By Thea Jarvis

At three-and-a-half, Calvin Lee Swinger, Jr., is a curious young man. Round and hearty, dressed in mini-baseball togs and sneakers, his big brown eyes and investigative fingers probe whatever he can find at the Tender Healthcare Center (THC).

Known as C.J. to friends at THC, Calvin Lee has a lot of catching up to do. Born prematurely, he developed bronchopulmonary dysplasia, a scarring of the lung tissue caused by the ventilator tube that helped him breathe during the early, stressful months of his life.

C.J. came to THC last February because he refused to eat. Memories of the pain and discomfort experienced when he first began ingesting food translated to a dislike for eating altogether.

"Anything that touched the top of his mouth he threw up," explained Terry Austin, THC's director. The center, which received a $2,500 grant from the Campaign for Human Development this year, is a not-for-profit pediatric day treatment facility providing nursing care, therapy and developmental stimulation for medically fragile or technology-dependent children aged six weeks through preschool.

It took six months to teach C.J. to eat, Ms. Austin said, admitting it was "a test of wills" requiring staff to don raincoats and spread plastic tablecloths when his meals were served.

"All the children would sit around and every time he ate something they would clap," she said, explaining one step in the center's gentle behavior modification that changed C.J.'s eating habits.

So good a job has THC's staff done that last month, C.J.'s doctor took one look at his little patient's growing frame and advised it was time to "cut back," Ms. Austin said.

Tender Healthcare Center, located on Dresden Drive in Atlanta, not far from the Brookwood MARTA station, specializes in success stories like C.J. Opened in July 1991 as a prototype for its parent company, Pediatric Services of America, Inc., located in Norcross, THC offers an alternative to in-home and regular day care services for special needs children.

Often, parents bring their children to THC because they have reached the end of their financial and emotional rope.

"It I hadn't found this place, I have no idea what I would have done," said Charlotte Smith, whose son, one-year-old Jonathan, came to THC after suffering cardiac arrest in another day care center. His heart had been affected when the tracheotomy tube in his throat became dislodged and he was unable to breathe.

Children with health problems often exhaust insurance benefits in the first year of life. Parents must sometimes mortgage their home, take a second job or face bankruptcy to meet the exorbitant costs for children with special health problems.

Mrs. Smith and her husband, both fully employed, were told by their Health Maintenance Organization that Jonathan should be able to receive care from any custodial caregiver.

When their son's medical emergency proved that was not the case, the Smiths brought Jonathan to THC. Like most youngsters at the center, his is on scholarship because the insurance company refuses compensation. His parents pay daycare fees on a sliding scale basis. Jonathan still needs careful attention, but he is thriving at THC.

"A child's condition doesn't go away," just because "an insurance company decides they're not going to take them anymore," said Ms. Austin, who worked in Grady Hospital's neonatal intensive care unit before heading up THC.

The center, open from 7 a.m. until 7 p.m. Monday through Friday, now cares for 11 children. The maximum number it can accommodate is 15. Since it opened, 25 children have come through the facility.

"They all come in with a discharge plan," Ms. Austin explained. Some of the children are in care for a short while, others for extended periods. One set of twins who were four pounds at birth stayed at THC until they reached 15 pounds and could be admitted to regular daycare.

"It depends on the medical problem," she said. But always, "the purpose is that they aren't treated like sick children." They engage in normal activity that leads to socialization. "We teach them to give a high-five, shake hands and give each other kisses," she laughed.

A Syracuse, N.Y., native and Boston College graduate, Ms. Austin is a Catholic who trained at St. Joseph's Hospital in her hometown. She is enthusiastic about CHD support.

"It was the first grant we secured," she said, pleased that "somebody recognized we are a good cause."

Three-quarters of monies raised through the annual CHD pre-Thanksgiving collection goes towards national projects. The remainder stays in local dioceses to fund projects like THC.

The center has a $300,000 seed loan from Pediatric Services of America, Inc., a debt that hangs heavy over her head, said Ms. Austin, who works a 10 hour shift, from 9 a.m. until 7 p.m. five days a week. Other staff members include two L.P.N.'s and three nursing assistants. THC subcontracts speech, occupational and physical therapy for its young clients and is currently working up a volunteer pool and an "adoption plan through which groups and individuals can offset costs for one child's care.

Despite the long hours, Ms. Austin says her job has "a lot of rewards."

"These are my kids," she said. "They are sick kids, but everyone here works so hard to keep them healthy, they don't seem sick."

Contented murmurs from her little charges affirm Ms. Austin's observation.

"They are very happy," she said of the children. "There's rarely a time that you hear anybody crying. They know each other very well and are very affectionate and loving."