Hiring a part-time nanny means inviting someone into your home during your most vulnerable moments—when your children depend entirely on their care. Before you hand over your keys and your peace of mind, you need concrete assurance that the person watching your kids has been properly screened. Here's exactly what health and background checks you should require before any part-time nanny starts their first day.
Why Health Screenings Matter More Than You Think
Part-time nannies spend 15–30 hours per week in close contact with children, sharing meals, touching toys, and managing sick kids. A nanny with undiagnosed tuberculosis, untreated mental health conditions affecting judgment, or communicable diseases puts your family at direct risk. Health screenings aren't bureaucratic overhead—they're your first line of defense.
Essential Health Checks to Request
Tuberculosis (TB) Test This is the gold standard. Most families require a negative TB test before hiring, and many states legally mandate it for in-home childcare workers. A skin test costs $15–$50 and takes 48 hours for results; a chest X-ray runs $100–$300 if needed. Require proof dated within the last 12 months, and ask for annual updates if your nanny works for multiple families.
Physical Examination A basic physical from a primary care doctor confirms general health and catches underlying conditions that might affect reliability. Expect this to cost $100–$300 depending on your area and the depth of the exam. You're looking for documentation that the nanny is fit to perform the physical demands of childcare—lifting, bending, running after toddlers.
Immunization Records Request proof of vaccines against measles, mumps, rubella (MMR), tetanus, and preferably influenza. Part-time nannies should be up-to-date on these, especially if they care for infants under 12 months or immunocompromised children. This typically costs $50–$200 for any missing vaccines and takes 1–2 weeks to complete.
Background and Reference Checks Health isn't just physical. Run a criminal background check ($20–$50) and contact at least two previous families the nanny has worked for. Ask specific questions: Did the nanny show up reliably? How did she handle conflicts? Did she follow your household rules? A nanny who was fired for poor judgment is a red flag regardless of clean health results.
Creating Your Screening Checklist
Here's what to ask for before the first day:
- Signed TB test results (dated within 12 months)
- Doctor's letter confirming physical exam completion
- Immunization records or updated vaccination card
- Criminal background check authorization and results
- Written references from two previous families (with phone numbers)
- CPR and First Aid certification (ideally current, or renewed within 3 years)
- Emergency contact information and proof of valid identification
Who Pays for Screening?
This varies by region and agreement. Some families cover costs ($150–$400 total per nanny) to speed up hiring; others split the expense or ask the nanny to cover it. Clarify this upfront in writing. If a nanny refuses screening or balks at the cost, that's a warning sign—legitimate caregivers understand why families require it.
Ongoing Health Monitoring
One-time screening isn't enough. Ask your nanny to report any significant illnesses within 24 hours and to stay home if showing contagious symptoms. Consider requiring annual TB retesting if your nanny works for multiple families, and ask her to maintain current CPR certification (recertification costs $60–$100 every 2 years).
How Mercoly Streamlines the Process
When comparing and hiring part-time nannies, Mercoly helps you find vetted, screened providers in one place rather than vetting each candidate independently. This saves weeks of back-and-forth and gives you confidence that basic standards have already been met.
Frequently Asked Questions
Q: Can I ask a nanny to take a drug test before hiring? Yes—many families request it as part of standard screening. The cost ranges from $30–$100 depending on whether you use a simple urine test or a more comprehensive panel. Make sure it's legal in your state and discuss the policy upfront to avoid surprises.
Q: How long should I wait for screening results before making a final decision? TB tests take 48 hours; background checks take 3–7 business days; reference checks depend on how quickly previous employers respond. Plan for 2 weeks total and only issue a start date once all results are confirmed negative or clear.
Q: What if a nanny has an expired CPR certification? Require her to recertify before starting. While CPR isn't technically a health screening, it's directly relevant to your children's safety in emergencies and costs just $60–$100 to renew online or in-person.
Start your search for trusted part-time nannies by prioritizing health and safety screening—it's the investment that matters most.