We know that concerns about quality child care is one of the main reasons that Indian women choose to leave the workplace after becoming parents. While the prevailing assumption is that Indian women have numerous support options in the form of extended family, domestic help, and a growing daycare market, much of our recent work has shown that those “solutions” are a mirage. Indian women are struggling to find reliable, safe, and engaging child care options.

And a new poll of US parents suggests that the problem is as bad in the West, where the concerns are similar. Many of the parents who were surveyed aren’t sure if the daycare they pick is safe and healthy for their child.

About 62% of parents said it’s difficult to find child care options that meet all of their standards, and only about half were very confident that they could tell if a child care option was safe and healthy, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan.

The most important factors on parents’ checklists depended on the child care setting. Parents of children attending child care centers prioritized safety (background checks for staff, locked doors) and practical considerations (cost and location). Parents of preschoolers named similar safety factors as the most important factors they consider when choosing care, as well as those related to play (active play every day in a safe outdoor play area).

“Parents want to feel confident that all child care and preschool options meet certain standards,” says poll co-director Sarah Clark. “Parents could then choose their preferred child care option without compromising their child’s health and safety.”

The biggest deal breakers when looking for child care reflected parents’ overall focus on safety. For example, 48% of parents said the presence of other adults (not including staff) was unacceptable in a child care setting.

“Parents were clear that certain characteristics would automatically remove a child care or preschool option from their list,” says Clark. “First and foremost is safety.”

Other deal breakers included health-related considerations. About 4 in 10 parents said allowing unvaccinated children to attend child care was a deal breaker and about 3 in 10 would not allow their children in a home or facility where the staff person was a smoker.

The report includes responses from a nationally representative sample of 307 parents who had at least one child between the ages of 1 to 5.

“Our poll demonstrates the challenge of choosing a preschool or child care setting that meets all of a parent’s criteria,” Clark says. “Safety and health factors are important to parents, but too often, parents aren’t sure how to determine if a child care option is safe and healthy.”

Clark says parents should take extra steps to evaluate potential child care or preschool facilities in several different ways. This may include drop-in visits to observe safety features, such as the location of a playground relative to traffic or the security of an entrance.

In reviewing the website for cost and hours of operation, parents should also look for health-related policies like vaccination requirements for children and staff, background checks, and security policies.

Part of this review should also include any other safety or health related inquiries that the parents feel are important, for example whether the child care staff are trained in first aid and emergency response.

“Some health-related characteristics are observable while others, such as how often toys are cleaned, are not as obvious,” Clark says. “The more research parents do ahead of time, the more confident they will feel that their children are in a safe and healthy environment.”