Background: Childcare programs serving preschool children are generally of poorer quality than publicly-funded preschools both in terms of their classroom processes and structural features. Research on childcare programs has typically collapsed them into a single group, yet these programs vary greatly in neighborhood disadvantage and organization as they are managed by for-profit chains, non-profit community organizations, faith-based organizations, or individual owners. Little is known about variations in childcare program quality and what factors are associated with quality. Objective: The current study utilized latent profile analysis (LPA) with classroom process, structural features, and neighborhood disadvantage indicators to identify patterns of quality and neighborhood disadvantage within a diverse sample of childcare programs serving preschool children. Methods: Classroom processes (instructional support, emotional support, classroom management, positive discipline) and structural features (teacher age, experience, education, and satisfaction) data was collected from preschool teachers (N = 127) from 76 childcare programs. Neighborhood disadvantage (median income; rates of unemployment, single parents, and education) was measured using census tract data. Results: LPA indicated two profiles of childcare programs with high-quality classroom processes and two with poorer processes. Both of the high-quality profiles were in low-to-moderate income neighborhoods and the two low-quality profiles were in more affluent neighborhoods. Subsequent analyses suggested quality covaried with management type with the lowest quality centers often run by for-profit chains. Conclusions: Connections between classroom processes, structural features, and neighborhood disadvantage are complex making it extremely challenging for parents to identify high-quality care for their children.