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What Makes For Quality Child Care? It Depends Whom You Ask

Michelle Kondrich for NPR

When Jolie Ritzo was looking for day care for her son Cannon in Falmouth, Maine, she checked out as many centers as she could.

She was looking for a place with the right feel.

"Most importantly, the people who are providing the care are loving and kind, nurturing and interested in developing these little beings," she says.

There was one center in town that had a great reputation, but it was so pricey, Ritzo says, "It would break the bank."

She enrolled Cannon in a family child care based in a church. It was small and cozy with a sweet name and a nice playground. But after a few months, she started to get a bad feeling about the place.

"Let's just say she wasn't cut out for child care," Ritzo says of the woman who ran the center.

So the hunt was on again. She settled on a place called Little Hands.

Ritzo says it was convenient to get to, had a good reputation and a nice facility. It had good safety measures in place. It cost about $900 a month for four days a week. And it had space for Cannon immediately.

Ritzo is happy with the choice. Cannon just started kindergarten after going to Little Hands for three years, and now his 2-year-old sister is enrolled.

"It gives me peace of mind knowing that when I drop my daughter off for the entire day that someone is going to be loving, sweet and nurturing," Ritzo says

Like most parents, Ritzo says her children's day care is high quality. In fact, a new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Healthshows that the overwhelming majority of parents who use child care are happy with it.

The poll shows 88 percent of parents say their child care is very good or excellent.

It's an interesting result, because researchers in early child development say most child care in the U.S. is mediocre to poor.

A 2006 study by the National Institute of Child Health and Human Development showed that only 9 percent of child care arrangements in the U.S. were considered very high quality.

And a report by the New America Foundation says that only 11 percent of child care centers are accredited by one of the two main organizations that certify day care centers and preschools.

The disconnect between parents and researchers may be because the quality benchmarks measured aren't always the same as what parents are looking for, says, Mary Beth Testa, a child care policy consultant to the National Association for Family Child Care, the organization the accredits home-based child care centers.

"People are looking for, 'Do you care about my child? Is my child happy here?' " Testa says. "How do we regulate whether your child is going to be happy here?"

The NAFCC rates home-based child care and the National Association for the Education of Young Children rates centers. Each group evaluates child care providers on dozens of criteria such as curriculum, whether teachers have college degrees, how children interact with each other and the teachers, and the ratio of children to caregivers.

"There's research to back up that those things are important. The science says this is what children need in order to thrive," Testa says. "But parents are still looking for price, location and 'Do you love my kid?' "

The poll shows parents want quality child care, but that's not always the only deciding factor.

Like Ritzo, parents are also looking for child care they can afford and that they can get to conveniently. Our poll shows that 27 percent of parents say location played a major role in their child care choice, more than any other single factor. And 18 percent point to price.

"The bottom line is, there's still this three-legged stool of quality, access and cost, and to find all three, unless you are upper middle class, it is very difficult to do," says Rhian Allvin, chief executive of the National Association for the Education of Young Children.

"You find something that's affordable, and often it's not the highest quality," Allvin says. "To find an affordable provider that is high quality, you're driving an hour and a half. And to really find affordable high quality care that is convenient for your family and your situation is incredibly challenging."

That's the situation for Jennifer Nuesi, a single mother who responded to our poll and lives in Northport, Fla. Her mother cares for her 4-year-old daughter, Cairo, while she's at work, and she's not happy about it.

"She's not at all the person I would like to watch my child," Nuesi says.

She says her mom, who is from the Dominican Republic, doesn't share her values in terms of how to raise Cairo. They disagree on everything — from rules to schedules to diet.

"My mom just lets her do whatever she wants. Eat whatever you want, do whatever you want, if you want to go to bed at 12 at night, that's totally OK," says Nuesi.

But she had to go with her mother because "unfortunately she's free, and I can't find better than that," she says.

Two years ago Congress updated the Child Care and Development Block Grant Program, which gives money to states to help low-income families get subsidies for child care. The $9 billion program requires child care providers that receive block grant funding to meet strong quality standards.

But Mary Beth Testa, a policy consultant for NAFCC, says Congress didn't actually increase federal funding enough to help child care centers reach the goals, which include requiring states to create training standards for child care providers, provide parents with the ability to compare child care options and spend 7 percent of their federal grant on quality improvement. She estimates a funding shortfall of about $1.2 billion.

"They are good reforms, they are good ideas," Testa says. "We needed to raise this bar."

But if parents are as happy with their child care as our poll shows, Testa worries there won't be much pressure on lawmakers to spend tax money to make it better.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.