Existing research has found that home visiting programs for families with young children can improve children’s development and strengthen caregivers’ and families’ well-being. However, the pandemic created numerous challenges for home visiting programs, forcing them to deliver services online or in a hybrid format and to adapt the content of their program models to respond to pandemic-related challenges. Questions remain about the impacts of these programs when delivered at scale during this uniquely challenging time. The current study reports 12-month impacts from a randomized controlled trial of Child First—an evidence-based home visiting program that provides a psychotherapeutic, parent-child intervention embedded in a coordinated system of care—implemented across two states. After randomly assigning a racially and ethnically diverse sample of families (N = 226) from predominantly low-income backgrounds to receive the Child First services or typical community services, the research team surveyed caregivers (N = 183) about a year after program enrollment. Results from regression models with site fixed effects revealed that Child First reduced caregivers’ job losses, residential mobility, and self-reported substance abuse, and increased receipt of virtual services during the pandemic. Child First also reduced parenting dysfunction (the name of the subscale within the Parenting Stress Index) among caregivers who reported clinical depression at enrollment. There were null impacts on caregivers’ psychological well-being, families’ involvement with the child welfare system, children’s behaviors, and other indicators of economic well-being. Implications for future research and policy are discussed.