Although an abundant body of research demonstrates the need for quality health and physical education and reveals the innumerable benefits optimal health has on both physical and cognitive development, the number of preschools offering structured health and physical education programs is less than satisfactory [National Policy and Legal Analysis Network to Prevent Childhood Obesity (NPLAN), 2011]. Furthermore, preschool programs that do provide structured physical activity for children are usually required to do so without the support of a certified health and physical education teacher. Preschool teachers and daycare staff often need to be trained by a certified physical education teacher before successfully implementing fitness-based lessons (Roth, Mauer, Obinger, Ruf, Graf, Kriemler, & Hebestreit, 2010). The purpose of this study was to examine preschool staff members' perceptions of a grant-funded obesity prevention program that was implemented in a preschool setting where 50% of the children were classified as obese. The qualitative sample included eight preschool employees who were required to make substantial changes to their daily routines in order to meet the requirements of the new health and activity program. The preschool employees were trained in leading health and physical education lessons by a certified Pre-K-12 health and physical education teacher and a Certified Health Education Specialist (CHES). A local grant was received from the United Way for the select Northeastern United States preschool to incorporate a structured nutrition and fitness program into their existing preschool curriculum. The preschool's mission was to provide affordable and accessible childcare to children living in a community that was economically affected by the collapse of the region's coal mining industry. Despite a lack of parental involvement, preschool staff elected to apply for an extension to the grant because of the many positive changes that took place within their preschool facility. Although it is unclear whether the grant will be reinstituted, preschool staff agreed that the benefits of the obesity prevention program far exceeded the barriers. Therefore, they are hopeful that, with or without grant funding, they can continue to provide children with nutritious meals and snacks and include both structured and unstructured physical activity as part of the preschool agenda.