To inform the development of an inclusive national child care system for all families and children, we examine the institutional interactions of 127 Canadian families with disabled children. Our analysis demonstrates that families participated in numerous early-years services, but 79.5% experienced exclusion. Using an institutional ethnography lens, we illustrate that exclusion occurs through policy and regulations families confront to gain entry, maintain enrolment, and contend with professional meta-texts. Key rights-based, economic, and inclusion policy considerations are provided. Our research and policy considerations recognize not only the importance of inclusion in child care but also the role of child care in creating inclusive communities.