The establishment and subsequent modification of a child care system for employees, faculty, and students of the University of Colorado Medical Center are discussed in detail. The project was partially funded by the Office of Child Development. Components of the project included three direct service programs: (1) day care for children ages 2 1/2 to 6, (2) care for older children after school and during the summers, and (3) training and support for day care mothers and development of day care homes as additional child care resources. Family counseling and referral were provided as a fourth component. An Advisory Board was established to allow Medical Center employees, students, parents, and project staff members to contribute opinions and information. Extensive evaluative sections in the report cite problems encountered in program implementation, including poor relations between caregivers and administrative staff, pressure to disseminate prematurely, diffusion of individual staff members over all components, repeated administrative restructuring, and the desire of Advisory Board members to determine policy. Recommendations are made based on experience with these problems. At the end of three years Office of Child Development funding expired, and serivces at the Medical Center were discontinued, but part of the program was absorbed by other community child care facilities. (BRT)