Home-visit parenting programmes have been linked to positive developmental outcomes among participating children, yet few studies have explored the mechanisms behind this impact. We observe 40 home visits across seven countries in Latin America and the Caribbean, using an observational tool to assess visit content, coaching strategy, and the quality of the relationship between the home visitor (HV) and families. Across nearly all visits observed, we find strong rapport between visitors and families, and active participation in play-based learning activities introduced by the HV. Other aspects of home visit design are weakly implemented, namely the revision of topics from previous sessions, demonstration of activities, and dialogue between caregiver and HV. The visits observed provide an opportunity for caregivers to practice early stimulation activities, but it is unclear whether this strategy contributes to strengthening caregivers' knowledge of child development.