This report covers the risks to health, safety, and emotional well-being for infants and toddlers in child care settings, and examines opportunities for diminishing those risks and promoting healthy development. Part 1 examines the risks of poor caregiving practices, including the spread of infectious disease, the incidence of injury, and the risks to healthy emotional development. Part 2 proposes systematic approaches that states can use to diminish risks and to provide for the healthy development of infants and toddlers in child care, through the following four components of states' child care quality assurance systems: child care regulation, state planned health and safety training, child care monitoring, and data collection on the health and safety status of infants and toddlers in child care. The report calls for development of mechanisms to ensure that service systems operate in an integrated, coordinated manner. Appendices provide a recommended schedule for immunization; a list of conditions in children that call for immediate medical attention; a discussion of inclusion, exclusion, and dismissal of children with mild infectious diseases from child care settings; and recommendations for training of child caregivers. (Contains approximately 55 references.) (JDD)