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American parents choose from a range of child care arrangements in and outside the home, ranging from the informal—friends and family members—to the more formal and regulated child care centers. The diversity of settings makes it difficult to measure and compare care arrangements, but for the purposes of the Care Index, �鶹������ý groups care in four categories: child care centers, family child care homes; (in-home) nanny care;  and family, friend, and neighbor (FFN) care.

Children under 5 in Types of Child Care Arrangements
Each block represents 100,000 U.S. children.

Child care centers provide care in non-home settings. Centers may be operated privately or publicly, nonprofit or for-profit, and may receive funding from the government, parent fees, and/or donations—they range from small centers operated out of church basements to large facilities run by corporate chains. Most centers must be licensed by the state where they operate and follow safety and quality regulations, though some states exempt certain centers, like those run by religious organizations. Most states also have quality rating and improvement systems (QRIS), which rate centers at different levels of quality, above and beyond licensing standards, and offer financial incentives and resources for improving quality. Centers that accept child care subsidies are also subject to federal regulations under the (CCDBG), which provides subsidy funding to states through the Child Care and Development Fund (CCDF). Centers can receive funding to provide food through the USDA’s (CACFP), which imposes additional regulations. Centers can voluntarily seek accreditation from organizations such as the (NAEYC), which sets quality standards above those included in licensing and federal regulations.

Family child care homes are settings in which to a small number of children who are not related to them. Family child care homes are usually less expensive than center care, though, like centers, family child care homes can accept child care subsidies. In most states, family child care homes are supposed to be regulated and licensed to ensure a baseline of safety and quality.  Some states differentiate between “licensed” and “registered” homes, based on the number of children they are allowed to care for and the stringency of quality standards, and some homes may be license-exempt, generally if they are serving a very small number of children. However, regulations and oversight vary widely by state and in many states are extremely minimal, with only limited means of enforcing the regulations that do exist.

Like child care centers, registered family child care homes can participate in , and those that accept subsidy are subject to , even if they are . Licensed homes are usually eligible to participate in state quality rating and improvement systems (QRIS), though with different standards than for child care centers. They can also pursue accreditation by organizations such as the (NAFCC), whose quality standards go beyond basic state licensing requirements, and receive training and support from organizations such as .

Nannies and babysitters provide care in a child’s home. They may be affiliated with a nanny agency or work independently. Nanny care is unregulated, aside from basic (the “nanny tax”), and many parents ignore these laws in favor of paying nannies . Thus, very little reliable data on nanny care exists. One report put nanny use at around 3 percent of professional families and 2 percent of low-income families. The Care Index sample includes a higher share of families using nanny care.

Organizations including the National Domestic Workers Alliance and advocate for better compliance with existing laws and new policies with stronger legal protections for nannies, such as the .

Any discussion of the care landscape would be incomplete without mentioning informal care provided by family, friends, and neighbors. Aside from FFN providers who are paid using child care subsidies and subject to CCDF regulations, FFN care is not regulated or tracked, so its is difficult to determine.

Though FFN caregivers may be paid, many families rely on unpaid care, whether provided by family, friends, and neighbors or by parents themselves. Some parents choose to leave the workforce in order to care for their children full-time. Parents may make this choice due to financial factors such as the high cost of child care, personal or family preference, or both. Though many parents find it rewarding to stay home, the . Although the Care Index focuses on paid care, we believe that unpaid care should also be recognized, valued, and supported through policies such as paid leave and child benefits.