United States General Accounting Office

GAO Report to Congressional Requesters

January 2000 CHILD CARE

State Efforts to

Enforce Safety and

Health Requirements

GAO/HEHS-00-28

GAO United States

General Accounting Office

Washington, D.C. 20548

Health, Education, and

Human Services Division

B-281869 

January 24, 2000

The Honorable Pete Stark

The Honorable George Miller

The Honorable Sander M. Levin

House of Representatives

The need for child care has grown dramatically over the last few decades.

In 1975, 39 percent of women with children under the age of 6 were in the

labor force; by 1997 that number had grown to 65 percent. The work

requirements of the Personal Responsibility and Work Opportunities Act

of 1996 have also increased the demand for child care by moving many

more welfare parents into the workforce than ever before.

To help protect children in child care, states regulate providers by setting

health and safety requirements that child care providers must meet and

enforcing these requirements through activities conducted by state child

care licensing offices. However, most states do not regulate all types of

providers. Nonregulated providers are not required to meet state child

care requirements and are not subject to state enforcement activities.

Examples of nonregulated providers include relatives, such as

grandparents, aunts, and siblings; in-home providers like nannies and au

pairs; some family child care providers caring for small numbers of

children in the provider’s home; and center programs that operate part-day

or part-year.

Though setting and enforcing child care requirements are primarily the

responsibilities of the states and their localities, the federal government

requires that states have basic child care safety and health requirements in

place in order to receive funds from the Child Care and Development

Block Grant (CCDBG).1

 The block grant subsidizes child care costs for

low-income families. To obtain these funds, states must certify to the

federal government that they have in place requirements to protect the

health and safety of children in child care as well as procedures to ensure

that both regulated and nonregulated providers being paid with block

grant dollars comply with these requirements.2

 However, the block grant

1

In fiscal year 1999, the total amount of appropriated block grant money came from two sources.

Approximately $1.2 billion came from the reauthorized CCDBG and was to be used in fiscal year 2000;

approximately $2.2 billion was authorized by section 418(c) of the Social Security Act and is subject to

CCDBG requirements. We refer to the combined funds, which are also known as the Child Care and

Development Fund, as the block grant.

2

States have the option to exempt from health and safety requirements grandparents,

great-grandparents, siblings (if they live in a separate residence), and aunts and uncles.

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does not stipulate the scope or stringency of these requirements or how

states should determine compliance with them.

Because of the significant federal role in paying for child care services,

you have raised concerns about the way in which states ensure the safety

and health of children in child care settings. You asked us to (1) identify

the most critical licensing and enforcement activities that help states

ensure the safety and health of children in child care, (2) describe the

extent to which states conduct these critical activities for their regulated

providers, and (3) explain how states ensure that nonregulated providers

receiving block grant funds meet the law’s safety and health requirements.

To do this work, we conducted a literature search and interviewed child

care licensing experts and state and federal officials. We also surveyed

state licensing directors in 50 states and the District of Columbia about the

extent to which they conduct critical enforcement activities, and all but

one returned a completed questionnaire. The documents on which we

primarily relied to identify critical enforcement activities were the

National Health and Safety Performance Standards (NHSPS)—developed

jointly by the Maternal and Child Health Bureau of the Public Health

Service, the American Academy of Pediatrics, and the American Public

Health Association—and a position paper developed by the National

Association for the Education of Young Children (NAEYC).3

 In addition, we

compared data we collected for a 1992 report,4

 which was based on a

survey of state licensing offices about their activities, with data collected

by our survey for this work to determine whether significant changes had

occurred in state licensing and enforcement activities. We conducted our

work between January and November 1999 in accordance with generally

accepted government auditing standards.

Results in Brief Experts and the literature cite a number of licensing and enforcement

activities important to helping states ensure that providers comply with

state child care requirements. Additionally, they recommend that states

conduct these activities for all types of care provided in a setting other

3

Both documents, developed by expert panels knowledgeable about child care licensing issues,

contain specific recommended practices for licensing offices regarding enforcing child care standards.

The NHSPS also contains recommended safety and health requirements for use by child care programs

and states to structure and deliver high-quality child care services. Neither the NHSPS nor NAEYC

standards constitute federal requirements.

4

Child Care: States Face Difficulties Enforcing Standards and Promoting Quality (GAO/HRD-93-13,

Nov. 20, 1992).

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than the child’s home, except for care provided by relatives. Key among

these activities are

• completing state, and sometimes federal, criminal background checks as

well as child abuse registry checks on prospective providers in order to

screen them for suitability for working with children;

• conducting frequent and unannounced monitoring visits to providers—at

least once a year for centers and once every 5 years for homes—to get

firsthand knowledge regarding a provider’s compliance with requirements

as well as to help the provider achieve compliance; and

• having an array of sanctions available, including the authority to revoke a

license, so that providers who consistently or flagrantly violate

requirements for protecting the safety and health of children can be

prohibited from providing care to children.

To effectively and consistently carry out these critical activities, experts

and the literature recommend that licensing staff be adequately trained in

child care or related fields and have at least 24 hours per year of ongoing

training. Furthermore, licensing offices should have sufficient numbers of

staff to maintain caseloads at about 75 providers for each licensing staff

person so that staff have time to adequately conduct all their activities.

Most states’ policies for conducting background checks and monitoring

visits are generally consistent with recommended enforcement practices.

For example, 46 states said that they visit child care centers one or more

times a year, and 36 states reported visiting family child care homes at

least once every 5 years. Both practices meet or exceed the recommended

practices. States’ reported success in following the recommended

practices for visits appears to be related to increases in

full-time-equivalent (FTE) staff and budgets for licensing offices, which

increased on average by 53 percent and 44 percent, respectively, between

1996 and 1999. In addition, most states reported having an array of

sanctions to use, such as imposing fines, to bring providers into

compliance, and all stated that they had the authority to revoke a license.

Approximately half of the states reported that they require staff to have

education and experience in child care or a related field as well as ongoing

training, though only four states required 24 hours or more of training per

year, as recommended. Only 11 states reported caseloads at or below the

recommended 75 facilities per staff person, with about a third of the states

at 150 or more facilities per staff person. And while states conduct many of

the critical licensing and enforcement activities for their regulated

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providers, only two states reported regulating all types of care outside the

child’s home, except for relative care, as recommended.

The enforcement activities that a state conducts under its normal licensing

processes for regulated providers also satisfy the safety and health

requirements of the block grant. For providers that states have chosen not

to regulate, some states conduct activities usually reserved for regulated

providers. For example, 20 states reported conducting background checks

on nonregulated providers, while about 6 states reported making

monitoring visits to them. However, many states typically provide

packages of materials informing nonregulated providers of the safety and

health requirements they must meet and ask them to certify that they will

comply with the requirements. The trade-off states face is that, on the one

hand, relying on a self-certification process has the potential to reduce the

costs to parents and states that are associated with greater oversight. On

the other hand, self-certification does not afford as much assurance that

the requirements—which the block grant says states must have—are being

met by nonregulated providers as does the level of oversight for regulated

providers.

Background States are responsible for protecting the safety and health of children in

child care settings, which they pursue by developing requirements that

care providers must meet and conducting activities to ensure they do so.

While the federal government’s role is limited in this area, the block grant

does require states to certify that safety and health requirements, as well

as procedures to ensure compliance by providers, are in effect in order for

states to receive block grant funds.

State Responsibilities for

Safety and Health in Child

Care

Parents who need child care services select from different types of child

care providers: in-home care, in which a child is cared for by a provider

such as an au pair or nanny in the child’s home; family child care or group

home care, in which the child is cared for in the provider’s home;5

 and

center care, in which a child is cared for by providers in a nonresidential

setting, such as in a church, school, or business. Additionally, care can be

provided by someone related to the child other than the parents, such as

grandparents, aunts, uncles, or siblings, which is referred to as relative

care.

5

Typically, family child care consists of one provider caring for six or fewer children. Group home care

usually involves two providers caring for 7 to 12 children.

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States and localities are responsible for regulating child care providers so

that the safety and health of children are protected in child care settings.

States carry out this responsibility by (1) establishing specific

requirements that regulated child care providers must comply with in

order to legally operate and (2) enforcing these requirements through

activities conducted by state licensing offices. While states’ child care

requirements also cover supervision and curriculum, they focus mostly on

basic safety and health requirements, such as keeping smoke detectors in

working order, locking cabinets that contain dangerous materials, and

ensuring that children in care have up-to-date immunizations. The

licensing and enforcement activities, which are prescribed in state laws

and regulations, include screening potential providers for suitability by

checking medical and criminal background histories, making visits to

providers to observe firsthand if requirements are being followed, and

imposing sanctions on providers found to be out of compliance with the

requirements. The stringency of the requirements with which providers

must comply and the scope and intensity of state enforcement activities

differ among the provider types within states as well as among states

overall.

To decide on a level of enforcement activities, states consider a number of

factors, key among which typically are a state’s budget and staffing

resources to carry out the tasks necessary for enforcing a state’s

regulatory policies. We reported in 1992, for example, that in the early

1990s many states limited the number of monitoring visits that their

licensing offices routinely conducted because of budget cutbacks and the

constrained fiscal climate.6

 While the current fiscal condition of most

states is healthy, funds are not unlimited. Hence, given the competing

priorities for limited funds, states must make choices about the extent to

which they can conduct enforcement activities and the types of providers

to which these activities will apply.

State policies regarding child care regulation are also influenced by the

supply of child care and its cost to parents. Recent research has shown

that some types of child care regulation, such as requiring liability

insurance, may increase the cost of doing business for providers,

particularly for small providers like family and group homes. Providers

may choose to leave the market because they do not wish to spend the

time or incur the expense necessary to comply with a particular

regulation; alternatively, providers may raise their rates to recoup the cost

of complying, thus raising the cost of care to parents.

6

GAO/HRD-93-13, Nov. 20, 1992.

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Roles of the Block Grant

and the Department of

Health and Human

Services

The fiscal year 1999 block grant appropriation provided approximately

$3.4 billion to states to help low-income parents pay for child care.7

 The

law requires that states certify to the federal government that they have

requirements in effect to protect the health and safety of children in child

care. While the block grant does not require states to develop new

requirements if existing ones comply with the statute, it does stipulate that

these requirements cover the following areas: prevention and control of

infectious diseases, building and physical premise safety, and minimum

health and safety training appropriate to the provider setting.8

 States must

also certify that they have procedures in place to ensure that providers

receiving payments from the block grant comply with these requirements.

However, the block grant does not dictate to states the specificity,

stringency, or number of safety and health requirements they must have or

the manner in which they should enforce them.

The enactment of the welfare reform law of 1996, under which the CCDBG

was reauthorized, narrowed the authority of the Department of Health and

Human Services (HHS) to regulate the states. HHS’ role regarding the

enforcement of child care safety and health requirements in particular is

limited to checking that states applying for block grant funds have

certified and described the requirements and procedures for enforcement

that they have in effect. Specifically, HHS reviews state plans, which must

be submitted to HHS every 2 years, to determine state eligibility for block

grant funds. These plans describe, among other things, states’ safety and

health requirements and their procedures for ensuring provider

compliance with them. In addition, HHS provides technical assistance and

information to states through policy guidance, newsletters, conferences,

and on-site visits and consultations.

Another requirement of the block grant is that states submit data to HHS

about the families they are serving with these funds and the type of care

the children are using. Data reported by states to HHS for fiscal year 1998,

the most recent year for which data are available, show that approximately

28 percent of block-grant-subsidized children nationwide were using

nonregulated providers. This figure differs, however, depending on the

type of child care setting used. For example, only 2 percent of

7

Typically, states pay for child care with block grant funds by providing eligible parents with a voucher

that they take to the child care provider of their choice. The voucher certifies that payment up to an

amount allowed by the state will be made directly to the provider by the state for child care services

rendered. Some child care providers also receive block grant funds through contracts with or grants

directly from the state for child care services provided to eligible children.

8

While states must have requirements in these areas to obtain block grant funds, no national

mandatory health and safety requirements for child care exist.

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block-grant-subsidized children using centers and 1 percent using group

homes were with nonregulated providers, while approximately 54 percent

of block-grant-subsidized children using family child care were being

cared for by nonregulated providers. Very young children, typically from

birth through age 2, are more likely to be cared for in family child care

than older children are.

Several Licensing and

Enforcement

Activities Are Cited as

Critical

Both experts and the literature recommend that a range of licensing and

enforcement activities be conducted to ensure that providers comply with

a state’s child care requirements. Further, they recommend that states

conduct these activities for all providers who care for children outside of

the child’s home, except for relatives.9

 The licensing and enforcement

activities most commonly considered to be critical are listed in table 1.

Table 1: NAEYC- and

NHSPS-Recommended Practices for

Licensing and Enforcement

Critical activity Description

Background checks Before granting a license, state criminal record files and child

abuse registries should be checked for all adults permitted to be

alone with children in a facility. People with less than 5 years of

state residency should receive an out-of-state or federal check.

Monitoring visits Centers and group homes should receive at least one

unannounced inspection per year. Small family child care homes

should receive at least one unannounced visit every 5 years.

Sanctions Sanctions should be a part of the regulatory system and include

an array of enforcement options, such as fines and revocation of

licenses.

Training for licensing

staff

Staff should have appropriate education and experience for the

form of child care they are assigned to inspect. They should

receive at least 24 hours of continuing education each year.

Caseload size Each staff person’s caseload should consist of no more than 75

provider facilities.a

Note: For each activity, we used either the NAEYC or NHSPS recommendation, but not both,

because in some cases one of the documents did not cover a particular enforcement activity, or

in other instances, the recommended practice was not specific enough.

aNAEYC’s standard allows states that do not inspect family child care homes to assume larger

caseloads, but it does not specify how much larger the caseload should be.

Background Checks Background checks involve gathering information from state and federal

databases to determine if providers have a history of child abuse or other

9

The policies of NAEYC and the NHSPS are slightly different, in that NAEYC proposes regulating

providers who care for two or more unrelated children, while NHSPS recommends regulating all

providers who care for children outside the home.

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criminal convictions—in particular, committing violent acts against other

people or sexual molestation of children—that would make them

unacceptable for working with children. Experts and the literature

identified background checks as critical to identifying such individuals

before they are allowed to work with children and as a deterrent to

unacceptable individuals who may consider applying for child care work.

Monitoring Visits Through on-site monitoring visits, licensing officials periodically observe

daily operations and determine providers’ compliance with state

requirements. Visits also provide an opportunity for licensing staff to

educate or consult with providers to help them identify reasonable ways to

comply with child care requirements. Furthermore, experts recommend

making some unannounced visits so that licensing staff are given an

opportunity to see a provider’s operations without the benefit of “best

face” preparations.

Sanctions Sanctions are penalties a state licensing unit may impose when a provider

is out of compliance with state requirements. These sanctions can include,

for example, imposing fines, suspending a license immediately, refusing to

renew a license, and revoking an existing license. Experts believe that the

authority to impose sanctions, and in particular to revoke a license, makes

providers take seriously the state’s child care requirements and its efforts

to enforce them.

Training for Licensing Staff Adequately trained licensing staff are also critical to the effective

enforcement of a state’s child care requirements. Such training, which

should include both prior education and work experience in child care or

a related field, helps ensure that licensing staff understand the

requirements so they can effectively inform providers how to comply with

the requirements. Ongoing training for licensing staff in such areas as the

application of licensing rules and regulations is also considered important.

Through training, licensing staff also learn to apply the state’s child care

requirements in a consistent and objective manner so that children are

equally protected and providers are treated fairly.

Caseload Size Another critical element of effective licensing and enforcement is having

sufficient staff to carry out licensing and enforcement activities in a

competent and timely manner; one indicator of sufficient staff is caseloads

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that are not too large. A caseload is typically defined as the number of

providers for which one full-time staff person is responsible. The

responsibilities of licensing staff include conducting routine monitoring

visits, giving technical assistance to providers to help them achieve and

remain in compliance, carrying out follow-up visits to determine if

previously cited noncompliance has been corrected, and making visits to

investigate complaints. In addition, staff perform in-office duties, such as

checking documentation to determine a provider’s criminal history,

preparing licensing reports, and preparing for and testifying at

administrative hearings. Adequate staffing allows for the timely handling

of all of these duties.

Experts note, however, that there is only limited agreement on using the

caseload standard of 75 facilities per licensing staff person because a

single standard may not fully account for all the variables that need

consideration when determining an appropriate caseload level. Such

variables include the number of children cared for by individual providers

and programs, state policies for the number of monitoring visits to be

conducted each year, travel time to and from providers, and the

complexity and scope of the requirements to be enforced, to name a few.10

These variables differ among state licensing offices, further complicating

the use of a caseload standard.

States Follow Most

Recommended

Licensing and

Enforcement

Practices for

Regulated Providers

In comparing data reported by states about their licensing and

enforcement activities with the recommended practices identified by

experts and the literature, we found that states generally follow the

recommended practices for their regulated providers regarding

background checks, frequency of monitoring visits, use of unannounced

visits, sanctions, and training of their licensing staff. However, most states

do not have caseloads at the recommended level or regulate all

out-of-home providers, as recommended by the experts.

Most States Conduct State

Criminal History and Child

Abuse Checks; Fewer

Conduct FBI Checks

Background checks on providers include state criminal history checks,

state child abuse registry checks, and Federal Bureau of Investigation (FBI)

checks. All but four states reported conducting at least one type of

background check on child care providers, and many states reported

conducting more than one type of check. According to our survey, checks

for state criminal and child abuse histories typically take a month or less.

Of those states conducting FBI checks, about half reported that the checks

10Technical Assistance Bulletin No. 99-01: Licensing Workload Assessment, National Association for

Regulatory Administration, Apr. 1999, p. 3.

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took between 1 and 3 months, and half reported that these checks took

more than 3 months.

As table 2 shows, a total of 40 states reported requiring state criminal

background checks for family child care providers, 32 for group home

providers, 40 for center directors, and 39 for center teaching staff.

Regarding state child abuse registry checks, 35 states reported requiring

such checks for family child care providers, 30 for group home providers,

32 for center directors, and 29 for center teaching staff. Finally, more

states conduct state criminal and child abuse checks than FBI checks

across provider types.

In addition, many states reported conducting checks on individuals other

than those working directly with children who could have contact with the

children in care. For example, 38 states reported conducting state criminal

checks on a family child care provider’s spouse, while 28 states reported

conducting this check for the spouse of a group home provider. (See table

2.)

Table 2: Number of States That

Reported Conducting Background

Checks on Regulated Providers, by

Type of Check and Provider, 1999

Types of background

checks

State criminal

background

checks

State child abuse

registry checks FBI checks

Family child care

Provider 40 35 16

Provider’s assistant 37 32 13

Provider’s spouse 38 32 12

Provider’s minor children 14 18 1

Other adults living in the

provider’s home 37 30 11

Group homes

Provider 32 30 14

Provider’s assistant 32 28 12

Provider’s spouse 28 25 9

Provider’s minor children 9 14 0

Other adults living in the

provider’s home 27 24 9

Centers

Center director 40 32 16

Teaching staff 39 29 15

Other nonteaching staff 36 25 12

Note: Forty-three states reported data for group homes in 1999, although three of these states

refer to group homes as “small child care centers.”

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To determine if the number of states that reported conducting background

checks has changed over the years, we compared these results with the

data we collected in 1992. We found that the number of states that

reported conducting state criminal background checks, FBI checks, or both

increased, on average, by about 27 percent across provider types between

1992 and 1999. During this same period, the number of states that reported

conducting child abuse registry checks increased 6 percent for family

child care providers and 11 percent for group homes but remained

constant for child care centers. (See fig. 1.)

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Figure 1: Number of States That Reported Conducting Background Checks on Regulated Providers, 1992 and 1999

0

10

20

30

40

50

Family Child Care Group Homes Centers Family Child Care Group Homes Centers

Number of States

Criminal Checks (State, FBI, or Both) Child Abuse Registry a

29

40

26

34

41

33

35

27

30

32 32 32

1992

1999 b

Note: Forty-three states reported data for group homes in 1999, although 3 of these states refer to

group homes as “small child care centers”; for 1992, 38 states reported data for group homes.

aFor the 1999 data collected on criminal background checks, we combined state responses to

separate questions regarding state criminal checks and FBI checks in order to compare them to

data collected in 1992, when FBI and state criminal checks were not broken out separately.

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bThe 1992 survey did not capture separate data on whether states conducted checks on different

individuals working with a provider, such as a center director or provider’s assistant, while the

1999 survey did. Therefore, in analyzing the 1999 survey responses, we counted a state as

conducting a check if it did so for a provider, teacher assistant, or center director. Hence, in

some cases, the totals in table 2 may not match the totals for 1999 in this figure.

Most States Conduct

Monitoring Visits in

Accordance With

Recommended Practices

According to data reported to us through our survey, in 1999 46 states met

or exceeded the recommended number of monitoring visits for centers,

and 35 states did so for group homes.11 Similarly, monitoring activities for

family child care homes in 36 states also reflected the recommended

practice of visiting at least once every 5 years.12 Twenty-eight states met or

exceeded the recommended practice for family child care homes by

visiting them at least once a year. (See table 3; app. I presents the

frequency of monitoring visits by state.)

11Our survey asked questions about states’ policies for the frequency of monitoring visits as well as

about the actual practices. In almost all cases, states’ responses to both the policy and practice

questions were the same.

12The recommended practice also stipulates that all homes be regulated except homes in which care is

provided by relatives. Most states do not regulate their family child care homes to the extent outlined

in the recommended practice. See the discussion of exemptions later in this report.

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Table 3: Frequency of States’

Monitoring Visits to Providers, 1999

Number of monitoring visits per yeara

Number of

states

Family child careb

Less than once a year 8

At least once a year 12

At least twice a year 16

Group homesc

Less than once a year 6

At least once a year 14

At least twice a year 21

Centers

Less than once a year 4

At least once a year 17

At least twice a year 29

Note: Forty-three states reported data for group homes in 1999, although three of these states

refer to group homes as “small child care centers.”

aThese calculations are based on visits to providers conducted by states for both license renewal

and routine compliance.

bData for 14 states are not included in this table for the following reasons: 6 states reported that

they do not inspect family child care providers, and 8 states reported conducting visits on the

basis of a random sample of family child care providers.

cForty-three states reported data for group homes. Data for two of these states are not included in

this table because these states conduct visits on the basis of a random sample of group home

providers.

In addition to visiting providers as often as recommended, most states

reported that monitoring visits were unannounced, as recommended,

meaning either that no advance warning was given to the provider that

licensing staff would be visiting or that less than a day’s notice was given.

Specifically, 39 states reported making unannounced visit to centers, and

33 said they did so for group homes and family child care homes.13

Comparing how frequently states reported visiting providers in 1999 with

data reported to us in 1992, we found that the number of visits per year

generally increased for all provider types during these 7 years. For

example, the number of states reporting that they conducted visits two or

more times a year approximately doubled for all provider types between

1992 and 1999, as shown in figure 2.

13As with the frequency of monitoring visits, our calculations are based on data for both license

renewal and compliance visits.

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Figure 2: Frequency of Monitoring Visits Reported by States, 1992 and 1999

0

5

10

15

20

25

30

At Least

Twice

a Year

At Least

Once a 

Year

Less Than

Once

a Year

At Least

Twice

a Year

At Least

Once a 

Year

Less Than

Once

a Year

At Least

Twice

a Year

At Least

Once a 

Year

Less Than

Once

a Year

Number of States

Family Child Care

23

8

13

9

16

9

6

21

14

8

21

12

1992

1999

9

4

17

13

29 29

Group Homes Centers

Increased Resources and

Smaller Caseloads Appear to

Account for More Frequent

Visits

While states reported increases in the number of visits to all provider types

between 1992 and 1999, more states reported visiting centers more often

than any other provider type. As figure 2 shows, 29 states reported visiting

centers two or more times a year in 1999. States that reported visiting

centers this often tended to have smaller caseloads—smaller numbers of

provider facilities per FTE licensing staff person—than those states visiting

less often; these states also had larger average increases in FTE staff and in

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their budgets (see app. II for state budget and FTE data). For example, the

average caseload for states that reported conducting visits to centers two

or more times a year was 125 providers for each licensing staff person; for

states visiting centers less often, the average caseload was 159. Similarly,

state licensing offices conducting visits twice or more a year had increased

their FTEs and budgets, on average, by 57 percent and 68 percent,

respectively, between 1996 and 1999. For those states visiting less often,

FTEs increased an average of 28 percent, while budgets increased an

average of 37 percent. Overall, state licensing budgets and FTEs increased,

on average, by 53 percent and 44 percent, respectively, between 1996 and

1999.

States Have a Variety of

Sanctions Available,

Including License

Revocation

States reported having a range of sanctions to use to help bring providers

into compliance and keep them in compliance with child care

requirements. Furthermore, all states reported having the authority to

revoke or suspend a provider’s license for repeated noncompliance or an

egregious violation of state child care requirements, such as neglecting or

abusing a child (see fig. 3). Sanctions states can use vary, but more serious

sanctions include changing a provider’s license to a time-limited

provisional license, refusing to renew a license, and suspending or

revoking a license.

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Figure 3: Number of States Reporting Various Sanctions Available for Use

0 10 20 30 40 50

Suspend or Revoke a License

Deny or Fail to Renew a License

Impose Administrative

or Court-Ordered Fines

Restrict the Terms of a License

Change the Status of a 

License to Provisional

Extend the Time That a 

License Remains Provisional

Number of States

50

50

30

32

35

39

Types of Sanctions Available

About Half the States

Follow Recommended

Practice for Staff

Preservice Training

Requirements

Almost half the states reported having preservice training requirements14

for licensing staff that mirror the recommended training standard; that is,

applicants for licensing inspector positions should have appropriate

education and experience in the child care field before assuming a

licensing position. Although 26 states require ongoing training, only 4

specifically follow the recommended practice by requiring at least 24

hours of training; most do not require a specific amount (see fig. 4).

14Preservice requirements are the qualifications needed by a prospective employee to be hired for a

specific position.

Page 17 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

Figure 4: Number of States Reporting Various Training Requirements for Licensing Staff

0 5 10 15 20 25 30 35

At Least 24 Hours of

Ongoing Training per Year

Ongoing Training

Passing a Written Test

Education in Related Field

Experience in Related Field

Education and Experience

in Related Field

Number of States

4

26

7

33

23

32

Types of Training Required

Caseloads in Most States

Are Larger Than

Recommended

Our analysis of the data states reported in our survey indicates that 11

states have caseloads at or below the recommended level of 75 facilities

per inspector (see app. III for more complete caseload data). The

remaining states were above this level, with about one-third having

caseloads more than twice the recommended level. (See fig. 5.)

Page 18 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

Figure 5: Caseload Ranges for State Licensing Staff

aThe District of Columbia falls in the 76-100 caseload range.

At the same time that state data show few states maintaining caseloads at

recommended levels, states reported that they were visiting providers as

often as recommended, and in several cases, more often. Such

inconsistencies in data could be due, in part, to (1) the caseload standard

itself, which experts note does not fully account for individual state

Page 19 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

variables or time-saving measures that might allow states to operate

effectively with larger caseloads than are recommended; (2) the trade-offs

that licensing staff make, which were not captured in our survey, such as

maintaining their schedule for monitoring visits at the expense of

performing other duties, including processing applications, providing

consultation, or documenting monitoring visits in a timely manner; or

(3) inaccuracies in some of the reported data used to calculate caseload

size and frequency of monitoring visits.

Almost All States Report

Exempting Some Providers

From Regulation

While recommended practice is that all providers, except relatives, who

care for children outside of the child’s home be regulated, almost all states

exempt some types of out-of-home providers other than relatives from

regulation. States vary, however, in their choice of providers to exempt, as

table 4 shows.

Table 4: Types of Providers States

Reported They Regulated and

Exempted From Regulation, 1999

Number of states

Type of provider Licenseda

Registered or

certifieda Exempted

Nonrelative family child

care

30 18 39

Group homes 35 6 2

Centers

Commercial 47 2 0

Religious 43 7 3

School-based preschool 27 5 11

School-based after-school 33 4 13

Recreation 18 1 20

Work site 46 3 1

Federalb 20 2 21

State/localb 38 5 6

aLicensing is generally a stricter form of regulation than registration or certification. States require

licensed providers to comply with requirements that are more numerous and stringent; states also

conduct monitoring visits more frequently for licensed providers.

bThese categories include child care facilities operated by or on the property of federal, state, or

local governments.

Only 2 states—Kansas and Connecticut—reported regulating all of the 10

provider types listed in table 4, although 26 states reported exempting only

1 or 2 of the provider types.

Page 20 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

As shown in table 4, many states regulate certain providers within a

category while exempting other providers in the same category. For

example, a full-day preschool program might be regulated by a state while

a part-day preschool program might be exempted. This is especially true

for family child care, for which the number of children a provider cares for

determines whether or not the provider will be regulated by the state. As

figure 6 illustrates, these numbers have been changing: more states

allowed family child care providers to care for more children without

being regulated in 1999 than in 1992.

Page 21 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

Figure 6: Regulation Thresholds as Represented by Number of Children Cared for in Family Child Care, 1992 and 1999

0

5

10

15

20

25

30

One Two to Four Five or More

Number of States

28

11

6

10

14

20

1992

1999

Number of Children Cared for by Family Child Care Provider

a

b

c

Note: Data from the annual licensing survey of the Children’s Foundation, a nonprofit national

education organization, were used for 1992 and, in a few cases, for those states that provided

incomplete data in 1999.

aStates in this category would exceed NAEYC’s recommended practice of regulating providers

who care for two or more unrelated children.

bForty-four states (including the district of Columbia) responded to this question. Data from seven

states are not included in our analysis because family child care providers in these states were

not required to be regulated in 1992.

Page 22 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

c1999 data for five states are not included because these states regulate family child care homes

on the basis of the number of children from the same family rather than simply the number of

children cared for.

Many States Rely on

Self-Certification for

Nonregulated

Providers to Enforce

Block Grant Safety

and Health

Requirements

For regulated providers, meeting the block grant safety and health

requirements is accomplished through adhering to states’ normal licensing

and enforcement requirements. Nonregulated providers who provide care

that is subsidized by the block grant must also meet applicable state and

local safety and health requirements. However, the block grant gives states

wide discretion in determining the scope and stringency of the

requirements for nonregulated providers as well as the approach states

take to enforce these requirements. HHS reviews and approves a state’s

approach before the plan can take effect.15 We found that many states

provide packages of materials to nonregulated providers to inform them of

the state requirements; some others are also applying two critical

enforcement activities: background checks and visits.

Many States Provide

Information Packages and

Use Self-Certifications

A common approach used by states to inform nonregulated providers

about applicable requirements is to give providers packages of materials

that explain what the requirements are. In total, 28 states told us that they

use this approach. Similarly, to help ensure compliance with the

requirements, many states rely on a “self-policing” approach, requiring

either the provider or parent to sign a form certifying that the provider will

meet the requirements. In their block grant plans for 1997-99, 21 states

reported using this approach to ensure compliance with the standard for

nonregulated family child care homes, 4 used it for group homes, and 8

used it for centers.

Background Checks and

Monitoring Visits Are Also

Used

According to our survey, some states reported that they are employing

enforcement activities for unregulated providers that have traditionally

been reserved for regulated providers—background checks and

monitoring visits—although more report conducting checks than visits.

Specifically, 20 states reported conducting background checks on

nonregulated providers receiving block grant funds; 6 states reported

conducting visits; and 4 states reported doing both.

In a few states, the state agency responsible for administering the block

grant funds requires that visits or checks be done. In one state, for

15Plans may include a description of how states will ensure that nonregulated providers meet the block

grant’s safety and health requirements.

Page 23 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

example, the state block grant agency makes background checks and

monitoring visits by the state child care licensing office a condition of the

funding agreement between a provider and the block grant agency.

Similarly, seven states reported that they require nonregulated providers

to become regulated as a condition for receiving block grant funds.

State licensing officials told us that, in some instances, they lack the

statutory authority to conduct background checks on, and monitoring

visits to, nonregulated providers who receive block grant funds. Block

grant officials in six states said that, because nonregulated providers are

specifically exempted from child care regulation by state law, the states

lacked the authority to conduct such regulatory activities. We were also

told that in such cases state law would need to be changed in order to

conduct these types of activities.

Conclusions The mission of state child care licensing offices is to help protect the

safety and health of children in settings outside of their home. And,

although challenged by growing child care demand, licensing offices

reported carrying out many key licensing and enforcement activities for

their regulated providers at levels recommended by experts and the

literature.

However, to ensure that nonregulated providers receiving block grant

funds are meeting block grant safety and health requirements, many states

rely solely on a certification process in which providers attest to the state,

usually by signing a form, that they will meet the requirements. It is not

surprising that states use less resource-intensive methods to enforce block

grant requirements for these providers, because they ordinarily fall outside

the states’ normal licensing process and because there are concerns about

the effects of regulation on the supply and cost of care. There is a

trade-off, however. Self-certification affords less assurance that safety and

health requirements—which the block grant says the states must

have—are being met by nonregulated providers than does the level of

oversight for regulated providers.

Agency and Other

Comments

We provided officials of the Administration for Children and Families

(ACF), HHS; the National Association for Regulatory Administration (NARA);

and NAEYC an opportunity to comment on a draft of this report. ACF, NARA,

and NAEYC provided technical comments, which we incorporated as

appropriate.

Page 24 GAO/HEHS-00-28 Child Care Enforcement
B-281869 

We are sending copies of this report to the Honorable Olivia Golden,

Assistant Secretary for Children and Families, HHS; appropriate

congressional committees; and other interested parties. We will also make

copies available to others on request.

If you or your staff have any questions about this report, please contact me

or Karen Whiten on (202) 512-7215. Janet L. Mascia and Katrina Ryan

made key contributions to this report.

Cynthia M. Fagnoni

Director, Education, Workforce,

 and Income Security Issues

Page 25 GAO/HEHS-00-28 Child Care Enforcement
Contents

Letter 1

Appendix I 

Frequency of

Licensure and

Monitoring Visits in

the States

28

Appendix II 

State Child Care

Licensing Budget and

Full-Time-Equivalent

(FTE) Staffing Levels,

1996 and 1999

35

Appendix III 

State Caseloads,

Fiscal Year 1999

37

Tables Table 1: NAEYC- and NHSPS-Recommended Practices for

Licensing and Enforcement

7

Table 2: Number of States That Reported Conducting

Background Checks on Regulated Providers, by Type of Check

and Provider, 1999

10

Table 3: Frequency of States’ Monitoring Visits to Providers, 1999 14

Table 4: Types of Providers States Reported They Regulated and

Exempted From Regulation, 1999

20

Figures Figure 1: Number of States That Reported Conducting

Background Checks on Regulated Providers, 1992 and 1999

12

Figure 2: Frequency of Monitoring Visits Reported by States, 1992

and 1999

15

Figure 3: Number of States Reporting Various Sanctions Available

for Use

17

Page 26 GAO/HEHS-00-28 Child Care Enforcement
Contents

Figure 4: Number of States Reporting Various Training

Requirements for Licensing Staff

18

Figure 5: Caseload Ranges for State Licensing Staff 19

Figure 6: Regulation Thresholds as Represented by Number of

Children Cared for in Family Child Care, 1992 and 1999

22

Abbreviations

ACF Administration for Children and Families

CCDBG Child Care and Development Block Grant

FBI Federal Bureau of Investigation

FTE full-time-equivalent

HHS Department of Health and Human Services

NARA National Association for Regulatory Administration

NHSPS National Health and Safety Performance Standards

NAEYC National Association for the Education of Young Children

Page 27 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

Alabama

Family day care 2 Yes Once every 2 years 1.0

Group homes 2 Yes Once every 2 years 1.0

Centers 2 Yes Once every 2 years 1.0

Alaskaa

Arizona

Family day care 3 Yes Twice a year 2.3

Group homes 3 Yes Twice a year 2.3

Centers 3 Yes Once a year 1.3

Arkansas

Family day care 1 No Three times a year 3.0

Group homes 1 No Three times a year 3.0

Centers 1 No Three times a year 3.0

California

Family day care License is nonexpiring b Less than once every 2

years

0.4

Group homes License is nonexpiring b Less than once every 2

years

0.4

Centers License is nonexpiring b Once a year 1.0

Colorado

Family day care License is nonexpiring Yes Once every 2 years 0.5

Group homes License is nonexpiring Yes Once every 2 years 0.5

Centers License is nonexpiring Yes Once every 2 years 0.5

Connecticut

Family day care 2 No Less than once every 2

years

0.4

Group homes 2 No Once every 2 years 0.5

Centers 2 No Once every 2 years 0.5

Delaware

Family day care 1 No Once a year 1.0

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

District of Columbia

Family day care 1 Yes Once a year 2.0

Group homes b b b b

Centers 1 Yes Once a year 2.0

(continued)

Page 28 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

Florida

Family day care 1 Yes Twice a year 3.0

Group homes b b b b

Centers 1 Yes Three times a year 4.0

Georgia

Family day care 1 No Random sample of 10%

of registered providers

Random sample

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Hawaii

Family day care 1 Yes Once a year 2.0

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Idaho

Family day care 2 b Not inspected Not inspected

Group homes 2 Yes b 0.5

Centers 2 Yes b 0.5

Illinois

Family day care 3 Yes Once a year 1.3

Group homes 3 Yes Once a year 1.3

Centers 3 Yes Once a year 1.3

Indiana

Family day care 2 Yes Once a year 1.5

Group homes 2 Yes Once a year 1.5

Centers 2 Yes Once a year 1.5

Iowa

Family day care 1 No Random sample of 20%

of registered providers

Random sample

Group homes 1 No Random sample of 20%

of registered providers

Random sample

Centers 1 Yes Twice a year 3.0

Kansas

Family day care 1 No Not inspected Not inspected

Group homes License is nonexpiring Yes Once a year 1.0

Centers License is nonexpiring Yes Once a year 1.0

(continued)

Page 29 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

Kentucky

Family day care b b Not inspectedc Not inspectedc

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Louisiana

Family day care b b Not inspectedc Not inspectedc

Group homesd 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Maine

Family day care 1 Yes b 1.0

Group homesd 1 Yes b 1.0

Centers 1 Yes b 1.0

Maryland

Family day care 2 Yes Once every 2 years 1.0

Group homes b b b b

Centers 1 Yes b 1.0

Massachusetts

Family day care 3 Yes Less than once every 2

years

0.7

Group homes 3 Yes Once a year 1.3

Centers 2 Yes Once a year 1.5

Michigan

Family day care 3 No Random sample of 10%

of registered providers

Random sample

Group homes 2 Yes Once a year 1.5

Centers 2 Yes Once a year 1.5

Minnesota

Family day care 2 Yes Once every 2 years 1.0

Group homes 2 Yes Once every 2 years 1.0

Centers 2 Yes Once every 2 years 1.0

Mississippi

Family day care 1 Yes Twice a year 3.0

Group homes 1 Yes Twice a year 3.0

Centers 1 Yes Twice a year 3.0

(continued)

Page 30 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

Missouri

Family day care 2 Yes Twice a year 2.5

Group homes 2 Yes Twice a year 2.5

Centers 2 Yes Twice a year 2.5

Montana

Family day care 3e Yes Random sample of 20%

of registered providers

Random sample plus 0.3 for

renewal

Group homes 3e Yes Random sample of 20%

of registered providers

Random sample plus 0.3 for

renewal

Centers 3e Yes Twice a year 2.3

Nebraska

Family day care License is nonexpiring Yesf Once a year 1.0

Group homes License is nonexpiring Yesf Once a year 1.0

Centers License is nonexpiring Yesf Twice a year 2.0

Nevada

Family day care 1 Yes Twice a year 3.0

Group homes 1 Yes Twice a year 3.0

Centers 1 Yes Twice a year 3.0

New Hampshire

Family day care 3 Yes Once a year 1.3

Group homes 3 Yes Once a year 1.3

Centers 3 Yes Once a year 1.3

New Jersey

Family day care 3 Yes Random sample of 20%

of registered providers

Random sample plus 0.3 for

renewal

Group homesd 3 Yes Once a year 1.3

Centers 3 Yes Once a year 1.3

New Mexico

Family day care 1 Yes Twice a year 3.0

Group homes 1 Yes Twice a year 3.0

Centers 1 Yes Twice a year 3.0

New York

Family day care 1 No Random sample of 21%

of registered providers

Random sample

Group homes 2 Yes Once a year 1.5

Centers 2 Yes Once a year 1.5

(continued)

Page 31 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

North Carolina

Family day care License is nonexpiring b Random sample of 5% of

registered providers

Random sample

Group homes b b b b

Centers License is nonexpiring b Once a year 1.0

North Dakota

Family day care 1 Yes Twice a year 3.0

Group homes 1 Yes Twice a year 3.0

Centers 1 Yes Twice a year 3.0

Ohio

Family day care 2 Yes Twice a year 2.5

Group homes 2 Yes Twice a year 2.5

Centers 2 Yes Twice a year 2.5

Oklahoma

Family day care 2 Yes Three times a year 3.5

Group homes b b b b

Centers 2 Yes Three times a year 3.5

Oregon

Family day care 2 No Not inspectedc Not inspectedc

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Pennsylvania

Family day care 2 No Random sample of 10%

of registered providers

Random sample

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Rhode Island

Family day care 2 Yes b 0.5

Group homes 1 Yes b 1.0

Centers 1 No Twice a year 2.0

South Carolina

Family day care 1 No Not inspected Not inspected

Group homes 2 Yes Twice a year 2.5

Centers 2 Yes Twice a year 2.5

(continued)

Page 32 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

South Dakota

Family day care 2 Yes Once every 2 years 1.0

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Tennessee

Family day care 1 Yes Three times a year 4.0

Group homes 1 Yes Three times a year 4.0

Centers 1 Yes Three times a year 4.0

Texas

Family day care License is nonexpiring b At least once every 3

years

0.4

Group homes License is nonexpiring b Once a year 1.0

Centers License is nonexpiring b Once a year 1.0

Utah

Family day care 1 Yes Twice a year 3.0

Group homes 1 Yes Twice a year 3.0

Centers 1 Yes Twice a year 3.0

Vermont

Family day care 1 No Once every 2 years 0.5

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Virginia

Family day care Varies according to

past performance

Yes Twice a year 2.0

Group homes b b b b

Centers Varies according to

past performance

Yes Twice a year 2.0

Washington

Family day care 3 Yes Once every 2 years 0.8

Group homes 3 Yes Once every 2 years 0.8

Centers 3 Yes Once a year 1.3

West Virginia

Family day care 1 Yes b 1.0

Group homes 2 Yes b 0.5

Centers 2 Yes b 0.5

(continued)

Page 33 GAO/HEHS-00-28 Child Care Enforcement
Appendix I 

Frequency of Licensure and Monitoring

Visits in the States

State

Number of years for

which license is

issued

Does the state

conduct renewal

visits?

Frequency of routine

compliance visits

Frequency of visits per

year (includes both

renewal and routine

compliance visits)

Wisconsin

Family day care 2 Yes Once a year 1.5

Group homes b b b b

Centers 2 Yes Twice a year 2.5

Wyoming

Family day care 1 Yes Once a year 2.0

Group homes 1 Yes Once a year 2.0

Centers 1 Yes Once a year 2.0

Note: “Less than once every 2 years” and “at least once every 3 years” are denoted as “.4”

years.

aAlaska did not respond to the survey.

bFor varying reasons, data were unavailable.

cThese providers may be inspected by another state agency.

dWhile these states provided group home category data, they refer to group homes as “small

child care centers.”

eLicense is issued for up to 3 years.

f

Renewal consists of only a one-time visit.

Page 34 GAO/HEHS-00-28 Child Care Enforcement
Appendix II 

State Child Care Licensing Budget and

Full-Time-Equivalent (FTE) Staffing Levels,

1996 and 1999

State

1996 child care

licensing

budget

1999 child care

licensing

budget

Percentage

change in

budget from

1996 to 1999

1996 FTEs for

child care

licensing

1999 FTEs for

child care

licensing

Percentage

change in

FTEs from

1996 to 1999

Alabama a a a 14 16 +14

Alaska b b b b b b

Arizona a a a 23 25 +9

Arkansas a $2,170,972 a 35 35 0

California $58,166,095 77,405,725 +33 197 197 0

Colorado 2,600,000 2,900,000 +12 a 25 a

Connecticut 1,633,900 1,750,000 +7 34 36 +6

Delaware a 1,689,841 a 12 14 +17

District of Columbia 868,000 1,186,000 +37 6 7 +17

Florida 4,607,021 5,719,145 +24 88 75 –15

Georgia a 4,017,676 a a 49 a

Hawaii 3,881,080 9,556,728 +146 a 0 a

Idaho a a a a a a

Illinois a a a a 171 a

Indiana 800,000c 2,152,464 +169 24 34 +42

Iowa a a a 18 a a

Kansas 1,253,588 2,596,754 +107 48 55 +15

Kentucky 7,989,300d 8,888,500d +11 9 21 +57

Louisiana 1,600,000 1,800,000 +13 0 0 a

Maine 350,000 600,000 +71 9 11 +22

Maryland 7,585,171 8,438,215 +11 132 126 –5

Massachusetts 6,000,000 7,000,000 +17 a 69 a

Michigan 7,500,000 8,000,000 +7 83 93 +12

Minnesota 3,237,653e 3,320,013e +3 114 114 0

Mississippi 350,000 750,000 +114 5 15 +200

Missouri 3,800,000 5,000,000 +32 69 86 +25

Montana a a a 10 12 +20

Nebraska a a a 28 28 0

Nevada a a a 3 17 +467

New Hampshire 638,565 692,576 +8 16 16 0

New Jersey 2,252,600 3,452,400 +53 20f 28f +40

New Mexico a 674,200 a a 15 a

New York 9,868,671 13,498,700 +37 181 234 +29

North Carolina 4,010,000 5,670,000 +41 50 67 +34

North Dakota 81,740 453,400 +455 a 18 a

Ohio 3,495,237 3,999,575 +14 38 66 +74

(continued)

Page 35 GAO/HEHS-00-28 Child Care Enforcement
Appendix II 

State Child Care Licensing Budget and

Full-Time-Equivalent (FTE) Staffing Levels,

1996 and 1999

State

1996 child care

licensing

budget

1999 child care

licensing

budget

Percentage

change in

budget from

1996 to 1999

1996 FTEs for

child care

licensing

1999 FTEs for

child care

licensing

Percentage

change in

FTEs from

1996 to 1999

Oklahoma 3,357,643 5,680,905 +69 89 111 +25

Oregon 1,527,650 2,732,259 +79 17 34 +100

Pennsylvania a 4,500,000 a 67 55 –18

Rhode Island a a a 4 7 +75

South Carolina 1,297,772 1,612,433 +24 15 15 0

South Dakota 329,562 608,110 +85 5 10 +100

Tennessee 1,855,919 1,922,700 +4 62 81 +31

Texas 13,500,000 14,100,000 +4 307 329 +7

Utah a 2,576,798 a a 31 a

Vermont 427,000 629,972 +48 7 7 0

Virginia 5,917,065 6,919,074 +17 50 57 +14

Washington 5,008,000 5,411,000 +8 76 79 +4

West Virginia a a a 2 7 +250

Wisconsin 2,600,000 3,480,800 +34 a 60 a

Wyoming 379,095 444,279 +17 6 6 0

Average +53 +44

aSome states could not provide us with FTE or budget information for particular years.

bAlaska did not respond to the survey.

cThis is an estimate of Indiana’s 1996 state budget for staff only.

dIncludes budget data for all human services licensing.

eBudget data are for state office only.

f

FTE data do not include private agency staff who, under contract with the state, monitor family

child care homes.

Page 36 GAO/HEHS-00-28 Child Care Enforcement
Appendix III 

State Caseloads, Fiscal Year 1999

State

Number of child care

facilities

Number of FTEs for

child care licensing

and enforcement

Caseload (based

on reported

number of

facilities and

FTEs)

Alabama 4,416 16 276

Alaskaa

Arizona 2,258 25 90

Arkansas 3,188 35 91

California 48,983 197 249

Colorado 8,319 25 333

Connecticut 6,142 36 171

Delaware 2,245 14 160

District of Columbia 597 7 85

Florida 8,881 75 118

Georgia 11,207 49 229

Hawaii 1,050 0 b

Idaho 1,425 b b

Illinois 12,794 171 75

Indiana 3,945 34 116

Iowa 6,128 b 60c

Kansas 9,154 55 166

Kentucky 2,037 21d 97

Louisiana 1,850 b b

Maine 3,600 11 327

Maryland 14,193 126 113

Massachusetts 14,110 69 204

Michigan 21,230 93 228

Minnesota 16,205 114 142

Mississippi 1,629 15 109

Missouri 4,513 86 52

Montana 1,818 12 152

Nebraska 4,280 28 153

Nevada 1,066 17 63

New Hampshire 1,191 16 74

New Jersey 3,615 28 129

New Mexico b 15 b

New York 24,390 234 104

North Carolina 9,053 67 135

North Dakota 1,872 18 104

(continued)

Page 37 GAO/HEHS-00-28 Child Care Enforcement
Appendix III 

State Caseloads, Fiscal Year 1999

State

Number of child care

facilities

Number of FTEs for

child care licensing

and enforcement

Caseload (based

on reported

number of

facilities and

FTEs)

Ohio 9,809 66 149

Oklahoma 6,171 111 56

Oregon 11,712 34 75e

Pennsylvania 8,634 55 157

Rhode Island 1,176 7 168

South Carolina 3,749 15 250

South Dakota 1,749 10 175

Tennessee 5,734 81 71

Texas 21,664 329 66

Utah 2,157 31 70

Vermont 1,897 7 271

Virginia 5,923 57 104

Washington 9,350 79 118

West Virginia 400f 7 57

Wisconsin 4,947 60 82

Wyoming 893 6 149

aAlaska did not respond to the survey.

bData were not available.

cIowa could not provide data on FTEs. Instead it provided an estimate of its caseload for child

care centers.

dKentucky’s FTE estimate includes state licensing staff who regulate other human services as well

as child care facilities.

eOregon provided an estimate of its caseload for group homes and centers only.

f

West Virginia could provide data only on the number of its child care centers.

(116027) Page 38 GAO/HEHS-00-28 Child Care Enforcement
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