A child died of an E. coli O157:H7 infection he acquired at the Fletch Family Day Care in Vancouver, Washington. The outbreak appeared to have been spread person-to-person. The environmental assessment and epidemiologic analysis revealed no point source for exposure. The index case-infant had diarrhea, while in attendance at the day care home, for several days. The day care home was temporarily closed by the Clark County Health Department, on April 2. The day care home's license was also suspended at that time. In June, the license was permanently revoked by the Washington State Department of Early Learning due to a pattern of noncompliance with minimum state licensing requirements.