Implementation of the RTT–ELC QRIS was in an early stage at the time the study began, but significant progress has been made over the course of the system's development, from 2012 to 2015. The dissemination of QRIS ratings has been limited, but analyses of the ratings as well as community input suggest that providing detailed quality element scores may be beneficial. The study provides some evidence of the validity of California's QRIS ratings, though it is too early in the system's implementation to draw many conclusions. Study analyses reveal high levels of participation in quality improvement activities by program staff and point to coaching as a promising approach to improving quality.
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