Children cared for outside the home are at an increased risk of enteric disease. Microbiological analyses were performed on environmental samples collected from child care facilities in North and South Carolina. Methods: There were 326 samples collected from 40 facilities corresponding to common surfaces (77% of samples) and the hands of care providers (23% of samples). Samples were analyzed for total aerobic plate counts (APCs), total coliforms, biotype I Escherichia coli, and pathogens Shigella spp, Salmonella enterica, E coli O157, Campylobacter jejuni, and human norovirus. Results: Median APCs and coliform counts for hands were 4.6 and 1.0 log10 colony-forming units (CFU) per hand, respectively. Median APCs for surfaces were 2.0 and 2.6 log10 CFU for flat and irregular surfaces, respectively. Coliforms were detected in 16% of samples, with counts ranging from 1.0 log10 to >4.3 log10 CFU, with higher counts most often observed for hand rinse samples. Biotype I E coli counts were below assay detection limits (1 log10 CFU) for all but 1 sample. No samples were positive for any of the 4 bacterial pathogens, whereas 4 samples showed evidence of human norovirus RNA. Conclusion: The relative absence of pathogens and biotype I E coli in environmental samples suggests the child care facilities sampled in this study managed fecal contamination well. (author abstract)