Childhood obesity is associated with significant morbidity and mortality and poses a health care burden. Child care facilities serve at the forefront in fighting childhood obesity among preschoolers. Since 2009, a significant shift has occurred in studying child care settings among children aged 3-5 in North Carolina and South Carolina in response to the rising rates of obesity in this population. Some of the hypothesized determinants of childhood obesity among preschoolers in North Carolina and South Carolina are outdoor activity, staff behavior, center's size and location. The purpose of this study was to investigate if significant relationships exist between childhood obesity and each one of these variables. This study was conducted within the framework of social cognitive theory within the contexts of the process of self-efficacy for realizing goals. A quantitative correlational design was used, while data were collected through Survey Monkey administering a closed end survey. Multiple linear regression was used to examine the associations between childhood obesity and center size, location, outdoor activity and staff behavior. The Power analysis determined total of 110 participants (N=100) who worked in North and South Carolina Head Start facilities of preschool children aged 3-5. The multiple regression indicated significant contributions of the center size (â = .32, p = .001), the location (â = -.28, p = .002), the outdoor activity (â = -.25, p = .005), and staff behavior (â = .27, p = .008). Therefore, the overall null hypotheses were rejected. This study may help to effect positive social change through identifying the important barriers to minimizing the risk of obesity among preschool children, which in turn would help to inform policy for developing and implementing strategies to reduce risks of preschoolers' obesity.