Pesticide use in and around child care centers is a potential health threat to children and staff. The implementation of integrated pest management (IPM) can reduce these risks yet child care providers receive minimal, if any, education concerning pest management. The objectives of this qualitative study are to: (a) develop a model to describe the process of implementing an IPM program in child care centers, (b) identify the facilitators and barriers to implementing an IPM program in child care centers, and (c) examine congruence between IPM practices identified on an IPM checklist with practices reported in qualitative interviews with child care managers. Interviews and IPM checklist observations were conducted with nine child care center managers in California before and after the introduction of a pilot IPM education intervention program. The qualitative analysis of the interviews revealed a four-stage IPM implementation process, from awareness of IPM, recognizing the importance of IPM and learning how to practice it, motivation and the decision to adopt IPM, to the implementation of IPM. A wide range of facilitators and barriers were identified. There was general congruence between the manager interviews and IPM checklist findings on IPM policies, practices, and management. Understanding the process of how an IPM program was implemented in these child care centers and the facilitators and barriers involved in the process can inform planning efforts for future health interventions in child care.