Telephone interviews with local officials and child abuse specialists gathered general data on all 270 cases and more detailed information from child protection officials, criminal justice officials, therapists, and others knowledgeable about a sample of 43 cases. The analysis indicated that children in day care are not at special risk of sexual abuse. Perpetrators include caregivers, their family members, volunteers, janitors, bus drivers, and outsiders. Sixty-two percent of the victims were girls. Two-thirds of the abuse occurred in the bathroom. Touching and fondling of the child's genitals was the most common form of abuse, although penetration occurred to at least one child in 93 percent of the cases. Abusers were relatively successful in preventing disclosure, with abuse continuing for more than 6 months before disclosure in one-third of the cases. Fears and sleep disturbances were the main symptoms shown by the victims. The study was unable to identify categories of child-care facilities that were either invulnerable or extremely vulnerable to abuse. Many agencies were involved in investigations, sometimes cooperatively and sometimes uncooperatively. Legal or regulatory action was unsuccessful in many cases. Tables, index, 44 references, and recommendations for prevention, detection, investigation, and intervention.