Transcript California Child Abuse Mandated Reporter Training

CALIFORNIA MANDATED
REPORTER GENERAL TRAINING
funded by California Department of Social Services,
Office of Child Abuse Prevention
prepared by The Chadwick Center at
Rady Children’s Hospital San Diego
Objectives
 After completion of this training, you should
understand:
 How the law defines child abuse and neglect
 What is required of you as a mandated reporter
 What protections the law provides for you as a
mandated reporter
 How to spot signs of child abuse
 How to report child abuse
 What happens after a report is filed
Introduction
 Child Maltreatment 2010*
 Most recent report of data from the National Child
Abuse and Neglect Data System (NCANDS)
 Approximately 3.6 million children had reports of
suspected abuse or neglect
 19.5% were substantiated, meaning
approximately 695,000 children were found to be
victims of child abuse or neglect in 2010
* US Dept of Health &Human Services
Introduction
 California passed it’s first child abuse
reporting law in 1963
 Stated that physicians must report physical abuse
of children
 CANRA was passed in 1974 in California
 Child Abuse Neglect and Reporting Act
 Has been amended over the years
 Expanded list of who is mandated to report
Who are Mandated Reporters?
 Complete list includes 37 categories, refer to
penal code 11165.7
 Generally includes anyone who works or
comes into contact with children in their job
 Does not include volunteers
 Can report, but not mandated
What must be reported?
 Under CANRA, suspicions of the following
must be reported in California
 Physical abuse
 Sexual abuse
 Emotional abuse
 Neglect
 When the victim is under the age of 18, and
the perpetrator is any age
Identifying Child Abuse
 Requires first the understanding that child
abuse can occur in any family, regardless of
socio-economic status, religion, education,
ethnic background, or other factors.
 Cultural beliefs may affect our perception of this
 Secondly, the professional must be aware of
and alert to the signs of child abuse.
Culture
 A set of beliefs, attitudes, values, and behavior
that is passed down from generation to
generation
 Shaped by many factors including race, religion,
and ethnicity
 Influences attitudes and ideas about acceptable
child behavior and discipline
 Also affects perceptions of stress, trauma, abuse
and reactions to all of those
Cultural Sensitivity
 It is natural to see one’s own culture as the
normal or correct culture
 We must be aware of our own values, beliefs
and biases, and how those influence our
expectations of others so that we
 are best able to understand differences in parenting
 avoid unnecessary reports
 meet the needs of all children in a sensitive manner
What to Report - Physical Abuse
 CANRA defines as a physical injury inflicted
by other than accidental means on a child
 Also includes unlawful corporal punishment
or injury, willfully inflicted, resulting in a
traumatic condition
 Spanking or corporal punishment is not
necessarily illegal, it should be “reasonable and
age-appropriate”
Physical Abuse
 A physical injury or action of harming a child
 Bruises, bites, burns, fractures, abusive head trauma
 Although the injury is not an accident, the parent
or caretaker may not have intended to hurt the
child
 May result from excessive discipline or
inappropriate physical punishment
 The injury may be the result of a single episode
or of repeated episodes and can range in severity
from minor bruising to death
Physical Abuse
 Type, location, and pattern of skin injuries
may help distinguish accidental injuries
from suspected physical abuse
 However, any injury, even a small bruise in
a very young infant is concerning
 Young infants are not mobile
 Completely dependent on their caregivers
 Any injury in this age group should raise
concern for the possibility of inflicted injury
Child Motor Development
 Developmental abilities of a child should be
considered when evaluating injuries
 If a child is unable to roll over or crawl, they are
unlikely to have sustained an injury on their own
Age
Milestones
2 months
Lifts head
4 months
Rolls over front to back
6 months
Rolls over both directions and sits up
9 months
Crawls, cruises
12 months
Walks
18 months
Runs
24 Months
Walks upstairs
Physical Abuse
 Once children are toddlers, and capable of
crawling or walking, bruises are very common
 Location and pattern of the injury needs to be
considered
 Common locations for accidental bruises in toddlers
and children include bony areas such as shins,
elbows, knees, forehead, and chin, among others
 Common locations of abusive injuries include the
back, buttocks, ears, face (particularly the soft
tissues of the cheek), neck, and genitalia
Location of Bruises
Normal or
Accidental
Bruising
Abnormal or Suspicious Bruising
Forehead
Cheeks of the face
Head
Buttocks
Chin
Ears
Knees
Neck
Elbows
Back
Outer arms
Genitals
Shins
***This is not a complete list or a perfect rule, it is a guide
Physical Abuse
 Abusive bruises and burns may also be
patterned, or have a distinct outline
 Accidental bruises usually do not leave a
clear pattern or outline
 While an outline or pattern should raise
concern, abusive injuries are not always
patterned, and may look very similar to
accidental bruises
 Some common patterns of INFLICTED
bruises are shown next
Physical Abuse
 Other types of injuries that may signal child
abuse include but are not limited to:
 Broken bones
 Lacerations
 Burns (hot water scald, iron)
 Abusive head trauma
 Any injury with a delay in seeking treatment
Intimate Partner Violence
 California is one of the few states that
mandates reports of intimate partner abuse
between adolescents / teenagers
 “Intimate relationship” not dependent on age
 Can be reported to either local child welfare
services or law enforcement agency
 Unfortunately, responses to reports of
intimate partner violence affecting minors
vary enormously from jurisdiction to
jurisdiction
Red Flags – Parent Behaviors
 Parental depression or other mental illness
 Parent tells you of use of objects to discipline the
child
 belts, whips, clothes hanger
 Parent has unrealistic expectation of child
 toilet-training a 6-month-old




Parent is unduly harsh and rigid about childrearing
Parental substance abuse
Parent berates, humiliates, or belittles child
Parent misinterprets child's normal behavior
 a parent interprets an infant's crying as evidence that
child hates the parent
 Parent is indifferent to child
Red Flags – Child Behaviors
 Hostile, aggressive, or verbally abusive toward
others
 Fearful or withdrawn behavior
 Self-destructive
 self-mutilates, bangs head, etc.
 Destructive
 breaks windows, sets fires, etc.
 Frightened of going home, frightened of
parents/caretakers
 Attempts to hide injuries
 Frequent absence from school
 Clingy, forms indiscriminate attachments
What is NOT Physical Abuse
 A "mutual affray between minors"
 "Reasonable and necessary force" used by a
peace officer
 "Reasonable and necessary force" used by a
person employed in a public school to quell a
disturbance threatening physical injury to
person or damage to property, for purposes of
self-defense, or to obtain possession of
weapons or other dangerous objects within the
control of the pupil
 Spanking that is reasonable and ageappropriate and does not expose the child to
risk of serious injury
Practice Question
You are an employee at a school. A 7 year old child
comes to school with linear red bruises on his
cheeks. He was absent the day prior. When you
ask him what happened to his cheek, he replies
that he fell while riding his bike. Do you report this
injury?
A. No, because falling off a bike is an accidental
injury
B. Yes, because he missed school the day prior
C. No, it is a very minor injury
D. Yes, because the injury is concerning for a
slap mark
Practice Question
You are an employee at a school. A 7 year old child
comes to school with linear red bruises on his
cheeks. He was absent the day prior. When you
ask him what happened to his cheek, he replies
that he fell while riding his bike. Do you report this
injury?
A. No, because falling off a bike is an accidental
injury
B. Yes, because he missed school the day prior
C. No, it is a very minor injury
D. Yes, because the injury is concerning for a
slap mark
Practice Question
In the course of your work, you observe a mother
spanking a 2 year old child twice on the buttocks
with her hand for eating food off the ground.
What should you do as a mandated reporter?
A. Confront the mother
B. Nothing, the spanking seems reasonable and
age-appropriate
C. Report this as physical abuse for excessive
discipline
D. Any of the above
Practice Question
In the course of your work, you observe a mother
spanking a 2 year old child twice on the buttocks
with her hand for eating food off the ground.
What should you do as a mandated reporter?
A. Confront the mother
B. Nothing, the spanking seems reasonable and
age-appropriate
C. Report this as physical abuse for excessive
discipline
D. Any of the above
Questions?
What to Report - Sexual Abuse
 Per CANRA, child sexual abuse includes both
sexual assault and sexual exploitation
 Sexual assault includes
 Sex acts with children
 Child molestation
 Intentional masturbation in the presence of a child
 Sexual exploitation includes
 Preparing, selling, or distributing pornographic materials
involving children
 Performances involving obscene sexual conduct
 Child prostitution
Sexual Assault
 Includes










CANRA cites following
sections of CA penal code:
261, section d of 261.5,
264.1, 285, 286, 288, 288a,
289, 647.6
Forcible Rape
Statutory rape (section 261.5)
Incest
Sodomy
Lewd or lascivious (indecent, or of
a sexual nature) acts upon a child
Oral sex
Sexual penetration
Child molestation
Intentional touching or fondling of the genitals or
intimate parts (including the breasts, genital area, groin,
inner thighs, and buttocks) or the clothing covering them,
for purposes of sexual arousal or gratification
Masturbating in the presence of a child
Sexual Abuse
Age of Victim
Report Required if:
Under 18
(14-17 years)
Rape, sexual assault, sexual abuse
Any sexual intercourse with a partner 21 years or
older (one form of statutory rape)
Under 16
(14-15)
Under 14
Any sexual activity of any kind with a partner 10
or more years older
Any sexual activity of any kind with a partner 14
or older
Reporting Consensual Sexual Intercourse
M = mandated, must be reported based on age difference
CJ = Clinical Judgment, the report is not mandated solely by age, but
other factors may warrant reporting
From “Understanding Confidentiality and Minor Consent in California”
http://www.californiateenhealth.org/download/toolkit-rri-Web.pdf
Sexual Abuse
 The following situations do not require
reporting:
 Unforced sexual activity between minors under
14 years who are "of like age"
 Unforced sexual activity between minors aged
14-17 and partners aged 14-20
 Note: There is no law that requires health
providers or other professionals who work
with adolescents to ask the age of a
patient's sexual partner(s)
Sexual Exploitation
 Depicting a minor engaged in obscene acts
 Preparing, selling, or distributing obscene matter
that depicts minors
 Employment of minor to perform obscene acts
 Any person who knowingly promotes, assists,
employs, uses, persuades, induces, or coerces a
child to engage in prostitution or a live
performance involving obscene sexual conduct, or
to either pose or model in child pornographic
material
 Any person who depicts a child in, or who
knowingly develops, duplicates, prints, or
exchanges, any film, photograph, video tape,
negative, or slide involving child pornography
Sexual Abuse – Risk Factors
 Identified risk factors include:
 Being female
 Living in a single parent household
 Having a mother who is unavailable
 Perceiving family life as unhappy
 Having psychological or mental delays
 Sexual abuse often occurs in the absence
of any risk factors and without any
obvious signs
Red Flags – Child Behaviors
 Inappropriate sexual knowledge for age
 Demonstrating sexual acts on other children




or toys
Molesting other children
Post-traumatic stress disorder
Emotional and behavioral problems
Sexually transmitted infections
Sexual Abuse - Disclosure
 Most victims of sexual abuse report the
crime(s) months or even years after they
have occurred
 Many victims never report at all
 It is very common for children to recant a
disclosure of sexual abuse
 They disclose the abuse and then change their
story, denying that it ever happened
 This happens for a variety of reasons including
fear, guilt, shame, embarrassment, or even a
desire not to hurt the perpetrator or family unit
Practice Question
You are working in a daycare. You repeatedly observe a
4 year old boy “humping” and kissing a teddy bear in a
sexual way. When you ask him why he is doing that, he
does not reply. He has never disclosed sexual abuse.
Which of the following are you required to do as a
mandated reporter?
A. Nothing, this is normal childhood behavior
B. Report this to local authorities as this is not normal
child behavior
C. Discuss this with his parents
D. Interview him about possible sexual abuse
Practice Question
You are working in a daycare. You repeatedly observe a
4 year old boy “humping” and kissing a teddy bear in a
sexual way. When you ask him why he is doing that, he
does not reply. He has never disclosed sexual abuse.
Which of the following are you required to do as a
mandated reporter?
A. Nothing, this is normal childhood behavior
B. Report this to local authorities as this is not normal
child behavior
C. Discuss this with his parents
D. Interview him about possible sexual abuse
Questions?
Neglect
 Under CANRA neglect of a child, whether
"severe" or "general," must be reported if the
perpetrator is a person responsible for the child's
welfare
 Includes:
 Acts (i.e. locking a toddler in a hot car)
 Omissions (i.e. not providing food)
 The neglect may cause harm to the child or just
threaten to harm the child's health or welfare
 Must still report even if no injury
Neglect
 General neglect
 Failure of a caregiver to provide adequate
food, clothing, shelter, medical care, or
supervision, where no physical injury to the
child has occurred
 Severe neglect
 The intentional failure of a caregiver to
provide adequate food, clothing, shelter, or
medical care
 Or caregiver willfully causes or permits the
child to be placed in a situation such that his
or her person or health is endangered
Neglect
 Can be further divided into different types - the
following examples do not constitute a complete
list
 General or physical neglect - not providing adequate
food, clothing, or a safe home environment
 Medical neglect - not providing appropriate medical
care, dental care, or immunizations
 Emotional neglect - not interacting with an infant or
child
 Educational neglect - not enrolling a child in school or
providing proper home-schooling
 Note: It is very important to distinguish between
neglect and failure to provide necessities of life
because of poverty or cultural norms
Drug-exposed Infants
 A positive toxicology screen at the time of the
delivery of an infant is alone not a sufficient
reason for reporting child abuse or neglect
 However, any indication of maternal substance
abuse shall lead to an assessment of the needs of the
mother and child
 If other factors are present that indicate risk to a
child, then a report shall be made
 A report based on the parent's inability to provide care
because of substance abuse shall be made only to
county welfare departments and not to a law
enforcement agency
Neglect- Religious Considerations
 Refusing medical care for religious reasons is
a hotly debated topic when children are
involved
 Per CANRA, a child receiving treatment by
spiritual means or not receiving specified
medical treatment for religious reasons, shall
not for that reason alone be considered a
neglected child
 An informed and appropriate medical
decision made by a caregiver after
consultation with a physician does not
constitute neglect
Red Flags – Child Behaviors
 Dirty clothes, poor hygiene
 Failure to thrive, or a malnourished child
 Severe dental cavities
 Developmental delay
 Self-abusive behaviors
 Socially withdrawn
 Behavioral problems such as anxiety or
aggression
Red Flags – Parent Behaviors
 Depression
 Domestic violence
 Unemployment
 Poverty
 Lack of social support
 Mental illness or mood disturbances
 History of abuse as a child
 Substance abuse
Red Flags – Home environment
 Medications, cleaners, toxins within reach
of a child
 Guns or other weapons that are not
properly secured
 Trash, rotted food, insects, or animal
waste
 Choking hazards within reach of an infant
or toddler
Practice Question
You are a paramedic. You are dispatched by 911 to a house for
a woman who is choking and having trouble breathing. When
you arrive, you notice a very dirty house with trash, cigarette
butts, and dead insects littering the floor. By the time you
arrive, the woman has stopped choking and is fine. You see a
young toddler in the house. You speak to him but he is very
fearful of you. You notice that he is also pale, very thin, and
wearing dirty clothes. What type of neglect is this, and what
should you do?
A. General neglect, report to a child protective agency
B. Medical neglect, report to a child protective agency
C. This is not necessarily neglect if the family is living in
poverty
D. Nothing, you were not called to the house to
evaluate the child
Practice Question
You are a paramedic. You are dispatched by 911 to a house for
a woman who is choking and having trouble breathing. When
you arrive, you notice a very dirty house with trash, cigarette
butts, and dead insects littering the floor. By the time you
arrive, the woman has stopped choking and is fine. You see a
young toddler in the house. You speak to him but he is very
fearful of you. You notice that he is also pale, very thin, and
wearing dirty clothes. What type of neglect is this, and what
should you do?
A. General neglect, report to a child protective agency
B. Medical neglect, report to a child protective agency
C. This is not necessarily neglect if the family is living in
poverty
D. Nothing, you were not called to the house to
evaluate the child
Emotional Abuse
 Under CANRA, also called cruelty
 Defined as willful cruelty or unjustified
punishment
 Includes:
 Inflicting or permitting physical pain or mental
suffering
 Or permitting the endangerment of the child's
person or health
Emotional Abuse
 Includes acts or omissions that have or could
cause serious behavioral, cognitive, emotional, or
mental disorders
 In some cases, the acts alone, without any
obvious harm are sufficient to warrant reporting
 i.e. extreme or bizarre forms of punishment, such as
torture or confinement of a child in a dark closet
 For less severe acts, such as belittling or cruel
words, it can be more difficult to determine what
constitutes emotional abuse
 For the mandated reporter, reporting the concern is the
only requirement
 It is up to the child protective agency to decide if the
act(s) in question are emotional abuse
Emotional Abuse
 Most difficult form of child maltreatment
to identify
 The effects of emotional maltreatment (lags
in physical development, learning problems,
and speech disorder) are nonspecific
 The effects of emotional maltreatment may
only become evident in later developmental
stages of the child's life
 The behaviors of emotionally abused and
emotionally disturbed children are often
similar
Emotional Abuse
 Although any of the forms of child
maltreatment may be found alone, they
often occur in combination
 Emotional abuse is most often seen in
combination with other forms of abuse
 The red flags for emotional abuse are very similar
to the red flags for other forms of abuse
Red Flags – Child Behaviors
 Frightened of going home, frightened of





parents/caretakers
Clingy, may form indiscriminate attachments
to unrelated adults
Developmental delay
Self-abusive behaviors
Socially withdrawn
Behavioral problems such as anxiety or
aggression
Red Flags – Parent Behaviors
 Parental depression or other mental illness
 Parent has unrealistic expectation of child
 Parent is unduly harsh and rigid about
childrearing
 Parent singles out one child as "bad," "evil,"
or "beyond control“
 Parent berates, humiliates, or belittles child
 Parent is indifferent to child
Practice Question
In the course of your work, you work with a troublesome 9
year old child. This child has frequent and severe behavior
problems and is on psychiatric medications for a mood
disorder. You notice the child is not eating lunch. When you
ask why, he tells you that he got in trouble with his parents
and is not allowed to eat today. He tells you the last time he
ate was 2 days ago, and that he sits at the table while the rest
of the family eats. What do you do?
A. Address this with the parents, as this difficult child may
B.
C.
D.
E.
not be telling the truth
Report neglect as the child has not eaten for 2 days
Nothing, sending children to their room without dinner is
a common form of punishment
Report emotional abuse, as this is cruel and bizarre
punishment
B and D
Practice Question
In the course of your work, you work with a troublesome 9
year old child. This child has frequent and severe behavior
problems and is on psychiatric medications for a mood
disorder. You notice the child is not eating lunch. When you
ask why, he tells you that he got in trouble with his parents
and is not allowed to eat today. He tells you the last time he
ate was 2 days ago, and that he sits at the table while the rest
of the family eats. What do you do?
A. Address this with the parents, as this difficult child may
B.
C.
D.
E.
not be telling the truth
Report neglect as the child has not eaten for 2 days
Nothing, sending children to their room without dinner is
a common form of punishment
Report emotional abuse, as this is cruel and bizarre
punishment
B and D
Questions?
When should I file a report?
 When one "has knowledge of or observes a
child in his or her professional capacity, or
within the scope of his or her employment
whom he or she knows or reasonably
suspects has been the victim of child
abuse..."
 If you suspect, report
 Proof of abuse is not required; that will be
determined through investigation by the child
welfare professionals or law enforcement
Bill AB 2380
 Recently passed in an effort to clarify the term
“reasonable suspicion”
 It is reasonable for a person to be suspicious, based
upon facts that could cause a reasonable person in a
like position, drawing on his or her training and
experience, to suspect child abuse and neglect
 Any reasonable suspicion is sufficient
 Does not require certainty that child abuse or neglect
has occurred
 Does not require a specific medical indication of child
abuse or neglect
 May be based on any credible information, including
statements from other individuals
 The goal of this bill was to prevent delays in
reporting, which can hinder investigations by
authorities
When should I file a report?
 Immediately (or as soon as practically
possible) by phone
 A written report must be forwarded within
36 hours
 Must be submitted on Department of Justice
forms, which can be requested from your local
child protective agencies or downloaded online
 May be faxed or submitted electronically,
depending on what is available in your county
Who files the report?
 Responsibility rests solely with the mandated
reporter
 Reporting to an employer, supervisor, school
principal, school counselor, coworker, or other
person is NOT adequate
 When two or more mandated reporters jointly
have knowledge of suspected child abuse or
neglect, a single report may be made
 Any member of the reporting team who has
knowledge that the designated person has
failed to report must do so him or herself
To Whom do I report?
 To a child protective agency
 “Child protective agency” is defined as a county
welfare or probation department, or a police or
sheriff’s department
 An example of a child protective agency is your local
office of the Department of Children and Family
Services
 The only types of law enforcement agency you may
report to are the Sheriff’s or Police Department in
your community
 Other law enforcement persons, such as school
security, are not authorized to receive reports
 County CWS numbers in packet
How do I report
 Immediately by phone, providing
 Name of the reporter
 Name of the child
 Present location of the child
 Nature and extent of the injury
 Any other information requested by the child
protective agency
How do I report?
 Then in writing
 Within 36 hours a written report must be sent to
the child protective or law enforcement agency to
which the telephone report was made
 Must be filed on Department of Justice Form 8572
 DOJ SS 8572, known as the Suspected Child Abuse
Report Form
 This form is available through county welfare
departments and local law enforcement agencies
 Forms and instructions also available online at
http://ag.ca.gov/childabuse/pdf/ss_8572.pdf
8572
Reporting Party’s
information
 Name
 Date
 Address
 Phone
8572
Information of
person taking
report
•
•
•
•
•
Name
Phone
Title
Address
Date
8572
Victim’s Information
• Name
• DOB
• Address
• School
• Present location
• Language
8572
Involved Parties
• Siblings
• Parents
• Suspects
8572
Incident
Information
• What
happened?
• What is the
concern for
abuse?
Practice Question
You work at a school. Volunteers come weekly to
tutor and work with troubled teenagers. A
volunteer tells you that a child has disclosed sexual
abuse by her father. What are you obligated to do?
A. Tell the volunteer to report their concerns to a
child protective agency
B. Tell your supervisor
C. Report to a child protective agency
D. Interview the child to obtain the
information yourself prior to reporting
Practice Question
You work at a school. Volunteers come weekly to
tutor and work with troubled teenagers. A
volunteer tells you that a child has disclosed sexual
abuse by her father. What are you obligated to do?
A. Tell the volunteer to report their concerns to a
child protective agency
B. Tell your supervisor
C. Report to a child protective agency
D. Interview the child to obtain the
information yourself prior to reporting
Safeguards for Mandated Reporters
 Confidentiality
 Immunity
Confidentiality
 Mandated reporters are required to give their
names when making a report
 The reporter's identity is kept confidential and
may only be disclosed as follows:





Between child protective agencies
To counsel representing a child protective agency
To the district attorney
To the child's attorney
To a licensing agency when abuse in out-of-home care
is reasonably suspected
 By court order
 When the reporter waives confidentiality
Confidentiality
 Reports of suspected child abuse and the
information they contain are also
confidential
 May only be disclosed to official agencies and
professionals involved in the investigation,
treatment, prosecution, or record-keeping of
these cases
 Any violation of confidentiality of this
information is a misdemeanor punishable by
up to six months in the county jail, or by a
fine of $500, or by both
Immunity
 Mandated Reporters have immunity from criminal
or civil liability for reporting as required
 Unless the report is proven to be false and the person
reporting knows it is false
 Or the report is made with reckless disregard of the truth
 Mandated reporters are not liable civilly or
criminally for photographing the victim of child
abuse and disseminating the photograph with the
report
Failure to Report
 Misdemeanor, punishable by
 Up to six months in jail
 Up to a $1,000 fine
 May also be subject to a civil lawsuit, and found
liable for damages, especially if the child-victim
or another child is further victimized because of
the failure to report
 No supervisor or administrator may impede or
inhibit a report or subject the reporting person
to any sanction
 To do so is punishable by imprisonment, a fine, or
both
Employer’s Responsibilities
 Any person entering employment that makes him or
her a mandated reporter must sign a statement that he
or she has knowledge of the reporting law and will
comply with its requirements
 Statement must be provided and retained by the employer
 A form for this statement is available from your local
child protective agency
 Licensing Requirement
The state agency issuing a license to a person who is
required to report child abuse must either send a
statement to the licensee explaining reporting
requirements and the penalty for failure to report, or
print the information on all application forms
Practice Question
You are a nurse in an emergency department. You observe a
father telling a 4 month old infant to “shut-up” and striking
him forcefully across the face. You notify the physician caring
for this patient of your concern. The physician examines the
patient again and sees no signs of injury. The physician tells
you there is no need to report the incident. What should you
do?
A. Tell your supervisor
B. Report anyway, as this is not appropriate discipline and
you are still concerned
C. Nothing, the spanking is reasonable and age-appropriate
and there are no injuries
D. Document your concerns in the patient’s chart
Practice Question
You are a nurse in an emergency department. You observe a
father telling a 4 month old infant to “shut-up” and striking
him forcefully across the face. You notify the physician caring
for this patient of your concern. The physician examines the
patient again and sees no signs of injury. The physician tells
you there is no need to report the incident. What should you
do?
A. Tell your supervisor
B. Report anyway, as this is not appropriate discipline and
you are still concerned
C. Nothing, the spanking is reasonable and age-appropriate
and there are no injuries
D. Document your concerns in the patient’s chart
Practice Question
You are a licensed daycare provider. You are concerned that a
young child may be being abused at home. You take photos of
the injuries, but do not report because you are not sure. The
child is hospitalized the following week for severe inflicted
injuries. During the course of the investigation, authorities
realize that you had concerns but did not report. Which of the
following could happen?
A. You could go to jail for 6 months for the misdemeanor
B.
C.
D.
E.
offense
You could be fined $1,000 for the misdemeanor offense
You could be sued in civil court by the non-offending
parent or family members
You could lose your license
All of the above
Practice Question
You are a licensed daycare provider. You are concerned that a
young child may be being abused at home. You take photos of
the injuries, but do not report because you are not sure. The
child is hospitalized the following week for severe inflicted
injuries. During the course of the investigation, authorities
realize that you had concerns but did not report. Which of the
following could happen?
A. You could go to jail for 6 months for the misdemeanor
B.
C.
D.
E.
offense
You could be fined $1,000 for the misdemeanor offense
You could be sued in civil court by the non-offending
parent or family members
You could lose your license
All of the above
What Happens After a Report?
 The primary purpose of the report is to make
child protective agencies aware of possible
abuse
 Reports are investigated either by the local
law enforcement agency and/or by the
county child welfare (child protective
services) agency
Child Welfare Services
 Interviews the child and family to evaluate the
situation
 Primary responsibility is protection of the child
 The child may need to be removed and placed in a safer
environment or the family may just need additional services
 Often, parents or others who mistreat children are
overwhelmed by their situation/problems
 Financial problems, mental illness, anger issues , etc.
 May not be able to handle the stresses of raising children
without help
 CWS offers services and resources to help manage the
problems of the family and child
 Counseling, referrals to self-help groups ; assistance in
obtaining medical care, emergency shelter, transportation
 The CWS worker's goal is to protect children and
enable families to stay together whenever possible
Child Welfare Services
 Reports received (except neglect) must be
cross-reported immediately, or as soon as
possible, to local law enforcement agency
 Not all reports are serious enough to require
the assistance of the law enforcement agency
 In these events, the family may be contacted only
by local child welfare services
Child Welfare Services
 Response time depends on the seriousness of
the events reported and the situation the child
faces
 If the child is in danger, the response will be
immediate
 If there is less risk involved, it may be three to ten
days before action is taken by child welfare services
 Reporting does not always mean that a civil or
criminal proceeding will be initiated against
the suspected abuser
 If an investigation does not reveal evidence of child
abuse but suggests other family problems or a
potentially abusive situation, the child welfare
agency may intervene and offer appropriate
services
Law Enforcement
 Officer also has a primary responsibility to
protect the child
 Interviews the parent(s) and the child
 Gathers information from interviews,
physical evidence, and other sources such
as medical and school records
 Often, the parent or caretaker is neither
arrested nor criminally charged in a child
abuse case
 However, in cases of serious abuse the
caretakers may be arrested and referred to the
district attorney for criminal prosecution
Law Enforcement
 Law enforcement is also required to cross-
report immediately, or as soon as possible, to
child welfare agencies and the district
attorney's office
What Happens Next?
 The report is determined to be one of the
following
 Unfounded - the report is determined to be false,
inherently improbable, to involve an accidental injury,
or not to constitute child abuse
 Substantiated - the report is determined to constitute
child abuse or neglect
 Inconclusive - the report is determined not to be
unfounded, but the findings are inconclusive and there
is insufficient evidence to determine whether child
abuse or neglect has occurred
Child Abuse Central Index
 Substantiated reports are forwarded to the
CACI, or Child Abuse Central Index
 Unfounded and inconclusive reports are not
forwarded
 Inconclusive reports were filed and maintained until Jan
2012
 A central repository of information about
reported child abuse that is maintained by the
California Department of Justice
 Records kept for minimum of 10 years
 Contains summary information from
investigation reports submitted by law
enforcement and child welfare departments on
child abuse victims and suspected abusers
CACI
 Does not investigate reports of child abuse
 Does provide the following services to law
enforcement and child welfare departments:
 Searches, indexes, and files child abuse reports
received from investigating agencies
 Searches the names of applicants for child care
service licenses and employment to determine if
they have a prior history of child abuse that may
result in disqualification
 Notifies child welfare department of current
victims and suspects with prior histories of child
abuse
Practice Question
As a mandated reporter, you must report to
child welfare services, local law enforcement,
and the CACI.
A. True
B. False
Practice Question
As a mandated reporter, you must report to
child welfare services, local law enforcement,
and the CACI.
A. True
B. False
Practice Question
A child protective agency will investigate all
reports immediately.
A. True
B. False
Practice Question
A child protective agency will investigate all
reports immediately.
A. True
B. False
Conclusion
 Primary intent of the reporting laws is to protect




the child
Protecting the identified child may also provide
the opportunity to protect other children in the
home
It is equally important to provide help for the
parents
The report of abuse may be a catalyst for
bringing about change in the home environment,
which may help to lower the risk of abuse in the
home
As a mandated reporter you play an obviously
crucial role in this process, identifying and
reporting concerns of abuse or neglect of
children that may otherwise go unseen
Local Resources