Washington State Licensed Child Care Facility Directors' Perspectives on Childhood Immunization.

Background: The study objective was to determine Washington State childcare facility directors' compliance with state immunization education and monitoring requirements and the role of directors' immunization attitudes and beliefs on compliance.

Methods: We mailed a self-administered survey to 2000 randomly selected childcare facility directors in Washington State. The primary outcome measures were reported compliance with state requirements to educate parents about the importance of immunizations and monitor the immunization status of enrolled children.