Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of program quality and provides a comprehensive look into how home visiting services are delivered. While additional research is underway for further testing and refinements, the initial research suggests that the HVPQRT is a promising instrument for home visiting stakeholders who strive to increase service quality.