This research aimed to assess the nutritional quality of diets as well as food safety and sanitation issues in child day care settings. More than 100 day care facilities participated in a comprehensive needs assessment and on-site visit. Data were collected regarding nutritional content of menus, compliance with Child and Adult Care Food Program guidelines, food consumption by children, and food safety and sanitation practices. Written menus submitted by the facilities exceeded 67% of Recommended Dietary Allowances for age. However, quantities of actual foods served were below requirements. Individual meal components were refused by up to 22% of the children, and no meal components were consumed by more than 65% of the children. Problems in food sanitation were also identified. Results indicate a need to identify barriers that day care personnel encounter in serving safe, adequate, and acceptable meals for children.