Child care outside the home can take place in different settings: centers, family child care homes, and relatives’ homes. Centers are usually large facilities that typically care for more than 13 children and are located in schools, churches, office buildings, and the like. In contrast, family child care is offered by individuals in their homes to a small number of children—usually fewer than six. These providers can be neighbors, friends, or someone families learn about through friends or advertisements. Relative care is care provided by a person related to the child other than a parent. The flexibility of family child care makes it an attractive choice for parents. In contrast to most centers, family child care providers accept infants and young toddlers. Approximately 23 percent of employed women use family child care for children between the ages of 1 and 2, while 20 percent of employed women use it for children under 1. Family child care providers also usually have longer hours, may provide weekend and evening care, and may accommodate the hours of parents working shifts. They are also more likely to offer part-time care. These features are important to many lesser skilled and lower paid employees who tend to work shifts or other untraditional schedules. Part-time care is useful for those in the type of job-training activities in which AFDC mothers participate. Hence, family child care is a frequent choice among low-income families. Between 18 and 20 percent of children under age 5 of poor, single, working mothers are in family child care. Whether provided in centers or in family child care settings, quality care is care that nurtures children in a stimulating environment, safe from harm. Research has documented the elements of care that are associated with quality. They include providers trained in areas such as early childhood development, nutrition, first aid, and child health; small groups and low child-to-staff ratios; low staff turnover; a variety of age-appropriate materials; space that is safe and free from hazards; and settings that are regulated. Experts believe that characteristics such as these are good predictors of whether quality care is being provided. While only a small proportion of the research conducted in this area has focused specifically on quality in family child care settings, researchers believe that the same characteristics apply to any setting. For many years, researchers have known that child care quality, regardless of the setting, is important to all aspects of children’s development—physical, cognitive, emotional, and social. The quality of these settings in preschool years also has implications for children’s development and success later in school. However, new research documents to an even greater degree that how individuals function from preschool through adulthood “hinges, to a significant extent, on their experiences before the age of three.” Research has also shown that quality child care can be most beneficial to economically disadvantaged children. Factors associated with low-income families—minimal parental education, linguistic isolation, single-parenting—increase a child’s risk of doing poorly in school. Quality child care settings can help poor children overcome some of the environmental deficits they experience. While family child care providers in the United States generally have low child-to-staff ratios, they work in isolation from others, are generally not trained in early childhood development, and tend to be unregulated. Hence, the quality in family child care is considered by experts to be quite variable. A study done by the Families and Work Institute, which found 35 percent of the family care providers in their sample were giving inadequate care, recently highlighted these concerns about quality. Although family child care is used by many employed mothers with young children, states and localities generally do not regulate it as they do center care. One study estimated that approximately 82 to 90 percent of family child care is unregulated in the United States. Hence, many family child care providers operate legally but do not have to meet any standards to protect the children’s safety and health. Experts believe that meeting at least some minimal child care standards as a precondition to providing care is an important step in building quality into all child care settings. If a family child care provider wants to become registered or licensed, the process can sometimes be intimidating and costly, especially relative to the low wages most providers earn. Incentives to become registered or licensed are few and providers may encounter barriers and be uncertain that they can charge parents higher fees if they meet requirements that help them provide higher quality of care. Family child care providers also have difficulty getting the information and resources they need to run a successful business and to enhance the quality of care they provide. For instance, family child care providers may be unaware of child care training available in their communities because they usually are not part of a professional organization or linked to other networks that would keep them informed of training opportunities. If they do learn of such training, barriers may prevent them from participating, especially if they are low-income providers. Barriers include the cost of the training, training schedules that conflict with providers’ hours of operation, training tailored to center care rather than family child care, or language differences. As a result, while training, like regulation, is seen by experts as a critical element in improving the quality of child care, it can be difficult for family child care providers to obtain. Many organizations sponsor initiatives to improve the quality of family child care. While their goals, purposes, and approaches to working with providers may differ, an overarching goal of all these efforts is to support providers by developing their professionalism and enhancing the quality of care they provide. Organizations involved with this work include resource and referral agencies, community-based nonprofit organizations, cooperative extension agencies, and public agencies, to name a few. Some focus on one or two activities, such as training, connecting providers to information and resources about health issues, or helping providers get licensed. Others weave together many activities into a more comprehensive network of support. As discussed later in this report, the organizations put together funding from different sources, both private and public, to support their activities. Since we could not identify a single database that provided a comprehensive listing of initiatives targeted at improving the quality of family child care, we developed one through discussions with experts, literature review, and an information request on Internet. Our database, which consists of 195 family child care quality initiatives, was built primarily on the work conducted by the National Center for Children in Poverty, the Families and Work Institute, the National Council of Jewish Women, and MACRO International. By putting together these different information sources and adding information on other initiatives we found, we believe that we have constructed the largest single database of family child care quality improvement initiatives. However, we could not determine the extent to which our database represents the universe of initiatives nationwide. While the database contains information on a number of the initiatives’ characteristics, we used it primarily to determine the funding sources for each initiative. However, while all the initiatives identified their sources of funding, very few provided the amount of funding from each source. We conducted site visits at 11 initiatives in three states: Georgia, Oregon, and California. The sites, which were highlighted in the literature we reviewed or in our discussions with experts, were judgmentally selected. We also visited family child care programs for three branches of the military—the Army, Navy, and Air Force—at installations in Maryland and Washington, D.C. In addition, we (1) interviewed experts and officials from the Administration for Children and Families, the Head Start Bureau, and the Maternal and Child Health Bureau at HHS; the Department of Defense (DOD); and the Food and Nutrition Service at USDA; (2) reviewed the literature about issues in family child care; and (3) analyzed funding data gathered for our database. We performed our work between April and October 1994 in accordance with generally accepted government auditing standards. Our analysis of the 11 initiatives we visited showed three approaches used to foster quality care: (1) support networks; (2) training, recruitment, and consumer education initiatives; and (3) health initiatives. Regarding the last two categories, the initiatives described here employed more than one activity in working with providers; however, we designated them according to their key or primary activities. Appendix I describes each of the 11 initiatives we visited in detail. Characteristics and activities of the 195 initiatives in our database are shown in figures 1 and 2 (the number of providers participating in the initiatives and the services provided by the initiatives, respectively), and table 1 (the initiatives’ funding sources). Five initiatives we visited seek to create a support network for providers.Typically support networks are part of an organization that, through a coordinator and staff, provides resources, support, and ongoing training to a group of family child care providers. For example, the Foundation Center for Phenomenological Research in California enrolls all of its family child care providers in the Montessori Teacher Education program. This program leads to the completion of requirements for the American Montessori Society diploma. Similarly, DOD’s family child care system has an extensive entry-level and ongoing training system. Support network staff usually make regular visits to provide technical assistance, bring supplies and toys, or conduct training. The network also assists providers in becoming registered or licensed. In addition, all five initiatives link their providers to USDA’s food program, which provides federal subsidies for nutritious meals and snacks served in child care facilities, including family child care homes, as long as the providers are state registered or licensed. The food program also provides regular training and monitoring visits. The five network initiatives also help or encourage providers to become members of local family child care associations or informal support groups. Given the large number of family child care providers, the development of associations—seen by experts as an important way to reach, support, and help train providers—is a key strategy in many initiatives focused on family child care. Research on child care quality shows that the types of activities support networks conduct contribute to enhancing the level of professionalism of the provider and, thus, improve the quality of child care.