We investigate what aspects of adult day care are regulated by licensure and certification requirements, whether differences exist among centers according to their regulatory status, and the relationship between regulatory status and satisfaction. The data come from a national survey of adult day care centers. We find that adult day care regulations are primarily structural in nature and that differences do exist among centers by regulatory status. Participants are very satisfied with the centers and their staff overall, especially at centers that are regulated; their satisfaction with milieu is less at regulated centers and with amenities is unaffected. Day care regulations have not been extended to the processes and outcomes of care as nursing home regulations recently have been. The choice that now faces policymakers is between increasing these regulations or relying on market mechanisms to protect day care participants.