State child care licensing regulations, which specify the standards for practice to which child care providers must adhere to be licensed, can be a policy tool for ensuring that child care providers use healthy nutrition, physical activity, and screen time practices. However, what state agencies do to support child care providers in actually implementing these practices, and how equitably this is done, is unknown. It is crucial to understand how best to actually translate state child care obesity prevention policies so that they ultimately improve child health; otherwise, efforts to improve the policies themselves may ultimately be futile. The aims are to 1) Identify specific strategies used by state child care licensing and public health agencies to implement nutrition, physical activity, and screen time policies specified in licensing regulations; 2) Explore state child care licensing administrators’ perceptions of barriers and supports to successful implementation of healthy eating, physical activity, and screen time policies and their perceptions of implementation in under-resourced communities, using qualitative interviews; and 3) Assess whether each state’s regulatory context and state demographics predict the total number of the state’s implementation efforts.