With the advent of a super-aged society, the quality of adult day care centers is crucial for promoting older adults’ well-being and satisfaction. The purpose of this study is to develop and validate a standardized, user-centered environmental quality scale that can bridge the gap between ideal and actual service conditions. Phase 1 involved literature review and expert evaluation; Phase 2 used a cross-sectional survey of 670 valid responses from 31 centers in southern Taiwan, all mixed-care facilities serving both frail and dementia elders, analyzed through exploratory factor analysis (EFA). The preliminary analysis identified three dimensions—Physical Environment, Service Function, and Atmosphere. Atmosphere was further divided into Natural Environment, Aesthetics & Culture, and Sustainable Living, yielding a final five-factor, 24-item scale. Each dimension showed high reliability (Cronbach’s α = 0.948–0.971) and strong construct validity (variance explained = 63.2%–67.3%). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) confirmed good model fit (CFI = 0.959; RMSEA = 0.057), with convergent validity (AVE > 0.634) and composite reliability (CR > 0.775). This validated scale provides a rigorous tool for quality monitoring, spatial design optimization, and evidence-based policy in adult day care settings.