Amends GS 110-91(7)a (staff/child ratios for childcare centers), as follows. Increases the minimum group size for children aged 0 to 24 months from 10 to 15 children and from 12 to 18 for children aged 12 to 24 months. Specifies that if a child care center is operating under voluntary enhanced requirements, the maximum group size for toddlers aged 2 to 3 years may be increased from 18 to 20 children when the child care center maintains a 1:9 staff-child ratio. Sets forth maximum group sizes for infants and toddlers ranging from groups of 12 with a staff/child ratio of 1:4 for children aged 0 to 12 months to groups of 20 with a staff/child ratio of 1:8 for children 2-3 years if the child care center is operating under the highest voluntary enhanced requirements. Provides that for groups of children 1 year of age or older, the staff/child ratio during nap time complies with the requirements of rules adopted by the Commission if (1) at least one person remains in the room, (2) all children are visible to that person, and (3) the total number of required staff are on the premises and within calling distance of the rooms occupied by children.