach of children | 6.4 | 1.1 | 2.5 | B > A** | |
| Poisonous, dangerous substances | 15.2 | 9.0 | 10.6 | B > A** | |
| Summary Variables | Total: Dangerous Situations | 2.4 | 2.8 | 2.7 | B>A*** |
| Any dangerous situation present | 83.1 | 56.7 | 71.6 | B>A*** | |
| Sample size | 165 | 492 | 637 | ||