Strictly legally speaking, the OT rate is based on a weighted average rate of the work week. So of 50% of the time it is a rate of $10/hr and 50% $20/hr, the OT rate would be 1.5 x 15$/hr.
Just be sure to show the nanny the math explicitly whether you decide to do this route or simply paying OT on the higher rate, so there is no confusion.
The relevant law is linked below.
See bottom paragraph on first page
http://www.dol.gov/whd/regs/compliance/whdfs23.pdf