Classroom quality and child outcomes were measured in Head Start classrooms across two separate sites in the southeastern United States. The classrooms were randomly assigned to treatment and control conditions. The treatment teachers received training and technical assistance to enhance the implementation of The Creative Curriculum ® (Dodge, Colker, and Heroman, 2002) (CC). The following measures were used to examine classroom quality: Early Childhood Environment Rating Scale-Revised (Harms, Clifford, and Cryer, 1998) (ECERS-R); Caregiver Interaction Scale (Arnett, 1989) (CIS); Teacher Behavior Rating Scale (Landry et al., 2004) (TBRS); and CC Implementation Checklist (Dodge, Colker, and Heroman, 2003). The treatment condition yielded greater gains than the control condition across all measures at the end of the second year of the study. Stronger effect sizes were found in the treatment group at the site that maintained higher quality technical assistance. Across the full range of child outcomes, there were no differences detected between the treatment and control children.