The cost of child care in San Diego is increasing as providers face rising costs to run daycares, doubling the cost of undergraduate tuition at San Diego State University. The rising costs are exacerbating local families' expenses, leading to increased living costs and forcing some mothers to leave their jobs. Many middle-class families are unable to afford child care due to low income and low wages. The cost of childcare has increased over the last three years as food, housing expenses, health care for staff, supplies, and play materials have also become more expensive. The median annual earnings for San Diego County providers in a family child care home are $35,000-$45,000, while teachers in child care centers make $18-$27 per hour. The situation is exacerbated by California's expanding the transitional kindergarten program to include 4-year-olds.