Effective Child Care and Early Head Start Collaborations that Promote High Quality Comprehensive Care: Part One
Kevin Booth: Good afternoon, everybody, and welcome to Part One of Effective Child Care and Early Head Start Collaborations that Promote High Quality Comprehensive Care. My name is Kevin Booth. I'll be your moderator for today's event; and just to let everybody know, we are recording today's call. To ask questions or seek assistance with us at any time for audio or signing in, both Kavita Casari and I are available. In the lower left hand corner of your screen, you can chat with us by clicking on the private tab and then double-clicking on "Leaders and Assistance."
Now, to begin our presentation today, we wanted to get a sense for what the weather is like where all of you live. And we'll be touching on these functionalities throughout the presentation to gain information from you, as well. So, on this slide we're just going to ask this question: Has it dropped below 50 degrees in your area yet? And to respond, on the left hand side, you'll see an answer set: Yes or No. Please just click on yes or no on the left-hand side of your screen. Has it dropped below 50 degrees in your area yet this month?
Excellent. Thank you. Now it looks like a lot of you are starting to get some of those nice, cool fall evenings and nights, as we've definitely got a majority in that area. So at this point, to officially start this webinar, I'm going pass the floor to one of your hosts for today, Heath Ouellette. Heath?
Heath Ouellette: Thank you, Kevin. Good afternoon, everyone. I'm Heath Ouellette, a technical assistance specialist with the National Infant & Toddler Child Care Initiative at ZERO TO THREE. I'm excited to be here with you. Today's webinar is Part One of a two-part series called Effective Child Care and Early Head Start Collaborations that Promote High Quality Comprehensive Care.
Today we'll be providing a general overview of the collaborations. Part Two of our webinar series, on November 4th, will cover managing finances and collaborations. Joining me here in Washington, D.C. is Sarah Merrill, a senior training specialist and writer with the Early Head Start National Resource Center. We are your hosts today.
Sarah Merrill: Thanks, Heath, and hello to everyone. In our audience today, we're joined by many across the nation, including federal staff, Child Care Development Fund administrators, regional and state partners, as well as staff from Child Care and Early Head Start programs.
And I want to repeat today's live event is being recorded and it will be archived for later viewing on several websites, including the National Infant & Child Care Initiative, the Early Head Start National Resource Center, and the Early Childhood Learning and Knowledge Center, which is also known as the ECLKC. So regardless if you're participating with us today live or accessing us from an archived event, we want to send you a hearty, warm welcome.
Heath: Sarah and I are very pleased to have a panel of guests joining us today. In D.C., we have Shannon Rudisill, the director of the new and officially named Office of Child Care, and Angie Godfrey, the infant and toddler care specialist from the Early -- from the Office of Head Start. We also have two panelists joining us remotely who will be lending their expertise later in the webinar: Sonja Svenson is a program development officer with Oregon's Child Care Division;...
...and Nancy Davidson is the partnership coordinator from Children's Therapy Center, an Early Head Start program in Missouri. As this webinar progresses, we will get an opportunity to hear from all of our guests and to learn about their perspectives. We really appreciate that they will share their expertise during today's presentation. Also with us today are several NITCCI and Early Head Start NRC staff.
Karen Heying, the director of NITCCI, will be facilitating your questions. So as Kevin previously mentioned -- mentioned, ask your questions throughout the live broadcast. Karen will capture those questions and we'll spend some
time addressing them after each panelist.
Sarah: Great. And to get our bearings, we want to get started and recognize that we understand and know that developing and maintaining effective collaborations is difficult, yet when we hear about successes, we hear about amazing outcomes that programs have when they successfully partner. And the purpose of today's discussion is to unpack the challenges and to highlight the triumphs.
So to do this, we're going to discuss the benefits, as well as the opportunities, for collaboration; we're going to provide strategies for states and programs to consider when sponsoring partnerships and collaborations; and we're going to share examples of effective partnerships.
Heath: Both the offices of Child Care and Head Start are very interested in improving the quality for our youngest children. Over the years, collaborations have been important to both, and they continue to be supported through new efforts. As I mentioned earlier, we have with us today Shannon Rudisill and Angie Godfrey. To hear their perspectives, and to talk about the need for collaborations, we would like to get started with Shannon. Shannon, would you share your insight on why it's a priority to develop and foster collaborations between Child Care and Early Head Start?
Shannon Rudisill: Sure. Thanks, Heath. And I have to say I'm so excited to be on this webinar with you all today. Babies and toddlers are one of my favorite topics, and since I have to cover such a wide range of topics and ages in my job, it's always a pleasure when I get a chance to talk about infants and toddlers. And over the next few weeks, I think I'm going to be seeing many of you in person here in D.C. for our joint Birth To Three Institute and addressing you a couple times then, so I'll just say a few words today.
You know, as Heath mentioned, at HHS and the Administration for Children and Families, we're really doing a coordinated approach to early childhood services. And under our Deputy Assistant Secretary for Early Childhood Development, Joan Lombardi, both Yvette Sanchez Fuentes at the Office of Head Start and me and my staff at the Office of Child Care are working on coordinative approaches to helping more low-income children access high-quality care.
That's really the mantra that we've developed. It's the performance goal that we've set for the secretary, that we would help more low-income children access high-quality care, and we both have a work plan document that you may have seen -- there's the OHS "Road Map" that some of you may be familiar with, and here in the Office of Child Care we have our "Pathways to Child Care Excellence" document.
Both of those are focused on quality, and that's really our -- our primary focus, so we have a lot in common. And I would say that while we are interested in pursuing those partnerships across -- in Child Care, actually, we serve zero to 13, but at least across our overlapping age group of zero to five, between Head Start and Child Care, we're really out front with the infants and toddlers.
As you'll recall last -- let's see, summer of 2009, we had the Birth To Three Institute when we brought the Early Head Start and the Child Care infant/toddler specialists together for the first time. So you are really our pioneers in some ways of what's going to be the next phase of collaboration, and I look forward to seeing you in about a week and a half -- or just over a week -- to hear what's happened in the year since we last got together.
One of the things that's really important for us to acknowledge in Child Care is that we have hundreds of thousands of infants and toddlers receiving services under CCDF -- I believe it's about half a million -- and those are the kids that we're most worried about; they're the most vulnerable. They're also the ones that we believe quality matters the most, and so wherever we can work with you to do more comprehensive full-day/full-year quality care, that's what we want to focus on.
I should say that I've looked at some of the statistics about the risks of the kids who participate in CCDF and the kids who participate in Early Head Start, because folks know that you can be in Child Care subsidy up until 85 percent of the state's median income if the state allows it. And so I think there's an impression out there that the kids that we're
serving in Child Care are somehow at less risk than the kids that are in Head Start.
But when you look at who we are actually serving in Child Care, over half of our kids are under the poverty line, 80 percent of them are below 150 percent of poverty. So we really have a direct overlap in terms of -- and 90 percent of our kids are with -- with single parents. So we -- we have a much more direct overlap in terms of the vulnerable population we're serving. However, in Child Care, as I'm sure you know, we're not funded on a per child basis to provide the same kind of comprehensive support that Early Head Start can provide.
And I'm sure Early Head Start partners will be quick to remind me that you're not funded at the level you would need to do that kind of comprehensive support on a full-day/full-year basis. And so that's why we're really interested in bringing this -- this -- you know, these two programs together. And I'm really excited. I read a little background materials about the two models you're going to hear about today, and I know at least one of them, the EQUIP model, was really bolstered by the Recovery Act funding for the -- for Child Care and Early Head Start.
So I'm excited to be learning with you, and this is the first opportunity of several over the next few weeks -- and over the next months and years -- where we're going to be learning together. I appreciate you being willing to be going on this journey with us. Heath? Heath: Thank you, Shannon. It's really great to hear how you and all our leaders are supporting the efforts of those working for families. Angie, can you share your perspective from the Office of Head Start?
Angie Godfrey: Thank you, Heath. I too am really excited to be here today. And I'm the infant/toddler program specialist at the Office of Head Start, but I also bring greetings from Yvette Sanchez Fuentes, who couldn't be here this afternoon. But as Shannon mentioned, the two of them have been working so closely to support collaboration with Office of Head Start and Child Care, and... And we are also aware, as Shannon mentioned, of the numbers of children that overlap,...
...that we serve the most vulnerable children and families in Early Head Start, and Child Care serves the most vulnerable children and families, and it's our goal to work together to provide the best opportunities. And just a couple -- I mean, there are a couple of differences that we're really aware of and trying to work with. Shannon talked about programs funded through CCDF, and we know those are funds that go to states. Head Start and Early Head Start are federal to local.
So we know there are some differences, but we're working really hard to see how we work through those differences to partner and leverage resources in communities to support families year-round, to support the needs of families in early childhood and birth to five, for Head Start to ensure that the needs of families are met through the needs of programs.
For me, I think one the most exciting parts of collaboration, both in my current role and my previous role as a director, is the ability to provide continuity of care -- through the day, through experiences throughout the day, and through having children served in the same site, often with the same staff -- through braiding both Child Care and Head Start funds. And I think that's something we've all learned to appreciate and gives us an idea of where we want to go in terms of offering continuity for infants and toddlers and their families.
And again, to meet the needs of families... The most vulnerable families are not always families who are unemployed, but they may be families who are working but still need services beyond what just Early Head Start can provide, and we're learning how to do that with the help of Child Care so families become much more self-sufficient as they are working and growing their families.
The other thing that I think that is so critical to this is the idea of working with -- building a professional work force. I think we've begun to look at professional development together. Shannon mentioned that the infant/toddler specialists who visit the initiative with NITCCI came in at -- at the 2009 Birth To Three Institute. And we're really happy that we're going to be having new state-based ECE specialists, many of whom will be infant/toddler specialists working with the birth to three population,...
...many of whom bring an early childhood perspective and education and experience with birth to five, and they will
also be coming to the meeting, And we're very happy to be building this professional work -- workforce. The other thing I just want to mention, and I'll -- I'll talk a little more about at the end of the program when I mention another webinar that's coming up, is also working together on the Family Child Care/Early Head Start task order.
It's a wonderful task order that is co-led by me and Don Ramsburg from the Office of Child Care, and we're very excited to be working on that. And we can talk more about that at the end of the at the -- webcast -- just a little plug on that. But I think it's going to be another opportunity to build this strong partnership that we're all -- all hoping will help programs be more successful.
Heath: Thank you so much, Angie. I used to work for an Early Head Start program, and it's really nice to hear how the Office of Head Start has focused on continuity of care through their collaborations, and to -- in an attempt to meet the needs of families while continuing to provide those important comprehensive services. As we begin, we have another survey question for you. This question is: True or False: In the U.S., the average price for full-time center-based child care is $14,591 per year/per child.
So I think on the left hand side of your screen, you'll be able to select true or false to this question. So it looks like just over a quarter of you believe that this is not true, and it looks like just over -- just under three-quarters of you believe that this is a true figure. It is in fact true that $14,591 was the average price being charged. Based on your responses, I imagine that some of you find this number is too high, and others of you think this number is too low.
It's important to note that the average -- that this average price is without regard to the quality of care that is being provided for infants, in which we also know that research has shown us it's mediocre at best throughout the country. If we want the true cost of quality child care, it would be much higher. To look at one piece of this puzzle, we know salaries are the biggest expense for child care centers. In 2009, a full-time child care provider's mean salary was just under $21,000.
To quote Joan Lombardi: "For decades, child care has been subsidized by an underpaid workforce." In contrast, we also know that kindergarten teachers were paid a mean salary of just over $50,00 in 2009. That's almost $30,000 difference more than a child care provider.
You can draw your own conclusions here, but what's important is to note that the average price for infant care is not the true cost of quality care. So, one of the ways that we want to improve the quality for -- of care for infants and toddlers within our current funding system is for Child Care and Early Head Start to play together.
Sarah: Thanks, Heath, for sharing that. And to add on and to sort of summarize what Shannon and Angie were highlighting about the importance of true collaboration efforts -- and especially when they're well done -- it's really important for entities to pool dollars and share their resources, and for programs and states to -- to utilize optimal regulations and standards, And all this is really to help support quality care and comprehensive services in our program practices.
And truly, we do all of this for our infants and toddlers and families within our community because they are, after all, the center and the heart of our work. So now we're going to segue off to really take a look at specific collaboration efforts. But we first want to -- and we're first going to focus on how states can support partnerships through the policies and practices, and let's start by getting a pulse from our viewers.
We have another yes or no survey, and the question is: Are you aware of any policies or practices within your state that support Child Care and Early Head Start collaborations? And it's about, well, 60/40 and it's still fluctuating, but it seems like over half of our viewers are indeed aware of state policies, and then are are some that, if they're there, they're unaware of them or states are beginning to forge them on.
Heath: Sarah, states certainly have an impact on how collaborations can work. Shannon and Angie talked about this in their opening remarks. In some states, when a child care program also provides Early Head Start services, they are required to keep separate funding streams. For example, a child attending 8:30 a.m. to 5:30 p.m. may be funded with Early Head Start funds from 8:30 a.m. to 12:30 p.m., and with Child Care Development Funds from 12:30 p.m. to
Overall, these types of state policies can result -- result in programs receiving only one half to three-quarters of the full reimbursement rate from Child Care Development Funds. It's important to keep in mind, in most states the reimbursement rate is already reduced by 75 percent of the average price. On the flip side, other states have policies supporting braided and/or blended funding.
For example, Child Care Development Funds may pay for the full hours of care, 8:30 p.m. to 5:30 p.m. Early Head Start then adds additional services, such as high teacher-to-child ratios, curriculum, family services, health screenings, and professional development opportunities.
Sarah: Thanks, Heath. And I want to share that the state of Oregon has recently taken initiative to improve the quality of care for their infants and toddlers. And Sonja Svenson is joining us today from Oregon, and she will share their story. Sonja is the program development officer for the Oregon Child Care Division, which is the lead agency of the Child Care Development Fund. Sonja has spend eight years as a workforce policy analyst prior to entering the child care arena in 2002.
And with a background in economics, as well as a background in training and development, she likes being engaged in the child care workforce and in small business development policies. So welcome, Sonja; thank you for being here with us. And I'm hoping that you can share with our audience more information about your role as the program development officer within Oregon, as well a little bit about Oregon's infrastructure.
Sonja Svenson: Well, first off, thank you so much for inviting me to participate in the webinar. I'm always happy to talk about Oregon. My job is to manage the Child Care Development Fund budget and administer all the contracted essential child care services. The division administers over 200 contracts in a biennium. Another unique thing about the lead agency for Oregon, our division is part of the Oregon Employment Department, which is one of three states where the Child Care Development Fund lead agency is located in the state workforce agency.
Child care, for us, equals quality, affordability, accountability, and safety. But we think beyond child care to include other agency programs, such as Early Head Start, Head Start, and Early Intervention. As you know, each state develops plans on how their child care services and quality dollars will be used. Oregon's child care partners have been very instrumental in making decisions on how Child Care Development Fund quality dollars will be used for essential child care services and programs.
The Oregon Commission for Child Care Work Fund Child Care Policy, while the Childhood Care and Education Coordinating Council helps build the state's CCDF plan and implements programs and service -- both are -- are advisory bodies to the Child Care Division.
Sarah: Great, thank you. And can you share a little bit about what Oregon's recent history is regarding the Child Care and Early Head Start collaboration efforts?
Sonja: I'm going to go back to early 2007. The division started conversations with the state Head Start Collaboration Office and local Head Start program operators on how family- and center-based child care could be used for community placements. This full-day/full-care model seems to be the path to providing a continuum of care for very low-income working families with children in Head Start programs. We also wanted to answer the basic question: How can we connect subsidies to quality child development?
The two-year conversations with Head Start evolved into the development of a crosswalk document that outlined the similarities and the differences between Head Start Performance measures, the National Association for the Education of Young Children Accreditation Standards, and Oregon state licensing requirements. The document helped to identify areas where family- and center-based child care could meet Head Start requirements. And this document also formed the basis of standards for community placement.
In addition, the Head Start Act of 2007 required states to have an Early Childhood Advisory Committee. This lead to a
governor's executive order in 2010, which was early this year, that created the Early Childhood Matters Advisory Council in Oregon. The decision was made by Child Care and early childhood policy makers to include ages zero to eight in their policy work, not just zero to five.
Additionally, the state received a National Governor's Association technical assistance grant to work on policies that would create a bridge between Child Care and Early Head Start and Head Start services. But stepping back, I want to talk about some parallel activities that were happening at the same time in the child care arena.
In 2008, a high level concept paper was developed between the division, Child Care partners, including Head Start, and two non-profit organizations -- the Oregon Community Foundation and Children's Institute -- that focused on child development and child advocacy. From this concept paper, an overall umbrella initiative was formed to direct funding to specific, focused, quality improvement efforts now known as the Education & Quality Investment Partnership, or EQUIP. Sarah: That's great. And can you share a little bit more about what's the purpose of EQUIP?
Sonja: EQUIP's purpose is to improve the quality of child care, strength -- strengthen the childhood and education workforce, and to prepare -- prepare our youngest for a lifetime success. Although it's not included the tagline, another purpose is to stabilize the statewide supply of child care.
The components of EQUIP are: education awards for individual providers, for child care workers; Oregon Registry Online, which is the professional development system for the child care workforce; structural indicators of quality, or quality indicators, which is our Q.I. project; and Oregon Program of Quality. These components all comprise the quality rating and improvement system for Oregon.
I will focus the rest of my time on one component of EQUIP: Oregon Program of Quality program, or OPQ. And I'm going to refer to it as OPQ from now on. In Oregon, OPQ facilities will have a high level of quality that is not quite accreditation. So you're wondering, well, why not move to national accreditation as the first goal?
National accreditation for many facilities seems very unattainable, and it doesn't help facilities that want to be Early Head Start, Head Start, or Early Intervention community placement. Being accredited is different than meeting Performance Standards. OPQ improves the quality of facilities of all types of care with a limited -- limited amount of resources, and this stepping stone allows Oregon to improve the quality of care for a larger amount of facilities statewide. And OPQ designation provides financial benefits.
The facilities can then choose to move to national accreditation based on the type of care they provide, and it is more attainable because of the rigorous portfolios they have already developed for OPQ. OPQ also provides a stepping stone for facilities to potentially choose to move to national accreditation. Just to be clear, OPQ designation can be attained by all types of licensed care -- family-, center-based, or school-aged after-school programs -- because all children deserve the same standards of quality care no matter the type of care they are in.
Sarah: Great. And what are some of the other benefits of OPQ, Oregon's Program of Quality? Sonja: Well, one financial benefit for OPQ-designated programs is that they can choose to receive additional technical assistance beyond the OPQ designation and become a community placement for Early Head Start, Head Start, or Early Intervention families.
For Early Head Start, this means that OPQ-designated facilities have identified early on in the application process that their goal is to provide full-day/full-year care for infants and toddlers who qualify for Early Head Start services. With OPQ designation, the facility becomes eligable to receive a subsidy slot for low-income working families. With technical assistance from Early Head Start staff, they get the additional help with Performance Standards they need to meet for Early Head Start services on-site.
And this provides three elements: a quality placement for a child to receive Early Head Start services; stable income for the provider; and continuity of care for the infant or toddler. To be -- to be successful statewide among all of our early care and education stake holders, we knew we needed to align local and state standards to national standards.
So we opted to design the Oregon Program of Quality standards around child care licensing, Head Start Performance measures, and accreditation standards for the National Association for the Education of Young Children, National After School Association, which now accredits through the Council of Accreditation, and the National Assocation for Family Child Care.
Sarah: Great, thank you, Sonja. And we're having a little bit of difficulty hearing you; if you could make sure the phone is a little closer to your mouth when I ask you this next question. And we're wondering -- great, that's perfect -- when you were designing the standards, who did you invite to the table and how did you decide whom to invite?
Sonja: At the table were Head Start; child care licensing management and licensing specialists; child care resource and referral; health, mental health -- health advocates; early childhood development specialists; early intervention; Oregon Registry Online representatives; and nonprofit child care advocacy organizations. We specifically invited stakeholders that had shown a particular interest in community placements for Early Head Start and Head Start, increasing the professionalism of the child care workforce, and increasing quality of child care facilities.
Sarah: Did you encounter any challenges or learn anything from the -- all the entities? Sonja: Well, yes. There were plenty of challenges, [Coughs] and we are still working through many of the policy issues, but I want to focus on what we did correctly. Sorry... [Coughs]
It is important, very important, to include or hire staff who model excellent collaboration skills. Personally, I can talk about it and honor it, but I have a harder time putting it into practice. It was better to have someone who is more relationship-based to compliment other staff skills and abilities. I could then focus my time on policy, budget, and technical issues, basically cutting through red tape. [Coughs] We also focused on project management, which is more than just being very organized.
We received the training we needed, and one staff person is a state-certified project manager. The key to all of this is: Persistence pays off. I have two staff who won't take no for an answer; between the three of us, we have worked with many, many partners on both policy and program issues. Plus, we have a very -- we had a very supportive division administrator who retired, but we now have a new [Coughs] administrator that is just as supportive. Key project areas where we did not have the skills or did not have the time, we contracted with experts.
Sarah: Thank you, Sonja. I wish I had hired some of the staff you were talking about, the folks you want in your pocket. And can you... Feel free to take a few minutes to clear your voice, I apologize, I keep asking you questions. Sonja: I got it.
Sarah: You're sharing so much, but could you describe the process for developing your plans? How long did it take and other things like that?
Sonja: Over a period of 14 months, the Oregon Program of Quality Advisory Committee, which is under EQUIP, met and worked on the alignment of standards and accreditation criteria. Western Oregon University Teaching Research Institute was contracted to actually build the standards, document all the work, and provide technical assistance to the advisory committee.
So the end result was our Oregon Program of Quality Standards, which are: collaborative family involvement; enhancing child development in learning; maintains an appropriate physical environment; highly qualified personnel; effective administration and business practices; and promotes health and safety. [Coughs] And those standards will be provided to all who are listening on this call today.
Sarah: Absolutely, we'll be sure to get those out. I want to take a minute, too, to remind folks if you have questions to go ahead and plug them in using your chat box at any time during today's webinar -- we can always circle back. And the other question I have for you, Sonja: What are some of the overall benefits that, as you think about moving forward -- can you share some of those, and do you have any recommendations for the audience today?
Sonja: The EQUIP Steering Committee is a small, tight group, but a group that can make program and funding
decisions. And having that small, tight group really allows EQUIP to be nimble and take advantage of opportunities. A good example: when the ARRA funding came to the state just as a majority of the EQUIP initiatives were ready to be implemented, because of prior planning, we were able to get the funding out the door within six weeks of the ARRA award.
We focused on benefits for Child Care, Early Head Start, and Head Start partners to get decision makers to the table, and we made Oregon's Program of Quality marketable to both child care providers and families looking for -- for quality care. And in the process, we also built a cadre of professionals that supported the concept and now support implementation.
Sarah: That's fantastic. And how will this -- how do you plan on continuing to fund this in the future? Sonja: We are very efficiently using our Child Care Development Fund private foundation dollars and tax credit resources. Example: the Oregon Community Foundation has funded EQUIP education awards at $200,000 statewide for the 2009-11 biennium.
Also, the Child Care Division directly receives $1.3 million in child care contribution tax credits each biennium. We are building something that can be sustained over time, even in economically stressed times like now, because EQUIP is about infrastructure. All the initiatives under EQUIP will become part of the way we deliver essential child care services. It will become established business practices.
We are also creating opportunities for our nonprofit and private sector funders to invest in child care and childhood -- childhood education. For example, a foundation may want to fund a cohort of family child care providers in a specific region of the state or a specific community to achieve OPQ designation.
All their funding would be directed to that cohort, with specific outcomes to -- to be achieved as part of their grant. Or, a foundation may want to fund only educational awards in a specific area of the state rather than statewide, like The Oregon Community Foundation has done. Sarah: And what are our next steps for Oregon and -- and ways to promote Child Care and Early Head Start collaborations?
Sonja: Well, we're currently planning for full implementation of Oregon Program of Quality in 2011. We had a pilot group of six facilities that represented all types of care that helped develop the application portfolios, and the portfolios built by these facilities demonstrated how they met the criteria for each of the six OPQ standards.
The OPQ Advisory Committee will work on the Early Head Start and Head Start community placements component, and this will be integrated with the subsidy components that were mentioned earlier in the Early Head Start community placement example.
We plan to fund the first cohort of 25 facilities in the fall of 2011. It is a number that is sustainable with current resources, it's manageable by our current staffing level, and is a small cohort model that builds a networking relationship between the funding facilities.
We plan to start small, build on our successes, manage our technical issues, and then replicate it across the state; and we hope to add 75 additional facilities in year two. The cohort selected will -- for next year will include facilities whose end goal is to be in Early Head Start or Head Start community placement.
Heath: Sonja, this is Heath. Certainly you all are doing some impressive work in Oregon. It sounds like EQUIP is helping to bring many components together and sometimes -- that sometimes operate in those silos that we see in states.
As you are developing a common set of standards, Oregon's Program of Quality certainly took into account the many entities that already exist in the field, instead of duplicating them. Overall, this process sounds very thoughtful, and that you have and will bring all of the right people together.
It's a true example of effective collaboration in bringing all of the parties and programs together to improve services
for our youngest children. At this time, we want to remind people that you can submit questions via the private "Leaders and Assistance" chat box at the bottom left-hand corner of the screen. We have received a couple of questions for you, Sonja, and then we have also received one question for Angie and Paula at the Office of Child Care.
So Sonja, we'll give you a break; and we'll ask the question for Angie or Paula, if you don't mind piping in. And the question is: "Where do we find our state policies on collaboration?"
Angie: Okay. This is Angie, and Paula you can jump right in, too. I -- you know, I think there are a variety of places -- and Paula, you may know the answer better than I do, because we're talking about states here and I'm still learning -- but I do know that the state Collaboration Office works very hard to support partnerships with Early Head Start, Head Start, and Child Care, and that would certainly be one of the first steps that I would refer an Early Head Start program to. And I know that those are in different divisions.
Sometimes they're in state Departments of Social Services, sometimes they're in the state Offices of Child Care, but I do know that state Head Start associations do communicate regularly with the state Collaboration Offices, so that would be the first step, and then I am going to turn it over to Paula because she may know more, She may have more specific ideas, also.
Paula Bendl Smith: Thank you, Angie. This is Paula Bendl Smith. I'm with the -- with Child Care, here in Shannon's office, and you're absolutely right. That's a great place to start. In addition to that, many states have their Head Start collaboration project persons -- will be a part of a statewide collaboration board that exists, or you can go directly to the lead agency for Child Care, and there's probably someone on their staff who manages and is aware of those collaboration projects that do exist.
And the more you ask those questions if they don't exist, the more frequently you'll start to get answers and -- and -- to respond to them. Heath: Great. Thank you, Angie and Paula. Sonja, I have a question for you. You talked earlier in the presentation about the partnership-ready person, and the question has come in about, "What are the elements of a partnership-ready person?"
Sonja: What has been successful in our current partnerships is taking out the money focus and really defining the vision or end goal. That is what creates the buy-in. People want to partner. They just can't figure out how to do it or don't have the time. And for Early Head Start and Head Start, it is really high stakes for them to join up with the Child Care world. So I think the visioning process that we went through in the very beginning really helped. And I know that that is kind of a stock phrase, but it's really true.
Heath: Great. I think those are definitely some positive words to have our audience hear today. Another question is: "Who is at the head of pulling all of this together in Oregon?"
Sonja: Oh. I would say probably the Child Care division took the lead, but we're really so partner-focused that having the EQUIP initiative as the rallying group around which we planned initiatives really helped. Because we're the lead agency and we're responsible for the appropriate use of those funds, the buck stops with us. So we really did take on a pretty big leadership role, but really used the collaborative process to -- to -- and consensus to come to decision- making.
Heath: Great. Another question that we have is: "How does the Oregon model provide health, nutrition, family support services that are required in the HSPS, the Head Start Performance Standards?"
Sonja: And I saw that question come up, and I went, Hmmm, I need some time to think about that one. Because we're still in the planning process for all of this, and we're still working with Western Oregon University on the standards and developing -- and the criteria and helping programs meet the criteria, I don't have a stock answer for that. I -- but I can provide information later.
Heath: Wonderful. One final question that we have time for is: "Can you share more about the private funding? How did it come to be and any recommendations for other states?"
Sonja: Children's Institute and Oregon Community Foundation have been involved in Child Care, and especially Head Start and Early Head Start, for many, many years. The John and Betty Gray Scholarship part of -- of the Oregon Community Foundation have provided scholarships for child -- the child care workforce for a really long time. So, there was a natural partnership that was already in place.
They originally -- both of those entities originally came to the table because they wanted to see the Head Start connection to -- to the -- to Child Care. So, having them -- that wasn't the hard part, getting them to the table. They were -- they were probably the initiators of this, rather than the state agencies. They wanted it to happen.
So, having private sector partners that were taking the lead on it really helped. And I would say in probably many states, there are private sector foundations that are interested in early childhood. They just need to be approached. Heath: Thank you. We did have one other final question. So... And then we'll let you off the hook. Sonja, "Do you folks have a per child or per setting cost for EQUIP?"
Sonja: We are actually working with an evaluator. She's been on board with us for probably nine months, and part of her evaluation is to help us get to that information. So she'll be on board until November of 2011, and it's a question that we have for her to answer. But it's not a per class setting for EQUIP, because EQUIP is the umbrella initiative. If - - if -- if we're looking for a per class/per child cost, it would be around OPQ.
Sarah: Okay, great. Thank you. And thank you, Heath, for leading the Q&A. And thank you, Sonja, for spending time to flesh out some -- some clarifying questions, and you really get to the key point that collaboration is an ongoing process, so it's really nice to know that you have an evaluation component so we can always keep shoring up all the good work that you've started.
We're going to continue to explore specific Child Care and Early Head Start collaborations, and we want to provide some examples of effective partnerships on the ground. But before we proceed, we want to get another pulse from the audience, and so the true or false question is: The Head Start Program Performance Standards, do they mandate Child Care and Early Head Start partnerships? So if you can take a few seconds to see the -- the responses. And we have about a quarter of our participants say that that statement is true, and then three-quarters say that that is not true.
That seems to be right on the dot. A little bit of fluctuation. And so if we turn to the next slide, we can show that the Performance Standards mandate that programs have affirmative steps to establish collaborative relationships with many community organizations, and they recommend including providers of child care services. And that's 1304.41(a)(2)(viii) -- little -- Roman Numeral eight, I guess is what it is.
And -- and what we're finding is that families, through the community needs and assessments programs -- are finding that families more and more are requiring and needing child care services, hence the focus on partnerships with child care programs and family child care providers in our community. Let me switch my paper. Here, so now we're going to be switching to a little bit more of a program focus. Heath, do you want to...?
Heath: Yes, and as we do so, thank you again, Sarah, for brushing us up on our Head Start Performance Standards. We did want to give you a sense of some different types of collaborations that do exist. Collaborations between Child Care and Early Head Start vary. Sometimes it might be a child care and Early Head Start program planning and attending trainings together. Other times it may be that they share resources to order things like supplies.
However, specifically, there are several different ways for Child Care and Early Head Start to partner and provide full- day, year-long comprehensive services. One way is to bring existing center-based child care programs together with Early Head Start. This can be done by linking families up with their program, but the programs provide separate services. Usually one entity helps to link the family with the other program option. Early Head Start may link a family with Child Care if the family is working or going to school.
Child Care may link the family up with Early Head Start if they want further family support and health services. Another type of collaboration is for Child Care and Early Head Start to partner. In these situations, generally one party
provides certain services, and the other party provides other services. Sometimes they may overlap, but both parties communicate with each other on a regular basis.
An example is Child Care providing all-day, year-round, center-based care with a solid curriculum in education, and Early Head Start provides support to the center, as well as comes in with family and health services. Another option is for Head Start to partner with family child care providers or family child care networks. On the flip side, a final way to collaborate is for an Early Head Start Program -- they can use non-Head Start funds to lengthen the day or year.
In these situations, programs can use Child Care funds and/or other public and private funds. To share with us specifics about a Child Care and Early Head Start partnership, I'd like to introduce Nancy Davidson. She is the partnership coordinator at the Children's Therapy Center, an Early Head Start program in Missouri. Nancy has been in the early education field for over 26 years. Her first job after graduation was as a Head Start director and teacher for 20 children in a small, rural Missouri town.
Then for 14 years, she was a director of a preschool child care with a total enrollment of over 100 children. For the past 11 years, Nancy has been the Early Head Start-Child Care partnership coordinator with the Children's Therapy Center. Thanks for being with us today, Nancy. Would you mind starting by telling us about your program in general?
Nancy Davidson: Thank you, Heath. It's an honor to be here today. Yes, we are a rural, stand-alone Early Head Start program, which means we only have Early Head Start. We serve 151 pregnant mothers, infants, and toddlers. And we are grantee for both a federal and a state grant. Our federal grant has a center-based option and a home visitation option.
Our -- through our state grant, we serve 45 children with existing child care providers in our community, and we recently received expansion dollars to serve seven more children. We started Early Head Start services in 1998, and received the straight -- the state grant funding in 1999. So we have been doing this for a while.
Heath: Thank you, Nancy. Can you tell us a little bit more about the specifics of your partnerships and how they look?
Nancy: Sure. Currently, we have five centers; we serve 47 children in those centers. And we have one family child care right now that serves five children. We don't have a fixed number of slots for each partner. We leave that number very flexible so that way the families can choose where they would like to attend and which facility best meets their needs. That could be because of location or opening and closing time, just general preferences.
Most of our partners have been partnering with us for many years. In fact, the one picture that you see now has been our partner for 10 years. Five of them own their own business, and one of them is located on a college campus.
Heath: Nancy, what brought your program to partner with community child care programs? Nancy: Our community assessment showed a very high need for infant/toddler care, which I'm sure it's like that in most areas. By accessing center-based slots within our community child care programs, it's a win-win situation for everyone.
We're helping the community by providing care for working families and providing jobs for child care providers. We help the facility raise quality, not only for Early Head Start children that are there, but also for all the other children enrolled in those classrooms.
Last year, we added a family child care as one of our partnerships. It gives parents another option to choose what's best for their child. We know that child care facilities generally know what's best on how to care for children in an all-day, all-year-long setting. They understand the needs of children who are in care for long hours, and staff really do understand parents who are working and know how to best communicate and work with them and not to overwhelm them.
Heath: And Nancy, how did you select who to partner with, and were there, or are there, any challenges?
Nancy: Yes. There's lots of challenges on a daily basis. We do have a list of criteria. They have to be state licensed
with our state of Missouri. They have to participate in the USDA Food Program; they must have liability insurance; and they must meet the teacher qualification mandates. That's just to name a few. However, probably the most important indicator of success and their willingness to partner is their willingness to meet all of the Head Start Performance Standards. They really have to want to deliver quality services. We ask a lot of them.
It's very challenging, as I mentioned earlier. One of the facilities that partnered with us several years ago, it was not successful. Their staff were not able to meet the CDA mandates, so we had to dissolve that partnership.
Recently, they approached us and they said they were in a different place and they wanted to try it again. We entered slow into this partnership. We improved the environment before we placed children there, and it's turned out to be very successful this time. So you have to remember that there's always going to be stumbling blocks along the way. Heath: Would you mind explaining a little bit more of any specific stumbling blocks that you had?
Nancy: Probably the biggest challenge is fully implementing all the Performance Standards at all times. We're not at those sites every day and the child care staff are not our employees, so sometimes consistency is an issue.
It's really difficult when regulations don't easily align, so I'm glad to hear that Sonja was speaking about addressing that on the state level. One example for us in Missouri is that the ratio for two-year-olds is one adult to eight children. Of course, for Early Head Start it's one to four.
So this cuts the income in half for owners. We have to help them make up the deficit in other ways, such as: we help pay more for Early Head Start child care slots than they charge for private pay; we've purchased equipment to help them raise the ITERS scores; and we also provide training for their staff to help them acquire their CDA and their continuing education units. We have -- part of our budget allows for these incentives because they do accomplish goals, the goal of providing high-quality comprehensive services.
Another major challenge for us is teacher turnover. With such low pay in this field, we have a high rate of teacher turnover. Staff are often leaving for higher paying jobs, even if early childhood is their career path.
And sometimes you have to remember that it doesn't always work out. We have had several that we've had to dissolve, and that's okay. I think probably one of the biggest lessons that I've learned is that when you sign an agreement or a contract, you're signing it with that director. However, when it comes to the daily work -- the everyday work, you're really partnering with all the staff.
So, the last time we did partner, we had a meeting with everyone at the table so we could explain who we were, what we were doing, what were the expectations going to be, and what were the non-negotiables. Heath: Nancy, with all the high expectations, why did child care opt to partner with you?
Nancy: I think many of them are interested in ensuring quality through the Early Head Start comprehensive services. It increased marketing for their facility in the community. It increased funding opportunities. They also saw it for a way for their staff to get the training because we do an in-house CDA class for them. Of course, fiscal is always important. They get a guaranteed check every month by a specific date, since we do pay for the child care.
We also offer many resources and a support network. We have visits daily -- I'm sorry, weekly -- to the sites through staff called PALs, which stands for Partner Advocate Liaison. So they're a great resource and support person for the facility. They also are the family advocate for the children that attend that site and they do the home visits with those families.
The PALs use many different monitoring tools to make sure that the quality has been established and stays that way. They use Performance Standard checklists, health and safety checklists, and we do the ITERS and the family child care environmental rating scale every year.
Heath: Nancy, you mentioned that you have a partnership with a family child care program. Could you share a little bit more about this with us?
Nancy: It's relatively new. We've only partnered with her for about a year, but we were very lucky because the owner/director used to be a caregiver and a home visitor with our agency, so she already knew Early Head Start. She already knew the Performance Standards. She does have a PAL visit her every week that offers support. We do the FDCRS, or the environmental rating scale, there and she has a very high score. It's a beautiful environment.
We decided as a program to keep the ratios low. So she does have a care -- co-caregiver, and together they have a total enrollment of only eight children. So we hold her to a very high standard. We like really having this option so it will be a different option for the families to choose.
Heath: Thank you. Earlier you talked about that you have contracts with the directors. Could you share a little bit more about these contracts or memorandums of understanding?
Nancy: Yes, we do have agreements with them. They are very specific. We use them to provide clarity in roles, both what we are going to do and what we expect of them. They're very concise, very clear, and I would highly recommend, if you're going to do this, to have as much in it as you can so there's no misunderstandings.
We update them and revise them annually. And along the way we have tweaked them several times, as we have had new learnings. One example is when the state adds things to our contract, then we have to add things to theirs, such as fingerprinting of staff. When the CDA requirements changed from getting it from -- in one year to already being hired with the CDA, then we have to update those contracts as well.
Heath: Great. It sounds like the work is always revolving and evolving. What are some of the strategies you implement to ensure that you have success in your partnerships?
Nancy: Well, I think it has to be relationship-based. You have to know that it takes time, and I think lots of very open communications, even sometimes daily. The directors can call me at any time. I was a director for 14 years, so I can kind of relate to the difficulty of their job. Sometimes they just need someone to listen to or bounce ideas off of.
They have to know exactly what's going to be expected of them. If you don't know the rules, you're not going to know how to play the game. So they need to know what's expected. We have had several of our partners be with us since the very beginning, and it has gotten smoother. So you got to be persistent and just stick with it.
Heath: Wonderful. What could you say are some of the overall benefits for your community, for programs, and families, and infants and toddlers that you serve?
Nancy: Well, it's increased the number of infant/toddler slots in our community. It's impacted quality. Not only the Early Head Start children that are in the classrooms, but all the children are impacted. Every month, when we do our reports to the state, we count over 60 children that are not Early Head Start children who are benefitting from the high- quality care and the education that the staff are receiving. It helps families have choices for their child care as they're working, and it helps them to realize what quality care looks like.
We have built a professional cadre in our community. We're working very hard on building a pool of CDA candidates. Families are receiving increased support through their family advocate, as well as getting the hours and the type of care that they need. It's raised awareness around the need for quality care in the community. It's increased collaboration among community agencies, such as our local college, doctor's offices, Head Start. It's increased comprehensive services per family. Basically, everyone benefits.
Sarah: This is Sarah, and I will heartily concur. You really have exemplified how -- how the rubber meets the road right at the program level. And I love that you've talked about having everyone as partners, basically, the direct service care because they're the ones who are literally with the children and the families on a daily basis. And it sounds like you really see everyone as leaders and as collaborators.
Nancy: Thank you. We try. Sarah: Yes. Nancy: That was a lesson that we learned. We didn't do that at the very
Sarah: Well, the nice thing about collaboration, which I've heard from -- from both of you, is that it's an ongoing process and it's always, as Heath said, evolving and revolving. And it's nice to know we get better and better as we go along. So I appreciate you taking time to share your expertise.
I want to let our participants know to keep the questions coming in. And, if you don't mind, Nancy, we have a few all ready for you, if that's okay? Nancy: Okay. Sarah: And folks are wanting a little bit more about your partnership agreements. Did you have some specific items or terms that you'd like to highlight or lessons learned for our participants?
Nancy: Yes, we have added our Creative Curriculum as a requirement -- that they use that. And we will assist them in implementation and do training with Creative Curriculum. We will give them a summary of the Performance Standards, obviously, and help them through it step-by-step. We will provide forms for them for recordkeeping, just all kinds of supports and resources.
We have a resource library here at our building and we can share all of those resources with them, just to name a few. I would be glad to share copies of ours if anyone would like to have it.
Sarah: Oh, that'd be great. Yes, if you send it -- forward -- forward it to us, we'll be happy to share it to -- with our audience, because it sounds like you have a whole collection of nuts and bolts that have been really well thought out. Do your agreements vary from site to site?
Nancy: No, they don't. We have the same expectations for everyone. Sarah: Does that include the family child care also? Nancy: Yes, it does. Sarah: Wonderful. Nancy: We want their care to be just as high, just as quality.
Sarah: And can you share a little bit more about the partnering relationship? You talked about how it gets smoother as you go along. Do you have any recommendations for supporting this process, like hastening it but not compromising the -- the efficiency?
Nancy: I think just be open and honest with them, and make sure that the expectations are outlined so they know what you expect. And have non-negotiables. There are some things that are negotiable and there are some things that are not, and make sure that they know what those are.
Sarah: Great. And we know Head Start -- you had mentioned that the Performance Standards are huge and we ask a lot. Were there any specific services or programming issues that your -- your programs needed a little more support with, such as health or inclusion or something like that?
Nancy: Well, we have had several sites that have done inclusions for us. We have some that are stronger at it than others. Sarah: So it sounds like you just deal with the relationship-base and the one-on-one scenario, and they'll call you on a daily basis if needed?
Nancy: Right. Regular contact is really important. Sarah: Absolutely. Nancy: Be available when they need you.
Sarah: And you had mentioned that it's really been helpful for you having a background in child care, and I think that's true to have that empathy and understanding so that you can be supportive while you're coping with a non-negotiable. Nancy: Not an easy job being a director.
Sarah: Absolutely. Absolutely. Now you'd mentioned that you had to dissolve some of your partnerships, and it's pretty amazing that programs returned, so it makes me think that you did something amazing. Can you talk a little bit about this process?
Nancy: We've had several partners that have dissolved because they have chosen a different career path. The ones that -- that we have dissolved, it's just been a mutual understanding that it was something that they just didn't think they
could do. So we mutually came to a decision that it wasn't working and possibly at a later date, if they would want to come back, they would more than be welcome to do that.
Sarah: So to summarize, it sounds like you didn't judge them whatsoever. It was just building that relationship and that rapport and honoring everyone's hard work. Nancy: Exactly.
Sarah: Well, we have finished the collection of questions that we have so far. But I will let -- we'll continue on, but please, if you have questions for any of our guests, please go ahead and write them in and we can pause as we go. And Heath is going to take us on a little bit further.
Heath: Great. Thank you, Nancy, and thank you, Sarah. Nancy, it's been a pleasure to hear about your program and all that's happening in your community. Nancy: Thank you very much for giving me the opportunity. It's pretty exciting work.
Heath: As we close today, we want to remind you all that we will post this webinar on the NITCCI, EHS NRC, and ECLKC websites. We'll also post all the questions and responses and, certainly, if there are more that come in, we would be happy to answer those as well.
Sarah: I think we'll also post the resources that were offered today very graciously by our -- our guests. In addition, we want to highlight that there are additional resources on the Web. The site shown on the slide, Partnerships and Collaborations, is available on the National Child Care Information and Technical Assistance Center, or also known as NCCIC.
And on the right side of the -- their home screen, if you select the Partnerships and Collaborations, it will lead you to the next page, which highlights specific resources. And they have a plethora of federal regulations, as well as policy resources, a Child Care bulletin, and some tools that support with partnering and develop -- developing efficient collaborations.
Additionally, on the Early Childhood Learning and Knowledge Center, or the ECLKC, they too have a Community Partnership landing page. And on the left-hand column there is [Beeping] is how you can access it. And if you select that, that leads to tip sheets and partnering tools, and -- thanks, we'll wait for the slide to move ahead. One more... There we go.
Heath: In addition, we would like to remind you all that the second part to this webinar that will focus on financing will be on November 4th, and the time is from 2:00 to 3:30 p.m. Please note that this is an hour earlier than this current webinar and it's also a change from our original announcement.
We are going to be highlighting an Early Head Start program in Maine; and we're also going to be highlighting Minnesota, as a state, and some of their unique financing around collaborations between Early Head Start and Child Care. To register, you can visit the NITCCI and the Early Head Start NRC websites, and we'll also be sending out an email really shortly.
Sarah: And, Angie, you'd mentioned that you would share some more information about the Family Child Care task order and their upcoming webinar. So I'd love to have you take a few minutes to talk us through that right now.
Angie: Thank you, Sarah. I would be glad to. And as you see on the screen, there are two webinars coming up. The first one is October 18th at 2:00 p.m. There's also information to register. And these webinars are part of a task order that ZERO TO THREE received to support partnerships with family child care providers and Early Head Start programs that were funded with ARRA dollars through expansion.
And the goal is really to support continuity for families of infants and toddlers. One of the things that we know, also, is that many families with babies really like family child care. And it's an area in Early Head Start that we know that we
need to strengthen, and we'd like to follow the lead of the Office of Child Care that spent many years working with family child care.
The final rule on family child care as a program option and the Office of Head Start is about two years old, so we're new to it and we're trying very hard to support partnerships and work with them. One of the things that I've really loved about this call today, this webinar, is how important partnership is.
And when we wrote the RFA for the ARRA-funded Early Head Start expansion, we really spoke loudly and clearly about how much we valued partnerships and would be looking for partnerships such as those with Child Care and other agencies in the ARRA application.
So in a broad sense, we're looking for it with Early Head Start and we're hoping to help it grow. And then, very specifically, I'd just like to invite you on behalf of the staff, who are putting this on, to be sure and register for these two webinars. So thank you.
Heath: Great. On behalf of Sarah and I, and those of us at NITCCI and EHS NRC, we'd like to thank you all that have joined us, but we especially would like to thank Sonja and Nancy. You both have been so gracious with your time and expertise, particularly in planning this webinar. We appreciate you sharing your insights, your challenges, those triumphs in trying to provide quality comprehensive services for our infants, toddlers, and families.
Also, we would like to thank the audience today, but most importantly for working -- for all the hard work that you do on behalf of our infants and toddlers every day. It's because of the children and families that we remain charged and focused, but it's through you all that it becomes a reality. At this time, I would like to invite Paula and Angie for any final thoughts.
Angie: Paula, did you want to start? This is Angie. I can go, or would you like to? Paula: Oh, Angie, yes, thank you. This is -- this is Paula Bendl Smith, and again I want to thank everybody for participating today. It's really exciting to be a part of this group of people who have such a commitment to infants and toddlers. And it was wonderful to hear about these great initiatives in two states.
And I'm looking forward to hearing more innovative ideas -- ideas from everyone. And, partnering together, we have so many resources that we can maximize. I have nothing but the greatest optimism for what we are going to be seeing next week and in the coming years. Thank you.
Angie: Thank you, Paula. I can only second that and, again, thank everyone who joined us today. I'd like to thank all the folks at ZERO TO THREE and the Early Head Start National Resource Center. It's so much fun to do these things because they just organize them and pull things together, and -- and they know how to pull in the resources that are so meaningful for us.
And with that, I'd finally like to thank Sonja and Nancy. As always, I've learned so much today. I'm very excited to learn about all [Beeps] and the other -- the program quality standards that you talked about, Sonja. And, Nancy, I love that, as you expanded in the last year, you included family child care and that you -- I just love the discussion around what it's like to partner with child care partners.
We know that it's not easy, but you make it seem wonderful and -- and -- and possible beyond the barriers that we know that people encounter. So I just want to thank everyone for doing this and I hope that it's inspired the folks out in the field. It certainly has inspired me, so thank you.
Sarah: And that ends today's Part One webinar presentation of Effective Child Care and Early Head Start Collaborations that Promote High Quality Comprehensive Care. I know we're ending a little early. Thank you and we look forward to seeing you at Part Two.
Operator: And that concludes today's conference. We thank you for your participation. You may now disconnect. -- End of Video--
Esta serie de webinarios de dos partes describe cómo la Oficina de Cuidado Infantil y Early Head Start pueden trabajar juntos para proporcionar servicios integrales y globales, de jornada completa y año completo a los niños y sus familias. La primera parte se centra en los éxitos, desafíos y lecciones aprendidas de las asociaciones de cooperación a nivel local y estatal. El personal federal y del programa ofrece una visión en la creación de asociaciones exitosas entre Early Head Start y los proveedores de cuidado infantil (en inglés).