We identified 684 playground hazards in 66 child care centers despite regulations mandating that the grounds be hazard-free. Of 21 centers with less than or equal to 5 hazards, 42.9 percent reported a playground-related injury in the previous year; of 25 centers with 6-11 hazards, 52.0 percent reported a playground-related injury; and of 20 centers with greater than or equal to 12 hazards, 60.0 percent reported a playground-related injury. Climbing equipment greater than or equal to 6 feet tall generally had inadequate impact-absorbing undersurfacing and had over twice the rate of fall injuries as climbing equipment less than 6 feet.