This study reports on a medium-scale Jamaican study, The Early Interactions Project, which measured environmental quality in 42 childcare facilities in Jamaica using Infant and Toddler Environment Rating Scale (ITERS-3). One of the overarching goals of the project was to quantitatively measure programme quality with the goal of providing recommendations for the improvement of global process quality within the participating centres. These findings are then discussed relative to their implications for practices employed within childcare centres. The findings indicate that nursery settings are underperforming across all indicators of quality as measured by the ITERS-3 scale. This finding illuminates the need for increased access to professional development opportunities for nursery staff, improved financial capacities for nursery facilities and improved oversight of the sector catering to children in the 0-3 age cohort.