This paper describes the development of voluntary healthy eating and physical activity quality standards (HEPAQS) for out-of-school time programs. The final HEPAQS were developed using a national, mixed-methods needs assessment, review of existing standards and expert recommendations, and a participatory process of discussion, review, and consensus engaging 19 service and policy organizations and agencies in the Healthy Out-of-School Time (HOST) coalition. HEPAQS adapts individual-level recommendations for healthy eating (e.g., reducing or eliminating sugar-sweetened beverages) and physical activity (e.g., 60 minutes of moderate-to-vigorous physical activity) into program level recommendation. The final HEPAQS document comprises 11 standards for healthy eating and physical activity that address content, staff training, program infrastructure, curriculum selection, and creating a supportive social and physical environment.