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Child Care
Services
Provided by
Hospitals
■■■

Women’s Bureau

Wage and Labor
Standards Administration

U.S. Department of Labor

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BULLETIN 295

JUN 2 9 T9TO

WOMAMPOWERA NATIONAL RESOURCE







Child Care
Services
Provided by
Hospitals
WOMEN'S BUREAU

Elizabeth Duncan Koontz, Director

WAGE AND LABOR STANDARDS ADMINISTRATION
Arthur A. Fletcher, Administrator

U.S. DEPARTMENT OF LABOR
George P. Shultz, Secretary

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BULLETIN 295 / 1970

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The rising demand in our Nation for skilled workers has led
employers to explore new ways to meet their growing personnel needs.
One emerging practice is the establishment of child care centers
which serve as a tool in the recruitment and retention of needed
personnel and at the same time aid the working parent.
In order to determine the extent to which hospitals had established
such child care services, the Women’s Bureau, Wage and Labor
Standards Administration, U.S. Department of Labor, conducted a
survey of hospitals with 100 or more beds and a few smaller ones
known to have set up child care centers. The survey revealed that
hospitals operating child care centers find the provision of these
services beneficial to both employers and employees. Recruitment
of personnel is improved, and absenteeism and labor turnover are
reduced. Women who were unable to work because of lack of adequate
child care are now employed. Part-time employees can work more
hours a day and more days a week. Working mothers are more
comfortable knowing their children are nearby and can be reached
promptly in case of emergency.
Acknowledgment is made to all of the hospitals participating in
the survey for their excellent cooperation. This study was prepared
by Annie L. Hart, under the supervision of Isabelle S. Streidl, and
with the technical assistance of Pearl G. Spindler and Beatrice
Rosenberg, who also prepared the questionnaire and related
correspondence.
It is hoped that this report will serve as a stimulus to additional
hospitals and other industries to establish child care centers for
use of their personnel. The development of programs of this type
may aid considerably in meeting the increasing demand in many
segments of our economy for additional trained personnel as well
as in alleviating one of the problems encountered by many mothers
who work or who would like to work.




ELIZABETH DUNCAN KOONTZ
Director, Women’s Bureau

l»
1 K




Introduction
Child Care Centers Reported on by Surveyed Hospitals
Geographical distribution
Number of years in operation
Location of physical facility in relation to hospital grounds
Administration
Licensing
Capacity and use
Number and age of children enrolled
Occupation of parents with children enrolled
Days and hours of operation
Staffing
Financing
Services provided
Major Obstacles to Hospital Operation of Child Care Centers
Alternatives to Hospital-Operated Child Care Centers
Conclusion
Appendixes
A

13
23

Hospitals included in the analysis
Addendum

B

Survey questionnaire and transmittal letters




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To meet the ever-growing demand for skilled manpower in many
sectors of our economy, increasing attention is being given to
methods of tapping the reservoir of women who want to work but
who are not free to work because they lack adequate facilities for
the guidance, care, and supervision of their children during work
hours. Of concern, also, is the need for adequate child care services
for many mothers who are now in the labor force. Adequate care
for children whose mothers are at work is of vital importance not
only to the families involved but also to society as a whole.
In the labor force in March 1968, there were 11.1 million mothers
with children under 18 years of age; 4.1 million of these mothers
had children under 6 years of age.1 About 39 percent of all mothers
with children under 18 and about 29 percent of all mothers with
children under 6 were working or looking for work.
Mothers have used a variety of arrangements for the care of
their children while they are on the job. A study jointly conducted
by the Women’s Bureau and the Children’s Bureau in February
1965 found that, of the 12.3 million children under 14 years of age
whose mothers had worked—either full or part time—for at least
6 months during the preceding year, 46 percent were cared for at
2
home by the father, another relative, or a nonrelative.1 Another
28 percent were looked after by the mother, who either cared for her
children while she worked or worked only during their school hours.
Only 2 percent of the children were cared for in a group care
center, while about 16 percent were cared for in someone else’s home.
The remaining 8 percent looked after themselves. In fact, the survey
showed that even among children under 6 years of age a small
number looked after themselves.
As a result of pressing need, a growing number of employers—
some with the active participation of unions—have solved the

U.S. Department of Labor, Bureau of Labor Statistics.
U.S. Department of Health, Education, and Welfare, Social and Rehabilitation
Service, Children’s Bureau, and U.S. Department of Labor, Wage and Labor
Standards Administration, Women’s Bureau: "Child Care Arrangements
of Working Mothers in the United States.” Children’s Bureau Pub.
461-1968.
1

2




child care problems of mothers (or fathers) working for them by
providing for the care of the workers’ children.3 For example, to
improve recruitment and retention of needed personnel in the
medical and health services industry (where 80 percent of the
workers are women), some hospitals provide such services.
There is a shortage of skilled medical and health personnel,
especially nursing personnel; and anticipated requirements in this
field continue to increase. A survey conducted in 1966 by the
American Hospital Association (AHA) and the Public Health
Service (PHS) of all AHA hospitals and a survey the same year
by the PHS of extended care facilities revealed that urgent unmet
staffing requirements for all health personnel totaled 120,300 for
hospitals and 24,300 for extended care facilities.4 More than
three-fourths of the additional staff needed were in the field of nursing
—62,000 registered nurses (56,900 for hospitals and 5,100 for
extended care facilities); 21,800 licensed practical nurses (14,100
for hospitals and 7,700 for extended care facilities); and 29,000
aides, orderlies, and attendants (21,800 for hospitals and 7,200 for
extended care facilities). During 1966 about 286,000, or 31 percent,
of the more than 900,000 licensed registered nurses were not
employed in nursing.5
By 1975 employment requirements for registered nurses were
expected to rise by 240,000 from the 1966 level to a total of
860,000, with an additional 150,000 needed to replace nurses who
retire, die, or otherwise leave the labor force. Employment needs
for licensed practical nurses were expected to rise by 165,000 to

3 For a discussion of some of these programs, see “Report of a Consultation
on Working Women and Day Care Needs,” Women’s Bureau, Wage and
Labor Standards Administration, U.S. Department of Labor. 1968.
4 U.S. Department of Labor, Bureau of Labor Statistics: “Health Manpower,
1966-75: A Study of Requirements and Supply.” Rept. 323. June 1967.
5 U.S. Department of Health, Education, and Welfare, Public Health Service,
Health Services and Mental Health Administration: “Health Resources Statistics:
Health Manpower and Health Facilities, 1968.” Pub. 1509. December 1968.




465,000, with an additional 125,000 required to replace those leaving
the labor force. And requirements for aides, orderlies, and attendants
were expected to increase by 380,000 to nearly 1.1 million, with
an additional 310,000 required to replace those leaving the labor force.15
To determine the extent of child care facilities operated by
hospitals in their effort to recruit and retain personnel, and to learn
how useful these services might be in helping to meet anticipated
health personnel needs, in April 1968 the Women’s Bureau, Wage
and Labor Standards Administration, U.S. Department of Labor,
conducted a questionnaire survey of about 3,000 hospitals with
100 beds or more.6 A few smaller hospitals known to operate child
7
care centers also were surveyed.
Of the nearly 2,000 hospitals that responded to the questionnaire,
98 were operating child care facilities for use of their personnel.8 In
addition, nearly 500 hospitals were either considering or indicated
an interest in such a program, 22 had plans to start one, and 12 were
making surveys to determine the extent of personnel interest. Most of
the remaining hospitals indicated that they had no plans to open a
child care center.
Only 29 hospitals reported that their personnel had indicated
through surveys that they had no interest in a program of this type.
An analysis of the major portion of the information acquired as a
result of the survey follows. It is hoped that the results of this study
will prove useful to other hospitals, institutions, or industries
interested in establishing a child care center for their present and
prospective employees’ children.

See footnote 4.
As listed in the Journal of the American Hospital Association, Guide Issue,
August I, 1967.
8 A list of these hospitals is attached as appendix A. A few of the centers
reported on, although located on or near the hospital grounds primarily for use
of the hospital's personnel, are actually operated by private concerns.
6

7




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child care
centers reported
on by surveyed
hospitals

9

Geographical distribution.—Of the 98 hospital-operated child care
centers in the United States, 50 were located in the South, 27 in the
North Central area, 11 in the Northeast, and nine in the West.10 The
centers were located in 35 States. Ohio led with a total of 16
hospitals operating such facilities.
Number of years in operation.—Fifty-six of the centers had been in
operation less than 5 years; 16, for less than 1 year. Nine had
functioned for at least 15 years.
Location of physical facility in relation to hospital grounds.—
Seventy-nine centers were located on the hospital grounds (table 1).
Of these, 16 were located within the hospital building. Only four were
located more than 8 blocks from the hospital.
Table 1.—Location of Centers
Location

Number

Total reporting ..........................................................................................................

98

Within hospital building..........................................................................................

16

On hospital grounds, inbuilding other than hospital..........................................

63

Off hospital grounds:
Less than 1 block......................................................................................................

7

1 to 8 blocks...............................................................................................................

8

Vi mile or more...........................................................................................................

4

Administration.—Forty-five of the child care programs were administered
by the nursing service of the hospital; 26, by the administrator’s
office; and 11, by the personnel department. The remaining 16 were
administered by other hospital branches. In some instances
administration of the program required coordination between the
various hospital services because the child care facilities were used
in the training of selected personnel.

9 Copies of the survey questionnaire and transmittal letter are attached as
appendix B.
10 The location of one hospital operating a child care center was not shown.




6

Licensing.—In all 50 States there is some kind and some degree of State
regulation of day care, usually licensing. State licensing is usually
contingent on a facility’s meeting local ordinances in such areas
as fire and building safety, sanitation, and zoning. However,
several States grant exclusion from licensing requirements because
of the purpose of the program, the number of children in care, ages
of the children cared for, or number of hours of care provided.
A few grant exclusion based on operation under religious, fraternal,
or recreational auspices. One grants exclusion to facilities operated
on a nonprofit basis; one, to facilities operated by privately endowed
agencies; and one, to facilities operated under profitmaking
auspices. Two require licensing only in certain counties. In three
States child care facilities may choose not to be licensed.
Of the 96 hospitals which reported their licensing status, 64 were
licensed by their States. Three of the 32 centers not licensed were
located in Federal or State institutions; three were in the process of
being licensed; four provided babysitting services only; one gave
staff members annual physical examinations and required the
supervisor to have a foodhandler’s license; one was inspected
periodically by the health department; and 20 did not comment on why
they were not licensed.
Capacity and use.—Only 32 of the centers had facilities for less than
25 children (table 2). Of the 47 centers that could accommodate
25 to 49 children, 34 had at least 25 enrolled. Of the 19 centers that
had facilities for 50 or more children, 12 had at least 50 enrolled.
Some parents with children enrolled at the centers worked only part
Table 2.—Capacity and Current Enrollment
Current enrollment
Capacity

Number of
centers

Total reporting....................................

98

Less than 25 to 49 50 children
25 children children
or more
45

39

14

Less than 25 children .....................

32

32

—

—

25 to 49 children...............................

47

13

32

2

50 children or more..........................

19

—

7

12




time or on certain days of the week. Thus a number of hospitals,
particularly those with centers open during more than one shift or
operating 6 or 7 days a week, reported that the weekly total of
children cared for greatly exceeded the number who could be
accommodated at any one time.
Thirty-five centers had a waiting list for certain age groups or
work shifts.
Niimber and age of children enrolled.—The 98 child chre centers had
facilities to accommodate nearly 3,700 children (table 3). Almost
3,200 children were enrolled.
5'

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Table 3.—Age of Children Enrolled, by Number of Centers and
Number of Children
Age

Number
CENTERS REPORTING

Preschool age ........................................................................................................

98

Under 1 to 5 years .................................................................................................

66

1 to 5 years only........................................................................................................

20

3 to 5 years only ......................................................................................................

12

School age .............................................................................................................

141

6 to 9 years only........................................................................................................
6 to 13 years .............................................................................................................

32

9

CHILDREN REPORTED
Preschool age ........................................................................................................

2,944

Under 1 year...............................................................................................................

340

1 and 2 years .............................................................................................................

720

3 to 5 years ................................................................................................................

1,884

School age .............................................................................................................

6 to 9 years ................................................................................................................
10 to 13 years ...........................................................................................................
1 Centers admitting both preschoolers and school-age children.



221

191
301

All the centers enrolled children under 6 years of age. Sixty-six
centers admitted children under 1 year of age, 20 admitted children
from 1 to 5 years only, and 12 admitted children from 3 to 5 years
only. Nearly 1,900 of the enrolled preschoolers were 3 to 5 years,
720 were 1 or 2 years, and 340 were under 1 year.
In addition to caring for preschool children, 32 centers provided
afterschool care for children aged 6 to 9 years; nine centers, for children
10 to 13 years old. There were 191 children aged 6 to 9 and 30
children 10 to 13 years of age currently enrolled. Sixteen of the
centers provided care for about 150 children of persons not employed
by the hospital, such as residents of the hospital neighborhood;
welfare recipients; employees of other area hospitals; military
personnel of service hospitals; physicians, dentists, and their
employees; teachers and volunteers at child care centers; and
patients in the hospital.
Occupation of parents with children enrolled.—The major users of the
child care centers were nursing personnel, who constituted more than
61 percent of parents who had children enrolled in the 98 units (table
4). (This proportion is not surprising, since priority in enrollment
was given to children of nurses by 71 of the centers.) Laboratory
technicians accounted for nearly 12 percent of the parents; nurses’
aides and orderlies, 7 percent; administrative and clerical personnel,
Table 4.—Occupation of Parents With Children Enrolled
Total
Occupation

Number Percent Number Percent Number Percent

100.0
61.1
11.9
6.8

2,414
1,557
274
172

100.0
64.5
11.4
7.1

140
3
29
2

100.0
2.1
20.7
1.4

173

6.8

162

6.7

11

7.9

131
213

5.1
8.3

46
203

1.9
8.4

85
10

60.7
7.1

Total reporting................... .. .2,554

. . . 1,560
... 303
Nurses' aides, orderlies . . ...
174

Nurses .................................

Technicians (laboratory) ..

Administrative, clerical
workers............................. . . .
Doctors, dentists,
anesthetists ................... . . .
Other .................................... . . .



Fathers

Mothers

7 percent; doctors, dentists, and anesthetists, 5 percent; and other
personnel, 8 percent.
Only 5.5 percent of the parents using the child care centers were
male. Three-fifths of these were doctors, dentists, or anesthetists.
Days and hours of operation.—Of the 94 centers for which periods of
operation were reported, 54 were open 7 days a week; 12, 6 days
a week; and 28, 5 days a week (table 5). About half (48) were open
for at least 9 but less than 16 hours a day. Only five were open less
than 9 hours a day, while one center was open for 24 hours a day.
Table 5.—Number of Hours and Days of Operation

Number of hours

Number of days
Number of ------------------------------------------- 1 * * * 5
centers
5 days
6 days
7 days

Total reporting...............................

94

28

12

54

Less than 9 hours........................

5

3

—

2

9 and less than 12 hours............

39

17

9

13

12 and less than 16 hours.........

9

4

—

5

16 and less than 24 hours.........

33

2

1

30

24 hours...........................................

1

—

—

1

Combination1 .................................

7

2

2

3

1 Centers open a different number of hours on different days of the week.

'

The most common length of operation for the 54 centers open 7 days
a week was between 16 and 18 hours a day. In fact, two-thirds of the
centers open every day operated 12 or more hours daily. However,
for centers that were open 5 or 6 days a week, the most common
daily period of operation was between 9 and 12 hours (17 and 9
centers, respectively).
With respect to the actual hours of operation, most of the centers
were open during the daytime, from about 6 a.m. to approximately
5 or 6 p.m.
Forty centers were open during hours convenient for personnel
working on the 3 to 11 p.m. shift. Most of the 33 centers that
operated at least 16 hours a day were open from about 6 a.m.
to 11:30 or 12 p.m. Six centers began the day’s activities during
the afternoon (about 2:30 or 3 p.m.) and continued operating until




at least 7:30 p.m., although most continued on until 11:30 p.m.
In addition to the center open 24 hours a day, only one center
provided services during the 11 p.m. to 7 a.m. shift; this was open
from 10:30 p.m. to 12 noon.
Staffing.—Center staffs included teachers, assistant teachers, nurses,
attendants, assistants or aides, maids, orderlies, cooks, and janitors.
Nearly all staff workers were paid for their services, although
volunteers had been recruited in a few instances. Other staff
members were available in 29 centers because the child care center was
used to train nurses, pediatricians, Head Start teachers, workshop
students, or prospective licensed child care center personnel.
Of the 94 centers reporting on staff composition, 23 had
professionals only, 28 had nonprofessionals only, and 43 had a
combination of professionals and nonprofessionals.
Recommendations on child-to-adult ratios in day care centers were
included in day care standards developed in 1968 for facilities
receiving Federal funds under certain programs.11 They were as follows:
(a) 3 to 4 years: No more than 15 in a group, with an adult and
sufficient assistants, supplemented by volunteers, so that the total ratio
of children to adults is normally not greater than 5 to 1.
(b) 4 to 6 years: No more than 20 in a group, with an adult and
sufficient assistants, supplemented by volunteers, so that the total ratio
of children to adults is normally not greater than 7 to 1.
(c) 6 through 14 years: No more than 25 in a group, with an adult
and sufficient assistants, supplemented by volunteers, so that the total
ratio of children to adults is normally not greater than 10 to 1.
Most of the centers (91) had at least one staff member for each
group of 10 or less children under 6 years of age (table 6).
Of the 66 centers with professionals on their staffs, 55 had a ratio
of at least one paid professional for each group of 20 or less children
under 6 years of age (table 7). Of these, 25 centers had one paid
professional for each group of 6 to 10 children.
11 Federal Panel on Early Childhood, % U.S. Department of Health, Education,
and Welfare, Social and Rehabilitation Service, Children's Bureau: "Federal
Interagency Day Care Requirements.” September 23, 1968. (The Federal Panel
on Early Childhood was composed of representatives of the Departments
of Agriculture; Commerce; Defense; Health, Education, and Welfare;
Housing and Urban Development; Interior; and Labor; and the Office of
Economic Opportunity.)




Table 6.—Number of Children Under 6 Years of Age for Each
Member of Operating Staff1
Number of children
for each
staff member

Total

Number of centers with—
------------------------------------------------Less than 25 25 to 49 50 children
children
children
or more

Total reporting...............................

94

45

39

10

2 to 5 ................................................

49

26

20

3

6 to 10 ...........................................

42

17

18

7

11 to 15...........................................

3

2

1

—

1 Professional or nonprofessional.

Table 7.—Number of Children Under 6 Years of Age for Each
Paid Professional Member of Operating Staff
Number of children
for each paid professional
staff member

Number of centers with—
Total

Less than 25 25 to 49 50 children
children
children
or more

Total reporting

66

27

30

9

3 to 5 ..............

14

5

8

1

6 to 10..............

25

9

12

4

11 to 15 .........

7

4

1

2

16 to 20 .........

9

8

1

21 to 29 .........

4

1

3

30 and over . .

7

5

Financing.—Of the 96 hospitals that reported on fees, 90 charged for
services provided in the centers (table 8). Six set rates on a sliding
scale basis according to family income, and four others charged
a combination of rates based on income, hours, age group, and/or
military rank. Fifty-five varied rates according to the number of
children enrolled from the same family.
Of the hospitals that required payment for services, 67 set basic
rates on a daily basis, charging from $1 to-$4 for the first child, with
the most common rate $1 to $2.99. Eleven charged on an hourly
basis—from 25 to 50 cents. Seven set weekly rates varying from $8.50



]2

Table 8.—Fees Charged for First Child in the Family, by Type of Rate
Type of rate
and fee

Number of
centers

Total reporting ......................................................................................
Hourly...................................................................................................
Less than 25 cents ...........................................
25 cents to 50 cents...........................................................................
Daily ...,..............................................................................................
$1.00 to $1.99 ..................................................................................
$2.00 to $2.99 ..................................................................................
$3.00 to $3.99 ...................................................................................
$4.00..................................................................................................
Weekly ..................................................................................................
$8.50 to $20.00 ...............................................................................
Biweekly ................................................................................................
Monthly ................................................................................................
$60.00 to $90.00 ..............................................................................
No charge ..............................................................................................

96
U1
2
8
^67
26
25
9
3
£7
4
*1
14

3
61

1 Includes child care centers charging a fee not shown separately and based
on age of children, number of hours at center, and/or earnings or income of
parents.

to $20. Four hospitals charged by the month—from $60 to $90.
The remaining hospital charged on a biweekly basis—from $11.25
to $20, depending on family income.
Some illustrations of the methods used by other hospitals that
charged a fee on a sliding scale based on income are as follows:
(a) One hospital charged $2 a day for the first child in the family
if the employee’s salary was less than $2.40 an hour and $3 a day
if the employee’s salary was more than $2.40 an hour.
(b) Another hospital charged 75 cents a day for employees with
income of $260 a month or less and $1.50 a day for those with
income of $500 a month or more.
(c) A third hospital charged a weekly rate of $10 for the first child
in a family with income from $3,000 to $5,000 a year and $12 for
the first child in a family with income of more than $5,000 a year.
Fees paid to child care centers by hospital employees and other



users generally were not adequate to meet operating costs. This was
particularly true in the case of nurses’ aides and other low-paid
ancillary health workers. Most (90) of the surveyed hospitals
subsidized their centers—by donating the physical facility, supplies,
medical services, heat, light, or other necessary equipment,
and/or paying some portion of the administrative expenses.
Services provided.—Services provided at child care centers varied
according to the needs of the individual facility and the standards
set by appropriate regulatory agencies.
Other than the ready accessibility of emergency hospital facilities,
there was no significant difference between the basic services
provided at child care units operated by hospitals and those provided
at units operated by other types of institutions. Generally they
included, but were not limited to, nutritional, health, educational,
and social services.
Ninety-six of the centers provided meals and snacks for the
children (table 9). Some provided either dinner only, lunch only,
or snacks only. The meals were, of course, closely related to the
individual needs of the child as well as the hours during which the
facility was open.
Health services were provided by 56 of the centers. Seventeen
centers provided services for the handicapped child. Only seven
indicated that they provided any type of social service for the family.
Table 9.—Meals Provided to Children
Type of meal

Number of
centers

Total reporting ..........................................................................................................

96

Breakfast, lunch, and snacks ................................................................................

23

Breakfast, lunch, dinner,and snacks......................................................................

15

Breakfast and snacks ...............................................................................................

1

Lunch only ..................................................................................................................

2

Lunch and snacks ..................................................................................................
Lunch and dinner .................................................... ......................’..........................

33
2

Lunch, dinner, and snacks .....................................................................................

14

Dinner only .....................................................................................................................

3

Dinner and snacks ..................................................................................................

1

Snacks only ..................................................................................................................

2







major obstacles
to hospital operation
of child care
centers

Some of the hospitals which were not operating a child care center
cited certain obstacles to providing the services. A few of these
hospitals said that the expense of operating such a center or in
meeting standards set by licensing authorities was the major obstacle.
However, more hospitals reported that the major obstacle was
lack of adequate space or facilities. Licensing involves meeting
appropriate safety and sanitation standards as well as other requirements
set by regulatory authorities. A child care center must provide space
and equipment for free play, rest, privacy, and other indoor and
outdoor activities.
Another factor was the difficulty of providing services during the
evening and night shifts when the services would be most helpful.
The availability of other child care facilities apparently was the
determining factor in the 29 cases where personnel surveys had
indicated no need for a hospital-operated center.
Only nine hospitals reported that they had discontinued operation
of their child care centers (one of these centers has since been
reopened). The primary reason cited by more than half of those
hospitals was the lack of utilization by their personnel. Another
reason was that the proximity of the children caused some mothers to
visit them during working hours, resulting in reduced productivity on
the job and, occasionally, unsatisfactory relationships between the child
care staff and the mothers. (Most respondents who commented on
this subject, however, stated that having their children nearby
usually resulted in a more productive effort by the mothers.)




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alternatives
to hospital'operated
child care centers

Alternative methods of providing adequate child care for working
mothers were suggested by some of the hospitals responding to the
survey, One suggested that payment of salaries which would permit
mothers to take advantage of existing facilities would be preferable
to hospital operation of an expensive child care center. Another
respondent, concerned with recruitment problems during the evening
and night shifts, reported that the payment of a higher shift differential
was found to be less expensive than having the hospital provide child
care services. Another hospital reported an arrangement with a local
day care center to pay half the cost of caring for the children of their
employed registered nurses.
A final suggestion was that, in view of the great need for services of
this type, the Federal Government should consider establishing child
care centers for children of working mothers.




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Conclusion

The results of the survey illustrate that the provision of adequate
child care facilities for the children of health personnel benefits both
the employed parent and the employer. Mothers who are working
or would like to work find that having child care readily available
eases their dual responsibility of worker and homemaker. The same
is true for fathers who may be bringing up children in a motherless
home. Employers find that providing child care services for their
employees is effective as a recruitment tool and a stabilizing influence.
The very fact that 90 hospitals subsidized in some way the
operation of a child care center indicated that they considered
the benefits worth the cost.
The advantages to the parents of children enrolled in hospital child
care facilities are demonstrated by some of the comments which
were made on the questionnaires, as follows:
“[The child care center is] close and convenient to parent(s) working
in hospital. Mothers who are breastfeeding are able to continue
after returning to work.”
“We feel the day care center relieves many mothers of worry
concerning their children. They are nearby and can check on
children when necessary.”
“The day care center is conveniently located and provides a
program designed to meet the individual needs of each child in
an atmosphere of warmth and acceptance. This service allows
mothers to work with the knowledge that their children are
receiving good care; thus they are more effective employees.”
“We have any number of mothers who have told us that if it
were not for the nursery, they would be unable to work. Also,
they can relax and not worry about their children when they
know they are in the same building and can be contacted at once
in case of emergency.”
“It has been a convenience and economic fringe benefit for our
employees.”
Most of the hospitals operating centers advised that the availability




20

of child care services has been helpful in recruiting and retaining
needed nursing personnel, resident doctors, and other health
workers. This is supported by the fact that 86 hospitals reported
that they believe some of their staff would resign if the services were
discontinued. Some comments from hospitals on the usefulness of
the center in recruiting and retaining personnel are as follows:
“Since we have provided adequate responsible care for the
employees of . . . Hospital, the hospital has many new staff
members, especially R.N.’s. These workers have returned to work
now that our services are available.”
“The day nursery was inaugurated specifically to enable nurses
to work who would otherwise be unable to work due to lack
of adequate day care facilities. We are convinced it is fulfilling
.this need and that we would have fewer nurses if we did not
maintain the nursery.”
“There is no question that the nursery is a major asset in our
recruitment of nurses.”
“We feel that the facility has been most helpful to us, since it
brought back young graduates who needed little or no
orientation, many of them our own school graduates. Some of
these are part time but work full days when they are in.
We would not give up the Center but would rather think
that it might pay to enlarge it.”
“The . . . center has been of definite benefit in hiring women.
Many of the mothers have expressed the opinion that they
would not leaVe for more money because of the [child care
center].”
Other advantages cited were the opportunity for some nurses and
other personnel to work full time instead of part time or to work
overtime, the facilitation of shift rotation, and a reduction in
absenteeism.
“It was set up as a recruitment tool and we feel that it has
been beneficial in the employment of Registered Nurses and
Licensed Practical Nurses; they do not only return to work but
work more days and more hours per day.”




“Some would be unable to work at all. Many would be able to
work only part time.”
“Part-time nurses are able to work extra days. R.N.’s transferred
from part time to full time. Rotation of shifts made easier for
nurse.”
“The nursery not only attracts personnel, but increases tenure
and lessens absenteeism.”
“This program was developed to bring back to the hospital
nurses who could not work because of family responsibilities.
So far it has served very well as a method of encouragement to
nurses to work the 3—11 shift.”
“I am sure our hospital gets preference due to availability of
child care. Staffing is more stable and maternity leave shorter.”




♦*.0




Appendix A

HOSPITALS INCLUDED IN THE ANALYSIS*
Alabama

Colorado

Huntsville Hospital
101 Sivley Road
Huntsville, Ala. 35801

Fitzsimons General Hospital
Peoria Street and East Colfax
Avenue
Denver, Colo. 80240

Arizona**

Good Samaritan Hospital
1033 East McDowell Road
Phoenix, Ariz. 85006
Arkansas

Sparks Memorial Hospital
1311 South I Street
Fort Smith, Ark. 72901
Arkansas Baptist Medical
Center
1700 West 13th Street
Little Rock, Ark. 72202
California

Connecticut

New Britain General Hospital
100 Grand Street
New Britain, Conn. 06050
Florida

Alachua General Hospital
Post Office Box 1207
Gainesville, Fla. 32601
Hialeah Hospital
651 East 25th Street
Hialeah, Fla. 33013

Methodist Hospital of
Southern California
Post Office Box 418
Arcadia, Calif. 91006

John F. Kennedy Memorial
Hospital
Post Office Box 1489
Lake Worth, Fla. 33460

Santa Teresita Hospital
1210 Royal Oaks Drive
Duarte, Calif. 91010

Lakeland General Hospital
Drawer 448
Lakeland, Fla. 33802

Loma Linda University Hospital
11055 Anderson Street
Loma Linda, Calif. 92354

Baptist Hospital of Miami
8900 SW. 88th Street
Miami, Fla. 33156

U.S. Naval Hospital
8750 Mountain Boulevard
Oakland, Calif. 94627

Florida Sanitarium and Hospital
601 East Rollins Avenue
Orlando, Fla. 32803

* The analysis includes one hospital not listed here because the name and address of
the respondent were not shown.
**See Addendum.




Tampa General Hospital
Tampa, Fla. 33606
Georgia**

Athens General Hospital
797 Cobb Street
Athens, Ga. 30601
Crawford Whong Memorial
Hospital
35 Linden Avenue NE.
Atlanta, Ga. 30308
Georgia Baptist Hospital
300 Boulevard NE.
Atlanta, Ga. 30312
St. Joseph’s Infirmary
265 Ivy Street NE.
Atlanta, Ga. 30303
Hall County Hospital
743 Spring Street NE.
Gainesville, Ga. 30501
Kennestone Hospital
737 Church Street
Marietta, Ga. 30060

Eastern State Hospital
627 West Fourth Street
Lexington, Ky. 40508
Louisiana**

Flint-Goodridge Hospital
2425 Louisiana Avenue
New Orleans, La. 70115
Southern Baptist Hospital
2700 Napoleon Avenue
New Orleans, La. 70115
Maryland

Johns Hopkins Hospital
601 North Broadway
Baltimore, Md. 21205
Prince George's General
Hospital
Cheverly, Md. 20785
Rosewood State Hospital
Owings Mills, Md. 21117
Massachusetts

Illinois

New England Memorial Hospital
5 Woodland Road
Stoneham, Mass. 02180

Mennonite Hospital
807 North Main Street
Bloomington, III. 61701

Middlesex County Sanatorium
775 Trapelo Road
Waltham, Mass. 02154

Indiana

Minnesota

St. Francis Hospital
101 North 17th Avenue
Beech Grove, Ind. 46107

Mt. Sinai Hospital
737 East 22d Street
Minneapolis, Minn. 55404

Iowa

Mississippi

Iowa Methodist Hospital
1200 Pleasant Street
Des Moines, Iowa 50308

Methodist Hospital
Hall Avenue and Bay Street
Hattiesburg, Miss. 39401

Kentucky

Missouri

St. Elizabeth Hospital
21st and Eastern Avenue
Covington, Ky. 41014

State Hospital
1 East Fifth Street
Fulton, Mo. 65251

**See Addendum.




Independence Sanitarium and
Hospital
1509 West Truman Road
Independence, Mo. 64050
Bethesda General Hospital
3655 Vista Avenue
St. Louis, Mo. 63110
St. Vincent’s Hospital
7301 St. Charles Rock Road
St. Louis, Mo. 63133
Nebraska

Bryan Memorial Hospital
4848 Sumner Street
Lincoln, Nebr. 68506
New Jersey

Saint Barnabas Medical Center
Old Short Hills Road
Livingston, N.J. 07039
Newton Memorial Hospital
175 High Street
Newton, N.J. 07860
New Mexico

St. Mary’s Hospital
South Main and Chisum Streets
Roswell, N. Mex. 88201
New York**

Montefiore Hospital and
Medical Center
110 East 210th Street
Bronx, N.Y. 10467
Crouse-lrving Hospital
820 South Crouse Avenue
Syracuse, N.Y. 13210
North Carolina

Memorial Mission Hospital
509 Biltmore Avenue
Asheville, N.C. 28801
See Addendum.




Haywood County Hospital
1615 North Main Street
Waynesville, N.C. 28786
North Dakota

State Hospital
Post Office Box 476
Jamestown, N. Dak. 58401
Ohio

Children’s Hospital
Buchtel Avenue at Bowery
Street
Akron, Ohio 44308
Apple Tree Day Care Center
220 William Howard Taft Road
Cincinnati, Ohio 45219
(operated by members of Medi­
cal Auxiliary; serves various
hospitals in the area)
Highland View Hospital
3901 Ireland Drive
Cleveland, Ohio 44122
University Hospitals
2065 Adelbert Road
Cleveland, Ohio 44106
Riverside Methodist Hospital
3535 Olentangy River Road
Columbus, Ohio 43214
Good Samaritan Hospital
1425 West Fairview Avenue
Dayton, Ohio 45406
Miami Valley Hospital
1 Wyoming Street
Dayton, Ohio 45409
St. Joseph Hospital
205 West 20th Street
Lorain, Ohio 44052

Robinson Memorial Hospital
449 South Meridian Street
Ravenna, Ohio 44266
Mercy Hospital
1343 Fountain Boulevard
Springfield, Ohio 45504
Flower Hospital
3350 Collingwood Boulevard
Toledo, Ohio 43610
Maumee Valley Hospital
952 Toronto Avenue
Toledo, Ohio 43609
Riverside Hospital
1609 Summit Street
Toledo, Ohio 43604
St. Charles Hospital
2600 Navarre Avenue
Toledo, Ohio 43616
Toledo Hospital
2142 North Cove Boulevard
Toledo, Ohio 43606
Dettmer Hospital, Inc.
3130 North Dixie Highway
Troy, Ohio 45373
Oklahoma**

Oklahoma General Hospital
301 South Eighth Street
Clinton, Okla. 73601
Midwest City Memorial Hospital
2825 Parklawn Drive
Midwest City, Okla. 73110
University of Oklahoma
Hospitals
800 NE. 13th Street
Oklahoma City, Okla. 73104
Hillcrest Medical Center
1120 South Utica Avenue
Tulsa, Okla. 74104
“See Addendum.




Oregon**

Providence Hospital
830 NE. 47th Avenue
Portland, Oreg. 97213
Pennsylvania

Allegheny General Hospital
320 East North Avenue
Pittsburgh, Pa. 15212
Philadelphia General Hospital
34th Street and Civic Center
Boulevard
Philadelphia, Pa. 19104
Rhode Island

Rhode Island Hospital
593 Eddy Street
Providence, R.l. 02903
Tennessee**

Bristol Memorial Hospital
209 Memorial Drive
Bristol, Tenn. 37620
St. Mary's Hospital
Oak Hill Avenue
Knoxville, Tenn. 37917
Baptist Memorial Hospital
899 Madison Avenue
Memphis, Tenn. 38103
Clover Bottom Hospital
and School
Stewarts Ferry Pike
Nashville, Tenn. 37214
Park View Hospital, Inc.
230 25th Avenue North
Nashville, Tenn. 37203
Texas**

Northwest Texas Hospital
Post Office Box 1110
Amarillo, Tex. 79105

All Saints Episcopal Hospital
Post Office Box 31
Fort Worth, Tex. 76101
Memorial Baptist Hospital,
Central
1100 Louisiana Street
Houston, Tex. 77002
Memorial Baptist Hospital,
Northwest
1635 North Loop
Houston, Tex. 77018
Memorial Baptist Hospital,
Southwest
6440 High Star Street
Houston, Tex. 77036
Texas Medical Center
Houston, Tex. 77025
(Member hospitals of child
care center:
Ben Taub General Hospital
Hermann Hospital
Methodist Hospital
M. D. Anderson Hospital
and Tumor Institute
Texas Children's and St.
Luke’s Hospital
Texas Research Institute
for Mental Sciences
Texas Institute for
Rehabilitation and
Research)
Medical Center
Post Office Box 3277
Tyler, Tex. 75701

Virginia Baptist Hospital
3300 Rivermont Avenue
Lynchburg, Va. 24503

Virginia**

Wisconsin

University of Virginia Hospital
Jefferson Park Avenue
Charlottesville, Va. 22903

St. Catherine's Hospital
3556 Seventh Avenue
Kenosha, Wis. 53140

See Addendum.




Norfolk Community Hospital
2539 Corprew Avenue
Norfolk, Va. 23504
Norfolk General Hospital
600 Gresham Drive
Norfolk, Va. 23507
Petersburg General Hospital
Mt. Erin and Adams Streets
Petersburg, Va. 23803
Stuart Circle Hospital
413 Stuart Circle
Richmond, Va. 23220
St. Mary’s Hospital of
Richmond, Inc.
5801 Bremo Road
Richmond, Va. 23226
Roanoke Memorial Hospitals
Belleview Avenue and
Lake Street
Roanoke, Va. 24014
Washington

Tacoma General Hospital
315 South K Street
Tacoma, Wash. 98405
West Virginia

Memorial Hospital
3200 Noyes Avenue SE.
Charleston, W. Va. 25304

Addendum
Since the survey was completed, the Women’s Bureau has learned that the
following hospitals also operate child care centers for use of their health per­
sonnel. (NOTE.—There may be other hospitals not known to this Bureau which
provide child care services for their personnel.)
Memorial Hospital
1200 South Fifth Avenue
Phoenix, Ariz. 85003

Holy Family Day Care Centers
1923 South Utica
Tulsa, Okla. 74104

De Kalb Hospital
2701 North Decatur Road
Decatur, Ga. 30033

St. Francis Hospital
61st and Yale Avenue
Tulsa, Okla. 74135

Baton Rouge General Hospital
3662 North Boulevard
Baton Rouge, La. 70806

St. Vincent’s Hospital
2447 NW. Westover Road
Portland, Oreg. 97210

Touro Infirmary
1400 Foucher Street
New Orleans, La. 70115

Baroness Erlanger Hospital
261 Wiehl Street
Chattanooga, Tenn. 37403

Doctors’ Hospital
1130 Louisiana Avenue
Shreveport, La. 71101

High Plains Baptist Hospital
1600 Wallace Boulevard
Amarillo, Tex. 79106

Genesee Hospital
224 Alexander Street
Rochester, N.Y. 14607

Presbyterian Hospital
8200 Walnut Hill Lane
Dallas, Tex. 75231

Baptist Hospital
3303 NW. 56th Street
Oklahoma City, Okla. 73112

Mother Francis Hospital
825 East Houston
Tyler, Tex. 75701

Capitol Day School
NE. 21st and Kelly
Oklahoma City, Okla. 73105

Richmond Memorial Hospital
1300 Westwood Avenue
Richmond, Va. 23227







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Appendix B

Budget Bureau No. 44-S68004
Approval Expires August 1968

U.S. DEPARTMENT OF LABOR
Wage and Labor Standards Administration
WOMEN’S BUREAU
WASHINGTON, D.C. 20210

Name of hospital
Address _______

INQUIRY
HOSPITALS OPERATING DAY CARE CENTERS FOR CHILDREN OF THEIR HEALTH
PERSONNEL
Your reply will be held in strict confidence. Please return completed
questionnaire to Women's Bureau, Washington, D.C., 20210.
1. When was the day care center established? (date)
2. Where is it located?
□ Within the hospital building
□ On the hospital grounds
□ Other area (describe—include distance from hospital)

3. Which branch of your hospital organizational structure administers the day
care program?
□ Administrator’s Office

□ Nursing Service

□ Social Service

□ Pediatrics

□ Other (specify) ______________________ _________ ____




32

4.

How many children can you accommodate?

5.

How many children do you accommodate?

6. Do you have a waiting list?

□ Yes

Number_____________________
Number----------------------------------

□ No

7. What are the ages of the children you admit?
□ Under 1 year
□ 1 to 2 years

Number--------------------------------------

□ 3 to 5 years
8.

Number--------------------------------------

Number---------------------------------------

Do you provide afterschool care for any children?
□ Yes

NumberAge 6-9

Number---------------Age 10-13

□ No
9. Are any enrollees handicapped?
□ Yes

Number

□ No
10. Among the users of your service, about how many are:
Mothers

Fathers

Nurses

Number

Number

Doctors

Number -

Number

Technicians/Laboratory
workers

Number

Number

Nurses’ aides

Number

Number

Other (specify)

Nnmhpr

Numher

. Number

Number

11. Are the children of nurses given priority in enrollment over those of other
health workers?
□ Yes
□ No
12,

Do you also enroll children whose parents do not work in the hospital?
□ Yes
□ No




Number

If yes, which children?
□ Neighborhood children

□ Other children (specify).

□ Patients' children
13. During what days and hours does the center remain open?
Days of week: From __________________

To

Hours of day: From . To
14.

For the majority of children what is the average number of daily hours of
How many of the day care center staff are:
Paid staff

Unpaid volunteers

Teachers

Number

Number

Assistant teachers

Number

Number

Number

Number

Number

Number

Number

Number

Number

Number

Number

Numher

Other (specify)

.

Is the day care center used to train any of your hospital staff?
□ Yes

□ No

If yes, in which occupations?
Check:

□ Nurses

□ Pediatricians

□ Other (specify) ___________

17. Do you charge fees?

□ Yes

□ No

If yes, are fees based on a sliding scale?
□ Yes—describe:




□ No

34

18.

If you charge fees, what are the fees per child?
Per hour $Per month $-----------------------------------------------------------Per day $______________

Other

$---------------------

19.

If there is a special fee schedule where there is more than one child in
family, please describe:

20.

Does the hospital contribute, in either cash or kind, toward the operating
cost of the day center?

□ Yes

□ No

□ Yes

□ No

Comments, if any:
21.

Is the center licensed?
Comments, if any:

22.

Please check meals and snacks provided.
□ Breakfast

□ Mid-morning snack

□ Other

□ Lunch

□ Mid-afternoon snack

23. Are the children provided with health services?
□ Yes—describe:

□ No

24. Are families provided social services?
25.

□ Yes—describe:

□ No

Would any of your staff members probably terminate employment if you did
□ Yes
□ No
not provide day care services?
Comments, if any:

26. Please add any other comments you would like to make with respect to
particularly successful features of your day care program, and whether
you have any serious problems in maintaining the service.
27.

May we identify your hospital in relation to specific items in our report?
□ Yes

□ No

* U. S. GOVERNMENT PRINTING OFFICE : 1970 0 -382 -540

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402 - Price 25 cents




U.S. DEPARTMENT OF LABOR
WOMEN'S BUREAU
WASHINGTON, D.C, 20210

Dear Sir:
The Women’s Bureau has long been concerned with the need for day
care facilities, particularly for the children of working mothers. In this
connection we are undertaking a study of the availability of day care
services for the children of hospital personnel. Therefore, we are
sending inquiries to you and various other hospitals with 100 or more beds.
It is our belief that a survey of existing services may be exceedingly
helpful to those hospitals now considering plans for establishing day
care centers. The expansion of such centers may well play an important
part in helping to relieve present shortages of health personnel.
If you have such a program, may we look to you for cooperation in
answering the enclosed questions. The last question, number 27, requests
permission to identify your hospital in relation to specific items in our
report. If you do not wish us to refer to you specifically, we will of course
not disclose your identity. If you do not have day care services, we
would like to know whether you are planning to institute them. Also,
if you are interested, we can provide you with the names and addresses
of the hospitals which we know or believe have this type of day care
program.
We would be grateful for a reply to our inquiry at your early
convenience. We will be happy to send you a copy of the report when it
becomes available.
Sincerely,

Mary Dublin Keyserling
Director
Enclosure




U.S. DEPARTMENT OF LABOR
Wage and Labor Standards Administration
WOMEN’S BUREAU
WASHINGTON, D.C. 20210

Official Business




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