Proposition 10, also known as the California Children and Families Act of 1998, is the legislation for creating Kern County Children and Families Commission (First 5 Kern). Over the past 15 years, First 5 Kern administered a trust fund from a $.50 per pack tax on cigarettes or equivalent tobacco products to support children ages 0-5 and their families in Kern County. Guided by its strategic plan, First 5 Kern has allocated more than $160 million since its inception to support early childhood services in local communities. In Fiscal Year 2013-14, First 5 Kern spent over $10 million to fund 40 programs in Child Health, Family Functioning, and Child Development. Approximate 7.5% of the annual budget was devoted to strengthening systems of care through service integration. Following a model of results-based accountability, this report summarizes multilevel evaluation findings to show what works, for whom, and in which context of early childhood development in Kern County. The report includes five chapters: Chapter 1: highlights features of First 5 Kern support; Chapter 2: provides program-specific findings that impact children ages 0-5 and their families; Chapter 3: describes results of partnership building to strengthen the capacity of service integration; Chapter 4: includes longitudinal results from the Core Data Elements (CDE) survey and Family Stability Rubric (FSR) to describe sustainable accomplishments through ongoing improvements. This report ends with Chapter 5: Conclusions and Future Directions to clarify recommendations for stakeholders across a region as large as the state of New Jersey. Quantitative and qualitative approaches have been taken to describe service outcomes in different communities, including the city of Bakersfield that has surpassed St. Louis in population size. The report follows the Statewide Evaluation Framework for Proposition 10 and conforms to the Utility, Feasibility, Propriety, and Accuracy standards for program evaluation. The report also includes appendices: (1) Index of Program Acronyms; and (2) Technical Advisory Committee served in FY 2013-14 and Current Year.