SIDS deaths in child care settings may be as high as 37% (Minnesota). With 49% of licensed child care centers always/sometimes using the prone position for infant sleep and 43% unaware of the association between SIDS and infant sleep position (Pediatrics 1997;100:75-78), concern has been raised about infant care in day care facilities. Because ≈ 9% of SIDS deaths in Illinois (Dept. of Public Health Statistics) occur in day care or at a babysitter, we sought to determine adherence with modifiable risk factors for SIDS in any licensed child care facility to better understand this discrepancy in number of SIDS deaths in day care. A pilot telephone survey assessing knowledge and practice of SIDS risk factors was administered to 114 randomly selected licensed day care providers (for 406 infants ≤ 1 year of age in Chicago; 24 organized and 90 home day care facilities). Results indicate that 17% of centers use the prone position for infant sleep and 73% were unaware of the association between SIDS and infant sleep position. Further, parents in 35% of centers requested a specific position for sleep and of these 31% requested the prone position. None of the day care centers allowed smoking, yet 26% employed smoking caregivers. 46% of centers used soft bedding items(blanket, comforter, pillow, cloth diaper) under a baby's head. Although infants were not overbundled (96% of infants put to sleep in 1-2 layers of clothing), the temperature at 21% of the facilities was maintained at ≥ 75° F. Bed sharing was not practiced in any of the centers. SIDS experience (prior death in center 2%, SIDS sibling in attendance 5%, personal experience 28%) did not predict compliance with avoidance of prone position(p>0.05; Chi Square Test). These results indicate avoidance of prone positioning is being practiced by day care providers in Chicago, IL and thus may explain the discrepancy in the incidence of day care associated SIDS deaths. However, the practice is not associated with the knowledge of SIDS risk factors. This indicates an opportunity to reinforce proper parent education/caregiver practice specific to SIDS risk factors. One can anticipate that aggressive education at the time of licensing and recertification of day care facilities caring for infants will further decrease the incidence of SIDS.