Constructing a quality monitoring system for inclusive childcare services at the county level is an indispensable path to improving the fertility support policy system, advancing the development of a fertility-friendly society and promoting high-quality population development, a key carrier for realizing the connotative development of childcare services from “accessible childcare” to “quality childcare”, as well as a critical institutional guarantee for bridging the urban-rural imbalance in childcare services and consolidating the bottom line of educational equity. From the perspective of stakeholders, and guided by the principles of “demand-orientation, child-centeredness and continuous improvement”, this study constructs a framework for the quality monitoring system of inclusive childcare services at the county level around such structural elements as monitoring philosophy and objectives, monitoring subjects and objects, monitoring contents and tools, and feedback and application of monitoring results. On this basis, it examines the practical dilemmas confronting the system, including dilemmas in quality assurance, the imbalance of rights and responsibilities among multiple monitoring subjects, inadequate collaborative governance mechanisms, insufficient process quality monitoring, the lack of holistic design in the development of monitoring tools, and insufficient feedback and application of monitoring results. Based on this, using the CIPP theory and following the logic of context and input, operation process, and achievement output, we will accelerate the promulgation of the Childcare Service Law to ensure that childcare services are governed by law, clarify the input elements of the quality monitoring system for inclusive childcare services at the county level, uphold the concept of output-oriented, child-centered, and continuous improvement, innovatively integrate self-evaluation and external evaluation methods, carry out “comprehensive, whole-process, and three-dimensional” monitoring on the structural quality, process quality and outcome quality of inclusive childcare institutions at the county level, improve the release and feedback mechanism of childcare quality monitoring reports, improve the accountability and intervention mechanism of childcare quality monitoring reports, form a quality management closed-loop of “monitoring-evaluation-feedback-improvement”, and continuously promote the high-quality development of the county-level childcare service industry.