Much is known about how to provide safe environments for preschool children (3-5 years-of-age); however, many preschool children still experience preventable injuries--particularly children living in poverty. This study examined the use of an assessment tool used to identify children at risk for unintended injury in two large, federally funded Head Start programs during home visits. Families of preschool children in two multi-center Head Start programs (N = 499 and N = 228) were screened by teachers for risks related to safety in their home and parenting environment during mandatory Head Start home visits in the fall and spring. The safety screening tool was part of an established, broader interview assessment called the Family Map, which was designed to help Head Start programs meet mandatory performance standards related to the identification of risk and strengths in the family. Study results indicated that a large number of preschool children from low-income backgrounds were at risk for a variety of risks related to unintentional injury. Further, in some areas Head Start families increased their safety related parenting behaviors by the second assessment with different areas noted in the two programs. This study demonstrated that, beyond the use of the tool to identify families in need of intervention services, it can be used by childcare providers to effectively monitor family need and for program self-assessment.