This site will allow any mandated reporter who has already made a verbal report to the 24-Hour Child Abuse Hotline, to complete a Suspected Child Abuse Form (SS8572) on-line.  If you have not yet called the 24-Hour Child Abuse Hotline, please do so before attempting to complete the on-line report.

You can reach the 24-Hour Child Abuse Hotline by calling (916) 875-5437 (875-KIDS).

In case of an emergency always call 911 for law enforcement.

You must do the following before creating the On-line Report:

• Make a verbal report to the 24-Hour Child Abuse Hotline at (916) 875-5437 (875-KIDS).
• Obtain the required password from Hotline staff for On-Line report.

Creating the electronic Suspected Child Abuse Form (SS8572)

• Once password is received from Hotline staff, click on link below.
• Fill out form completely (see instructions below) and save.
• Attach saved form to email and send to: 11166@Saccounty.net

CLICK HERE for - Suspected Child Abuse Form (SS8572)

Instructions for completing the form on-line:

• All Penal Code (PC) references are located in Article 2.5 of the PC. This article is known as the Child Abuse and Neglect Reporting Act (CANRA). The provisions of CANRA may be viewed at: http://www.leginfo.ca.gov/calaw.html (specify "Penal Code" and search for Sections 11164-11174.3). A mandated reporter must complete and submit the form SS 8572 even if some of the requested information is not known. (PC Section 11167(a).) Mandated child abuse reporters include all those individuals and entities listed in (PC Section 11165.7.(a).) Mandated child abuse reporters include all those individuals and entities listed in PC Section 11165.7.

Mandated Reporting Responsibilities

• Any mandated reporter who 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 or neglect shall report such suspected incident of abuse or neglect to a designated agency immediately or as soon as practically possible by telephone and shall submit a report thereof within 36 hours of receiving the information concerning the incident. (PC Section 11166(a).)
   
• No mandated reporter who reports a suspected incident of child abuse or neglect shall be held civilly or criminally liable for any report required or authorized by the CANRA. Any other person reporting a known or suspected incident of child abuse or neglect shall not incur civil or criminal liability as a result of any report authorized by CANRA unless it can be proven the report was false and the person knew it was false or made the report with reckless disregard of its truth or falsity. (PC Section 11172(a).)
   
• Enter the number of victims. If you have more than one victim in a family, a separate child abuse form must be completed for each victim.
   
• It is important to indicate whether or not the child is developmentally delayed or has some disability.
    
• The mandated reporter must complete and submit the form SS8572, even if some of the requested information is "unknown"; please complete all fields on the form. If the information is unknown, enter "unknown".

DISTRIBUTION

• Mandated Reporter: After completing Form SS 8572, retain one copy for your records.

Completing the Narrative

The SS8572 requires that you provide the date and time of the incident and the place of the incident. Additionally, you are required to include the following in your narrative description:

• What the victim(s) said;
• What the mandated reporter (you) observed;
• What the person accompanying the victim(s) said and
• Similar past incidents involving the victims(s) or suspect.

Please review the questions below before completing the narrative. By providing the information requested, you will assist the Child Protective Services and/or Law Enforcement official assigned to investigate the allegations you have reported.  If you do not have all the requested information, please fill out as much information as you have available.

Keep these questions in mind when making your next report:

• The names of the victim(s) and the perpetrator(s) / suspect(s). Include relationship of the perpetrator(s)/suspect(s) to the victim.
• Address and/or current location of children and/or family.
• Date and time of incident.
• Description of child abuse/neglect incident, include any known details. 
• Specific location (address if known) of incident. 
• Identify witnesses to the incident.
• Where do the children attend school or daycare? 
• Does the victim (or any child in the family) have any physical or mental disability?
• Is there anyone else who may know about the incident or who may be able to provide additional information about the victim or the victim's family?  If so, provide their identifying information (name, address, telephone, etc.) and relationship to the victim/family.