The process evaluation identified six accomplishments in implementing the Safe Start initiative in the 11 demonstration sites as they sought to establish partnerships and programs that would improve a community's response to children exposed to violence, which is the focus of the Safe Start initiative. First, the sites brought attention to the impact of exposure to violence among children in their communities. Second, they assisted agency directors and front-line providers begin to formally recognize and define the system of care for these children. Third, sites acted to increase the capacity of community organizations to respond to children exposed to violence; and fourth, the sites improved collaboration across key sectors in the community. Fifth, the demonstration site launched institutionalized change that will reduce the impact of violence on young children exposed to violence. Sixth, demonstration sites improved community organizational awareness of the knowledge, skill, and experience of the variety of organizations equipped to assist children exposed to violence. The process evaluation also identified challenges in Safe Start program implementation, including gaps in capacities for assessing, treating, and monitoring outcomes for children exposed to violence, adaptations in existing interventions for such children, and difficulty in cultivating supportive family and community environments for children exposed to violence.