Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.6 Management of Illness

3.6.2 Caring for Children Who Are Ill Child-Staff Ratios for Facilities That Care for Children Who Are Ill

Each facility for children who are ill should maintain a child-to-staff ratio no greater than the following:

Age of Children

Child to Staff Ratio

3-35 months

3 children to 1 staff member

36-71 months

4 children to 1 staff member

72 months and older

6 children to 1 staff member

Some states stipulate the ratios for caring for children who are ill in their regulations. The expert consensus is based on theories of child development including attachment theory and recognition of children’s temporary emotional regression during times of illness (1-3); the lowest ratios used per age group seem appropriate.
These ratios do not include other personnel, such as bus drivers, necessary for specialized functions such as transportation.
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
  1. Davies, D. 1999. Child development: A practitioner’s guide. New York: The Guilford Press.
  2. Schumacher, R. 2008. Charting progress for babies in child care: CLASP center ratios and group sizes – Research based rationale.
  3. Crowley, A. A. 1994. Sick child care: A developmental perspective. J Pediatric Health Care 8:261-67.