To improve access to high-quality early childhood education, California has made historic investments in Universal Prekindergarten (UPK), including the California State Preschool Program (CSPP). The state’s UPK initiative elevates the importance of multilingualism and the early identification of disabilities in children. This report offers insights at the intersection of language development for multilingual children and disability. Given that language development for multilingual children occurs at different rates and in different ways, distinguishing a language need from a potential disability-related need can be complex. To date, however, there is no state guidance for CSPP practitioners to follow when determining whether to refer multilingual children for a special education evaluation—a procedure known as the pre-referral process. This report presents findings from a research study designed to understand current pre-referral practices in CSPP. (author abstract)