Despite economic and social challenges facing California, Children Now advocates that the foundation of state vitality and well-being is a healthy, educated and skilled population, and urges efficient investments in children. State leadership is called upon to: (1) Ensure every child has affordable health insurance coverage; (2) Invest earlier in a child's life, to capitalize on the opportunity to improve cognitive, social and emotional development; (3) Increase access to preventive supports and services through integrated services; (4) Improve the K-12 system with evidence-based reforms; and (5) Deliver safe and enriching after school programs to all children who lack access to them, tailoring them to the distinctive programmatic needs of local communities. The "2009 California Report Card" provides an agenda for strengthening California through its children by detailing: (1) key public policy developments in 2008 that impact children's well-being; (2) policy objectives for improving the well-being of children; (3) recent data representing the current status of California's children; and (4) specific, immediate actions to target during the 2009-10 legislative session. (Contains 208 endnotes.)