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A 3-year-old died at a Texas day care. Here are ways to keep your child safe.

Last week in Houston, a 3-year-old boy died after day care employees left him in a van for more than 3 1/2 hours in 113-degree heat, a heartbreaking loss that could have been prevented, officials said.

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Christina Caron
, New York Times

Last week in Houston, a 3-year-old boy died after day care employees left him in a van for more than 3 1/2 hours in 113-degree heat, a heartbreaking loss that could have been prevented, officials said.

The death of the child, Raymond Pryer Jr., after a field trip Thursday stunned Texans, raising questions about the day care’s safety procedures and prompting police to warn the public about the dangers of hot cars.

“This is just one more incident where something that shouldn’t have happened, happened,” Assistant Chief Bobby Dobbins of the Houston Police Department told reporters Friday. “And it ended tragically.”

On Thursday night, Alan Rosen, the constable of Precinct 1 in Harris County, called the death “gross negligence” and said it was avoidable.

Choosing a care provider is one of the most difficult decisions that parents have to make, and many of the options available to Americans are either unaffordable or inadequate. While it is not always clear whether a day care center is likely to be negligent, there are several precautions parents can take to help ensure that their child remains safe.

— Examine State Records

Most states, like Texas, provide easily accessible online records that detail the violations found at licensed child care facilities.

According to state records, the day care center that Raymond attended, the Discovering Me Academy, was cited for a violation in 2015 because at least one of its vans had not been equipped with an electronic child safety alarm. The day care also received a citation that year because a caregiver overseeing children during nap time did not know the exact number of children present, and in one case, a caregiver was overseeing more children than permitted by the required caregiver-to-child ratio.

It is unclear whether a child safety alarm was present in the vehicle where Raymond was found. The Discovering Me Academy did not immediately respond to a request for comment.

In some states, like Alabama, inspection records are not available online. Parents must then contact the appropriate agency and ask for a copy of the inspection reports and complaint history. The nonprofit Child Care Aware of America created an interactive map with information on how to find inspection reports in every state.

— Look for a Licensed Day Care Center

Unlicensed day cares, which operate outside the law, often come to the attention of regulators only after a child is hurt.

A 2014 investigation by The Richmond Times-Dispatch found that “children being watched in unlicensed facilities in Virginia are five times more likely to die of physical abuse, neglect or even sudden unexplained infant death than children in state-regulated homes.”

In 2015, an unlicensed day care center in New York City was shut down after a 3-month-old boy died during his first day at the facility, a few hours after his mother dropped him off.

And last year, the death of a 5-year-old boy who attended a church-affiliated day care in Mobile, Alabama, led legislators to examine the law that exempts religious day cares from being licensed by the state. The episode also prompted the Center for Investigative Reporting to take a closer look. It found that in Alabama’s two largest counties, “parents complained more than 50 times from 2010 to 2014 that their children were hit, slapped and punched at religious day cares — often so hard that they had bruises and welts.”

Licensing helps ensure basic health and safety standards, but, as was the case at the Discovering Me Academy in Texas, licensing alone is no guarantee of quality.

“Many times state licensing requirements are less rigorous than the minimum standards recommended by the ACF,” or Administration for Children and Families, said Dr. Julia Anixt, a pediatrician at the Cincinnati Children’s Hospital Medical Center. “However, many states also offer quality accreditation programs for child care centers that denote programs that are meeting additional standards of a high quality program.”

Two such accreditation programs are the National Association for the Education of Young Children and the National Association for Family Child Care.

— Examine the Caregiver-to-Child Ratio

The American Academy of Pediatrics advises parents to choose a day care that does not exceed the professional association’s recommended maximum caregiver-to-child ratios. For children 12 months and younger, for example, the ratio should not exceed 3-1, according to the association’s website. For children between 13 months and 35 months, the ratio should be 4-1 or less.

The fewer children per adult, the more attention those children receive.

— Check the Turnover Rate

“There may be good reasons for staff turnover, such as staff receiving professional training or completing advanced degrees allowing for their own career advancement,” Anixt said. “However, high rates of staff turnover could be a red flag that there are problems with the program such as dissatisfied employees working too many hours with low pay, feeling unsupported or having concerns with the children’s safety or approaches to discipline.”

If a program retains its caregivers, however, it is a sign that the employees are happy and that they will become a consistent presence for the children.

“All children, especially infants, need consistency and to build trust in their relationships with caregivers to thrive,” Anixt said. “Frequent staff turnover disrupts these bonds and attachments between children and their caregivers and can create stress for the child, especially if it happens frequently.”

This is partly why programs that assign primary caregivers are so effective.

“A caregiver who knows a child’s behavior well will know what to look for when supervising the child in group settings,” Anixt said. “And it is easier for caregivers to keep close track of a smaller group of children whom they know they are immediately responsible for.”

— Review the Minimum Standards

A 2015 report from the Administration for Children and Families outlines the minimum health and safety standards that experts believe should be in place for children receiving child care outside their home, Anixt said, including a section on transportation that specifies that “head counts of children should be taken before and after transporting to prevent a child from being left in a vehicle.”

This document, while lengthy, can help parents devise a list of questions to ask any day care centers they are considering, which brings us to one of the most important suggestions of all.

— Visit in Person and Trust Your Gut

Interview the owner of the day care in person and take a tour of the center during operating hours.

“I encourage families to spend at least 30 minutes observing the classroom at the child care center, including how staff supervise children and respond to children’s behavior,” Anixt said. “Be suspicious of child care programs that do not offer or allow parents to observe. All programs should have an open-door policy for parents to drop in.”

Questions to ask include: Is the staff trained to administer CPR and first aid? What is the sick policy? Are the toys sanitized? What procedures are in place for fire drills or evacuations? How are drop-offs and pickups monitored? How are children disciplined? Are the facilities childproofed? Does the day care center schedule outings, and if so, what protocols are in place during those trips?

A child care center might have glowing recommendations, great online reviews and a history free of violations. But if something doesn’t feel right during your visit, listen to your instincts and — if possible — go somewhere else.

Unfortunately, because of the dearth of quality, affordable day care in the United States, some people don’t have that luxury, said Sarah MacLaughlin, a senior writer and training specialist at Zero to Three, a nonprofit that promotes healthy child development and runs the national HealthySteps program.

“The waitlists are out of control,” she added.

Some parents, disappointed with the options available, choose nanny shares or rely on family members for help. But again, those are luxuries not available to everyone.

“We are in great need of high-quality child care, and that’s a nationwide problem,” MacLaughlin said.


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