Early care and education can prepare children for school, but while some preschool and child care programs do an excellent job, others are inadequate and some may even harm healthy development. This study focuses on child care center directors to better understand why there is so much variation, and how public initiatives can better help poor-quality programs improve. Using data from in-depth interviews and classroom observations, the research considers how various factorsincluding director and program characteristics, market forces, and federal state and local policiesare associated with each other, director decision making, and program quality.