Research Findings: Child care delivery practices promoting continuous, primary caregiver-child relationships (relationship-focused child care) were evaluated for 223 preschool-age children (45% African American, 55% Latino) attending child care centers serving low-income children. Both relationship-focused and non-relationship-focused centers were accredited by the National Association for the Education of Young Children. Children in relationship-focused programs received more sensitive, involved, and affectionate caregiving and were more engaged with their caregivers than children in comparison centers, but some differences were greater for African American children. Outcomes associated with relationship-focused care included greater parent-reported child compliance and closer parent-caregiver relations, but no consistent benefits for cognitive school readiness, receptive language, or child behavior problems were found. Follow-up assessments were completed 1 year later for 119 children who remained in their programs. Social and cognitive outcomes improved over time, but some changes were moderated by child race/ethnicity and center type. Over time, parents reported greater child compliance and caregivers reported better parent-caregiver relationships in relationship-focused programs. Practice or Policy: Some social benefits of continuous, primary caregivers were found, but children's cognitive competencies improved with sustained attendance at these accredited programs regardless of the relationship-focused practices. (Contains 4 tables.)