Early childhood obesity is at epidemic proportions and is a major risk factor for the development of chronic diseases in adulthood. Since the majority of preschoolers are placed in center-based care, best practice policy, system, and environment (PSE) changes in early child care settings plays an important role in defining early development of obesogenic behaviors. However, implementation of best practice PSE changes is often a challenge in low resource settings due to staff turnover, time constraints, cultural beliefs, and lack of health-related knowledge. Assess, Identify, Make it Happen for Preschools (AIM-P) is a strategic planning process that was used with wellness teams in early child care centers to implement PSE changes that support adoption of health behaviors. AIM-P uses key change-making strategies based on intervention mapping including assets and needs assessments, prioritization of changes based on importance and feasibility, development of action steps and action plans, and identification of dissemination and sustainability plans. The AIM-P process resulted in implementation of 6.5 best practice PSE changes per site. Qualitative findings highlight lessons learned and the facilitators and barriers associated with using AIM-P to implement PSEs.