As the United States celebrates its 250th anniversary this year, San Francisco ranks the 17th largest city in the nation.
A San Francisco family with one infant in licensed center care now writes a check for $33,553 a year — about $96 a day, the highest figure in the index, ahead of every Manhattan, Boston, or Seattle reading. The price is set by a market the city's median $141,446 household income can absorb at a 23.7% burden, only marginally above the 21.9% national rate. Strip out the wealth and the bill consumes 43% of national-median earnings. Mothers' labor force participation runs 77%, the highest in this index; single parents head 23% of households, well below the national share. San Francisco's State of Childcare ranking — a Moderate 59, fifth in California — is not a story of a system that works. It is a story of a city that works only for households able to pay.
Key highlights & actionable takeaways
- Highest infant-care price in the dataset: $33,553 a year — more than double the national median, ahead of every Manhattan, Boston, or Seattle reading.
- Score 59 (Moderate), ranked #56 of 250; absorbs the price only because $141,446 median income and 77% mothers' LFP carry the load.
- Childcare-to-rent ratio 1.16 — care costs 16% more than the median apartment; a national-median household would spend 43% of pre-tax income on one slot.
Actionable takeaways
- Lead with the absolute price ceiling. $33,553 a year — about $96 a day — is the highest infant-care figure in the entire 250-city dataset, ahead of every Manhattan, Boston, or Seattle reading; this is the city where the price floor for participation is set.
- Reframe affordability through the median-income test. SF's burden runs only 23.7% because the city's $141,446 median income absorbs it; a national-median household would spend 43% of pre-tax earnings on one slot — a useful frame for explaining why the city "works" only for high earners.
- Use Oakland as the East Bay split. SF and Oakland share Bay Area pricing but Oakland carries a higher single-parent share (35% vs. 23%) and lower median income — the cleanest in-region comparison for showing who absorbs the price and who exits the city.
Affordability — 36/100
For a San Francisco family with one child in a licensed infant center, the annual bill runs $33,553 — about $2,796 a month, or $96 a day for what is, in most centers, a 9-hour day. That is the highest infant center price in this index, ahead of every Manhattan, Boston, or Seattle reading. It consumes 23.7% of the city's median household income of $141,446 — slightly above the national 21.9% burden, but only because the income side of the equation is high enough to absorb it. Strip out the wealth and the price is brutal: a household at the national median income of $78,538 would spend 43% of pre-tax earnings on a single infant slot in this city.
Family child care offers some relief at $23,094 a year — still higher than center prices in most American cities. The local infant-care-to-rent ratio is 1.16; childcare is 16% more expensive per month than the median San Francisco apartment, and the apartment costs $2,419. A San Francisco family pays roughly $16,400 more per infant per year than the national median family. This is the highest absolute premium in the country, and the most honest read on what the city's State of Childcare score conceals: even the city that pays the most can absorb it — for those who can pay.
Supply — 65/100
San Francisco runs about 39 licensed slots per 100 kids under five with working parents — well below the national 73-per-100, but not technically a desert. What the city has in unusual concentration is establishment density: 504 licensed sites for 35,279 kids under five, or roughly 14 establishments per 1,000 — the highest density in this index. Translation: many small centers and family child care homes serving a dense urban population, rather than a few mega-providers. The supply gap is real but the search is shorter than in suburban California, where slots cluster in commercial strip centers spaced miles apart.
Workforce — 69/100
Childcare workers in San Francisco earn a median $21.62 an hour — $44,970 a year, the highest in this index. That sounds like a reasonable wage until you set it against the EPI single-adult living wage for the city: $33.71 an hour. San Francisco's childcare workforce earns 64% of what one adult needs to live in the city without children of their own. Better than most cities measured here, and still not enough. The retention pressure is the same one that explains why so many SF families end up using nannies who commute from Daly City, Hayward, or the East Bay rather than centers staffed by workers who can afford to live in the neighborhoods they serve.
Family strain — 89.2/100
Seventy-seven percent of San Francisco mothers with kids under six are in the labor force — the highest reading in this index, well above the 68% national average. Single parents head 23% of households with kids, below the 32% national share. The combination of high two-earner participation and low single-parent share gives San Francisco the strongest family-strain reading in the batch. The flip side: this is not a city where one-earner households with young children persist in any meaningful number, because they cannot.
Policy support — 56.2/100
California enrolls 48% of four-year-olds in pre-K and offers eight weeks of paid family leave — modest by Northeast standards but meaningfully above Southern and Mountain West baselines. State pre-K spending per child is $15,192, second only to a handful of Northeast peers. CCDF subsidy reach covers 16.4% of eligible kids statewide; California's program serves roughly 232,500 children monthly. San Francisco's own city-level investment — including Preschool for All and the Children's Fund — layers on top of state policy and helps explain why the policy dimension scores meaningfully above California's overall state reading.
In-home care in San Francisco
San Francisco's nanny market is among the country's most professionalized and highest-paying. Full-time live-out nanny rates for one child have settled in the $30-to-$40-per-hour range, with experienced career nannies in Pacific Heights, Cow Hollow, and Noe Valley routinely commanding $45 and up. Nanny shares — two families splitting one nanny across a single home or alternating weeks — have moved from a Mission and Bernal Heights pattern into widespread practice across the city, driven by infant center prices that exceed many household mortgages. East Bay commute patterns shape the labor pool: a meaningful share of full-time SF nannies live in Oakland, Hayward, and farther east, with families adjusting start times to BART schedules. Au pair hosting remains a known but less common option in the city's smaller housing footprint, more typical in Marin and on the Peninsula.
Methodology: The the score is a 0-100 composite score across five dimensions: Affordability (30 pts), Supply (25 pts), Workforce Health (15 pts), Family Strain (15 pts), and Policy Support (15 pts). City-level prices and supply use the city's primary containing county; San Francisco is a consolidated city-county. Policy Support is measured at the state level. Full methodology and data sources: beverly.io/research/methodology.
Sources: U.S. Census Bureau ACS 2019-2023 5-year estimates; U.S. Department of Labor Women's Bureau National Database of Childcare Prices; U.S. Bureau of Labor Statistics OEWS (May 2024) and QCEW; Buffett Early Childhood Institute / Bipartisan Policy Center / Child Care Aware childcaregap.org (Sept 2025); NIEER State of Preschool Yearbook 2024; HHS ACF CCDF FY2023; National Partnership for Women & Families (March 2026).