This report reviews all of the state QRIS validation studies that examined associations between individual rating elements and child outcomes as well as other research that exists on four elements of the California QRIS, referred to as Quality Counts California: teacher qualifications, program environment, teacher–child interactions, and child-to-teacher ratio and group size. The review indicates that the current elements in Quality Counts California have weak and inconsistent associations with child outcomes. The problem is not necessarily with the dimensions measured but with how they are measured and with how points are allocated. (author abstract)