California Child Abuse Mandated Reporter Adapted from the

California Child Abuse & Mandated Reporter Adapted from the resources provided by prepared by Merced County Office of Education – Family Resource Council The Chadwick Center at Rady Children’s Hospital San Diego Merced County Human Services Agency

Agenda/ Objectives 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 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 40 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 UNLESS: CASA volunteers (Court Appointed Special Advocates) = mandated reporters

What must be reported? Under CANRA, suspicions of the following must be reported in California Physical abuse Sexual abuse Emotional abuse/ damage Neglect When the victim is under the age of 18, and the perpetrator is any age Remember that reporting child abuse does not mean physical intervention or snooping. It simply means not ignoring the obvious.

What is Child Abuse and Neglect? Welfare & Institutions Code section 300, subdivisions (a) – (j) a. Physical abuse b. Neglect f. Parent caused death of a sibling c. Emotional damage g. Parent’s failure to support d. Sexual abuse h. Legal orphan e. Severe physical abuse of i. Cruelty children under five j. Other siblings neglected, child at risk

Definition of child abuse

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

Physical Abuse Definition What to Report

What to Report - Physical Abuse CANRA defines physical abuse 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” PC 11165. 6

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 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

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 Parent singles out one child as "bad, " "evil, " or "beyond control" 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 fight 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 suppress a disturbance threatening physical injury to person or damage to property, for purposes of selfdefense, or to obtain possession of weapons or other dangerous objects within the control of the pupil Spanking that is reasonable and age-appropriate 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 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

Vignette 1 12 -year-old Colin, a student in your class, has recently begun exhibiting a variety of concerning behaviors. He has engaged in recurrent fights with other students resulting in chronic probationary status. He uses verbally abusive language, is frequently truant, and has been suspended once for drinking at school. Over the past year, his grades have declined significantly and he has withdrawn from all sports. Colin has been absent for a few days, and when he returns to school, you notice that he has a bruise on his cheek. When you ask about his injury, he tells you that his father hit him when he came home late from a friend’s house. Confront the mother Do you make a report? Why?

Sexual Abuse Definition What to Report

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 PC 11165. 1

Sexual Assault Includes CANRA cites following sections of CA penal code: 261, section d of 261. 5, 264. 1, 285, 286, 288, 288 a, 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 Under 16 (14 -15) Under 14 Any sexual intercourse with a partner 21 years or older (one form of statutory rape) 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 PC 11165. 1 (c)

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

Vignette 3 You become concerned because 8 -year-old Sara, a student in your class, is caught exposing herself to other children on the playground and telling them to touch her. You talk with her about this behavior, and she informs you that her 14 -year-old brother always wants to see her “pee pee” and likes to touch it. What should you do? A. Call Sara’s parents to tell them what she said and to find out more about her brother. B. Nothing, Sara does not seem upset and you do not want to over-react. C. Make a child abuse report for possible sexual abuse. D. Tell the principal of your concerns and hope that s/he will take the appropriate action.

Neglect Definition What to Report

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 PC 11165. 2

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 PC 11165. 2

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 PC 11165. 2 [b]

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

Is this Neglect?

Neglect

Neglect

Neglect

First discovery or notation of head lice is not neglect. Each school has a policy on how to deal with head lice. You may want to know what your district’s policy is. Neglect? Merced County Office of Education’s head lice policy is on their web site. What Is This?

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

Emotional Damage Definition What to Report

Emotional Damage 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 PC 11165. 3

Emotional Damage 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 damage 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 Damage 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 Damage 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

Vignette 5 You have noticed that a student in your class, 12 -year-old Nancy, appears depressed and withdrawn. When talking about her family, she says that her parents often criticize her behavior and appearance, calling her stupid, lazy and fat. She also comments that she is frequently left home alone to care for her 8 -year-old brother, so is unable to leave the house or invite friends over. You note that she appears sad and fearful whenever she talks about her family. What would you do? A. Make a suspected child abuse report based on this information. B. Not report suspected child abuse based on this information. C. Like to obtain more information before reporting.

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 not be telling the truth B. Report neglect as the child has not eaten for 2 days C. Nothing, sending children to their room without dinner is a common form of punishment D. Report emotional abuse, as this is cruel and bizarre punishment E. B and D

Process of making a report

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? 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

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 PC 11166 [g]

The Suspected Child Abuse Report When/ How to report Imminent danger or immediate risk, call 911 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 Suspected child abuse or neglect, call 1 -800 -331 -1585, 24 hour hotline. After reporting, the mandated reporter must complete the Suspected Child Abuse Report form. Within 36 hours: Fax Suspected Child Abuse Report (SCAR) to 725 -3988 Penal Code § 11166(g)(3)

How do I report? Immediately by phone 1 -800 -331 -1585, 24 hour hotline Information CWS will ask: 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? (cont. ) 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 Mail in form to: CWS PO Box 671 PC 11166 [a] Visalia, CA 93279

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 PC 11167 [d]

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 P. C. 11172 [a] P. C. 11166 [f] P. C. 11172 [c] P. C. 11167. 5

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 PC 11172 [e]

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 PC 11166. 5 [a] PC 11165. 5 [b][c]

Vignette 6 While helping a fourth-grade student into a costume for a play, a teacher's aid notices that the child’s back is bruised and scabbed. When the aid asks what happened, the child appears uncomfortable and says he fell. He is unwilling to provide further information about how the injuries occurred. When the aid talks to the principal about the situation, the principal says that she knows the family, and there is no need for the aid to contact Child Protective Services. What should the aid do? A. Nothing, it is now the principal’s responsibility B. Report to law enforcement or Child Protective Services C. Talk to the child’s mother D. Watch the child more closely

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 offense B. You could be fined $1, 000 for the misdemeanor offense C. You could be sued in civil court by the non-offending parent or family members D. You could lose your license E. All of the above

Vignette 7 You are concerned about a seventh-grade student who has exhibited behavioral changes. Although she has always been a straight-A student, she has stopped turning in homework, and does poorly on tests. She frequently appears tired and has even fallen asleep in class. She also no longer socializes with her friends. You decide to talk with her about your concerns. Which of the following is not appropriate when talking with your student? A. Conduct the discussion in private. B. Allow the child to tell you of her experience in her own words. C. Reassure the child that you will not tell anyone what she tells you. D. Do not express shock, disapproval or disgust.

What happens after a report is made?

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 by law enforcement 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 crossreported 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

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

Practice Question A child protective agency will investigate all reports immediately. A. True B. False

Conclusion & Evaluation 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