Suspected Child Abuse Report Form SS8572 (SCAR) for Mandated Reporters
By law, any mandated reporter must make a verbal report to the 24-Hour Child Abuse Hotline and is then required to complete a Suspected Child Abuse Form (SS8572) within 36 hours. If you have not yet called the Sacramento County 24-Hour Child Abuse Hotline, please do so before attempting to complete the Suspected Child Abuse Report Form.
You can reach the Sacramento County 24-Hour Child Abuse Hotline by calling (916) 875-5437 (875-KIDS).
In case of an emergency always call 911 for law enforcement.
Mandated Reporting Responsibilities:
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. You may also reference the Mandated Reporter Information Sheet on this site for additional information.
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".
Instructions for Utilizing Form and Distribution:
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.
