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Adult Day Care Staff
Types of Staff in Adult Day Care Centers

Adult day care

Adult day care centers have different types of staffing than other care facilities that help adults with disabilities or the elderly.

In most centers, the hired staff need some training to assist recipients who are independent yet need some assistance with activities of daily living (ADLs). They help recipients get dressed, go to the toilet and assist with mobility, meal preparation, and transportation.

Residents of assisted living or nursing homes need more assistance with activities of daily living.

The staff requirements for adult day care is not as stringent as for medical facilities - no nurses or certified nurse aides required on staff unless a day care center provides 'day health.'

Day Healthcare offers services like nursing care:

  • Medication administration and oversight
  • Weights and vitals taken regularly
  • Diabetic care
  • Feeding tubes
  • Dressing changes
  • Doctor-ordered health care

If the center offers care for people living with dementia and memory loss, find out what security measures are in place to ensure recipients' safety and they do not leave a facility unattended. Ask how they're monitored. It's common for the elderly adult to become confused, lost and disoriented. Feelings of confusion upset them and cause acting out. Find out how employees receive skills, needed education and if they're properly trained to address and care for people with the specialized needs.

Adult Day Care Staff

State regulations
State regulations

The U.S. Office of Health and Human Services show that in most states licensure or certification standards exist. 25 states require licensure, ten states require certification, and four states require both licensure and certification. Medicaid providers have different requirements. Thirteen states require adult day care providers to obtain approval from a state agency.

States vary concerning staff requirements, and most have the minimum staff-to-recipient ratio. The mandatory rate ranges from one to four and one to ten. If the center is a licensed day health center, then states require lower rates in the number of staff of recipients.

Medicaid providers must hire a minimum of one staff for every six participants, and a ratio of one-to-four when serving a high percentage of recipients living with severe impairments.

Types of Staff in Adult Day Care

Administrator or Director

  • Directs and supervises all aspects of the day care program
  • Determines admission eligibility of recipients and discharges
  • Develops and implements in-services for staff
  • Supervises the staff
  • Maintains daily census levels.
  • Evaluates program and staff
  • Develops and implements a marketing plan.
  • Maintains community relations

Caregivers and Nurse Assistants

  • Assist recipients with eating
  • Hair styling
  • Using the toilet
  • Other personal care tasks

Activities Professionals

Develop and conduct personalized exercise programs like:

  • Art
  • Recreation
  • Discussion and support groups
  • Social events
  • Outside community activities and events
  • Games
  • Exercise and fitness programs

Registered and Licensed Nurses

  • Administers prescribed medications
  • Delivers educational programs
  • Manages day-to-day health needs
  • Attends to emergencies

Social Workers

  • Provide family support
  • Assist in developing care plans
  • Counseling when needed
  • Develop programs to assist with wandering, incontinence, hallucinations, sexually inappropriate behavior or speech difficulties

Dietary Consultant

  • Design meal plans
  • Check and design for special diets


  • Drive recipients to outside events
  • Assist in activities when needed
  • Help during meal times
  • Sing and lead fun groups of activities

Adult day care centers start and operate by people who enjoy working with the elderly and adults with disabilities. They're service oriented and wish to get involved in the human service industry.

The best, most qualified staff in the centers are professionals who want to give back to society and enhance their community.Many operators earn health care degrees.

Higher-quality centers hire staff with specialized training and experience in working with adults with disabilities or the elderly.

Those with services for dementia care hire staff with experience and training in memory loss, dementia and Alzheimer's care.

The best way to know how qualified the staff is; check credentials, speak with other recipients, and check state records.

Questions to Ask a Day Care Center

  • Do staff members seem committed, engaged, friendly, and knowledgeable?
  • What are the requirements for becoming an employee of the facility?
  • Do the staff members treat the seniors as adults?
  • What is the staff to the participant ratio? Do they meet the local requirements?
  • Do volunteers work at the center? Are they required to submit to a background check?
  • Is staff attentive? Do seniors have to wait for help?
  • How long have the staff members been working in their field? How long have they been employed at the same facility?

Who Operates Adult Day Care Facilities?

According to the National Adult Day Services Association (NADSA), there are more than 4,600 adult day care centers in operation across the United States. These facilities provide care for approximately 150,000 of the nation's adults, and more than 75% of these facilities operate as public or non-profit facilities.

The average cost of adult day services varies from state to state. Operational costs for these services are partly covered by the participant fees. Third parties and philanthropic organizations cover remaining costs.


Some individuals operate adult day care services from their home or another location. These are similar to in-home child care services in many ways. They are more affordable than other centers and space is usually limited in these settings.

While in-home care is given by licensed professionals, it is important to check credentials and licensing of the owner before trusting your loved one to the center's care.

They offer meals and snacks as well as games and other activities, but transportation and medical care's limited.


Larger businesses operate adult day care centers, the same that oversee nursing homes, home health, or assisted living facilities.

While they must adhere to local and federal laws, executives answer to shareholders.

Non-profit organizations

Charitable organizations, hospitals, and local communities also operate adult day care and senior centers on a non-profit basis. Their funding for services and programs come from community philanthropy, donations, and tax dollars through special funding funnels to the day centers.

Non-profits differ slightly in that their success is not measured by profit. Their measured success comes through the quality of services and the number of recipients participating.

Whether you opt to participate in adult care services that operate by an individual, a business, or a non-profit organization, it is important to research the facility first.

As with any care service, you contract for the care of a loved one, so do your homework. Your state's health department should have an on-line presence where you can search and find the latest requirements for staffing and licensure.

Interview the administration to find out the policies and procedures they operate by and follow before enrolling your loved one in their program. You can also check with your local or state government to see if the facility has had any staffing code violations, and how they corrected the violations.

Be sure to visit each center several times before selecting one. Observe the employees and recipients in action and how they relate to one another. Ask administrators to provide their licensing certificates and other credentials.

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.