There are usually three or four other handicapped persons in these homes, and the caregivers are employed in shifts. The staff have minimal or no training and the turn over may be continuous. Visits and communication with parents are usually unrestricted. For medical problems, clients are taken to physicians or hospital emergency wards. For schooling and training they are bussed to special schools and training centres.
Some parents take their child home for holidays or weekends.
A large facility of the second option is where 20 to 30 children are cared for in a cottage home with a pediatric setting. This makes full nursing care and physiotherapy cost effective. Playground, special mats, supports, tubs, jacuzzis and other facilities become cost effective. Schooling takes place in the home. A physician is on regular attendance, reviewing general health, nutrition, neurologic and other changes once or twice a week.