The ones in my town are mostly run out of the owner's house and they employ people who aren't fully certified in first aid and CPR. My stepsister actually quit her job to raise her son because of the fact that the benefits of staying home far outweigh the cons, and she got paid pretty well. It's a shame, but at least there is a parent that never misses out on the fun stuff. I got to see my daughter's first step, first words, and the first time she clapped about something. Plus she, adorably, imitates me when I do laundry. She will grab shirts from a basket and shake them out the way I do before loading them up lol! She also really loves to watch Pokémon with me.