We assessed the quality of child care in a nationally representative sample of 200 Dutch child care centers using the Infant/Toddler Environment Rating Scale-Revised and/or Early Childhood Environment Rating Scale-Revised and compared it with a previous assessment in 2005. The Caregiver Interaction Profile (CIP) scales were used to rate the quality of caregiver-child interactions. Results showed a significant and substantial decline in quality compared to 2005, with 49% of the groups now scoring below the minimal level. The CIP scales showed relatively high scores for the basic caregiver interactive skills of sensitive responsiveness, respect for autonomy, and structuring and limit setting but much lower scores for the more educational skills of verbal communication, developmental stimulation, and fostering positive peer interactions. Caregiver sensitive responsiveness was significantly lower in infant groups (0-2 years) than in preschool groups (2-4 years); caregiver respect for autonomy, verbal communication, developmental stimulation, and fostering positive peer interactions were significantly lower in infant groups than in preschool groups and mixed-age groups (0-4 years). Practice or Policy: Quality of child care is not stable across the years, and regular quality assessments are therefore needed to monitor child care quality. The low scores on the more educational versus the more basic caregiver interactive skills indicate that these skills deserve more attention in caregiver education and training. Training programs should be attuned to the individual interaction skill profile of caregivers. (author abstract)