What hospital-based services need to know
An ERO review is an opportunity to share what your hospital-based service does well, reflect on what could be strengthened, and show how your service supports positive outcomes for children and their whānau.
For a hospital-based service, ERO considers the service’s distinctive context. This includes how teachers work safely within the hospital environment, respond to children’s changing health and learning needs, work with families and whānau, and coordinate with relevant hospital personnel while maintaining the requirements of a licensed early childhood service. While every service is unique, ERO follows a consistent review process so that services know what to expect and how to prepare.
Services can expect the below review pathway:
Notification | Preparing for review | Review activity | After the review |
ERO contacts your service and explains the review process and what information is needed. | Your service provides the requested information and prepares the people and records that will support the review. | ERO gathers, verifies, and synthesises information through documentation, conversations, and observations relevant to your setting. | ERO completes a draft report for factual checking and then confirms and publishes the report. |
Before the review
How services can prepare for their review
Your notification information will explain the review process, key dates, what you need to provide and who to contact if you have questions. Read it carefully, because the information requested may vary according to the service and the focus of the review.
Before the review you must:
Complete and return the statistical profile of an Early Childhood Service - August 2025.
Send us an example of a completed recent review or evaluation.
We also recommend you
Identify any significant changes in your service since the previous review.
Contact ERO early if you are unsure what is required or need to discuss accessibility or practical arrangements.
Review progress against the improvement actions or areas of concern in your previous ERO report.
Gather current information that shows how your service monitors quality, compliance and improvement.
Information you may wish to have ready
information about governance, management and how the service oversees its network
visiting-teacher records and information showing how educators are supported and monitored
curriculum, assessment and planning information from across the service
internal evaluation, improvement priorities and evidence of progress
information about children’s health, safety and wellbeing, including relevant checks and records
information about educator homes, enrolments and the service’s operating context
evidence of partnerships and communication with parents and whānau
your service’s philosophy statement
your service’s annual plan.
Keep preparation useful
You do not need to create new material just for ERO if your existing information already shows what is happening in your hospital-based service, why decisions were made and what difference they are making for children and mokopuna
During the review
ERO designs the review using the information available about your service, including your previous report, the information you provide and discussions with service leaders. Review Officers may read documents, talk with people involved in the service and observe aspects of the curriculum in action.
Akarangi | Quality Evaluation
An Akarangi | Quality Evaluation looks at the learning and organisational conditions that support equitable and excellent outcomes for children.
Where do we start?
We will discuss your progress on the improvement actions identified in your last ERO report with you. Our reviewers also discuss your service’s recent reviews and internal evaluations and what you know about:
the process your service has in place for reviewing policies and practices
how well your service is doing in terms of improving quality and achieving equitable and excellent outcomes for learners
the extent to which learning and organisational conditions in your service support improvement.
Our reviewers use all the available information, including discussions with you, to design the evaluation.
Gathering information
We gather information by reading documents, meeting with key people, and observing aspects of your curriculum in action.
Using the indicators and the ECE Improvement Framework
We use Te Ara Poutama indicators of quality when we make judgements about what is happening for the children in your service, and the extent to which you are providing learning and organisational conditions that support their learning.
Akanuku | Assurance Review
An Akanuku | Assurance Review focuses more closely on whether the service is meeting regulatory standards and licensing criteria. ERO considers the service’s assurance information, checks relevant records and practices, and follows up where further assurance or actions are needed.
If concerns about compliance, risk, health, safety or wellbeing are identified, ERO may gather further information and set out actions that need to be addressed.
We do an Akanuku | Assurance Review of your service when:
Half or more of the licensing criteria or regulation ERO has checked indicate a systemic failure and one or more of the following criteria is also evident.
The assurance statement(s) indicates a limited understanding of the full licensing criteria.
There has been considerable turnover in teachers and / or leaders.
The ERO report history indicates that this service has not maintained compliance with regulatory standards.
What we focus on
In an Akanuku | Assurance Review we focus on whether your service meets and maintains the four regulatory standards and licensing criteria for:
Curriculum
Premises and facilities
Health and safety
Governance, management and administration.
We also look at how your service manages areas that have a potentially high impact on children’s wellbeing:
emotional safety (including positive guidance and child protection)
physical safety (including supervision; sleep procedures; accidents; medication; excursion policies and procedures)
suitable staffing (qualification levels, safety checking of staff, ratios)
relevant evacuation procedures and practices.
What we assess your service against
Akanuku | Assurance Reviews use the regulatory framework and licensing criteria to review your service.
See the regulatory framework and licensing criteria on the ERO website here.
Gathering evidence in an Akanuku | Assurance Review
Our reviewers gather and record evidence from:
discussions with people involved with the service
observations of the curriculum in action — including teaching practice, the environment and resources
any additional documents.
We then consider the evidence to determine our judgements about compliance.
Discussing emerging findings
Review Officers will discuss emerging findings with key people in the service. This is an opportunity to check that the review team has understood the context, ask questions and clarify the evidence. Final judgements are confirmed through ERO’s reporting process.
What happens if ERO identifies significant non-compliance or issues during hospital-based service reviews?
From 1 September 2026, ERO's review and regulatory functions work together to support quality, safety and positive outcomes for children and mokopuna.
Combining information from reviews and regulatory activity helps ERO build a fuller picture of the service’s performance and identify any areas where further action, monitoring or support may be required.
Most hospital-based service reviews focus on understanding what is working well, identifying opportunities for improvement, and considering how effectively the service supports children's learning, development, wellbeing and safety. This includes how the service responds to children's health and learning needs, works with families and healthcare professionals, and meets regulatory requirements.
Where significant concerns are identified, ERO may undertake additional review, monitoring, follow-up engagement or regulatory activity. This may include assessing compliance with regulatory requirements or concerns relating to the health, safety and wellbeing of children and mokopuna. ERO may also look more closely at the service's systems, practices and oversight arrangements, as well as the experiences of children receiving education and care.
If service providers, coordinators, visiting teachers, educators or leaders have questions or concerns about safety, wellbeing, or compliance with regulatory requirements, you can visit the managing an ECE section for more information. Parents and whānau can find specific information about complaints here. You can also contact the relevant team in ERO using the details on our contact page.