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CALIFORNIA MANDATED REPORTER TRAINING FOR ADDICTION COUNSELORS Introduction Child Maltreatment 2009* Most recent report of data from the National Child Abuse and Neglect Data System (NCANDS) Approximately 3.6 million reports of suspected abuse or neglect 20% were substantiated, meaning approximately 720,000 children were found to be victims of child abuse or neglect in 2009 * 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 Thanks to CAADE & CAADAC, addiction counselors on the list since 2009 Who are Mandated Reporters? Complete list includes 38 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 (only 19% of abuse cases) 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 Bruises Abnormal Bruising Patterns Abdominal Trauma Massive Bruising Broken Teeth Mouth Trauma Scald Burns Eye Trauma Retinal Hemorrhage Young victim of Domestic Violence Hand slaps on 1 month old Beating from hair brush Pattern of bruises on the jaw line. Obvious bite mark, probably inflicted by an adult Fading bite mark: same child SHAKEN BABY SYNDROME (ABUSIVE HEAD TRAUMA) Mechanism of Injury Repeated shakes ? 3-4 Can kill in 1-2- seconds! To lay observer, force used obviously harmful to the child Similar to fall from major height NOT playful tossing /bouncing Patterns of infant shaking based on characteristics and distributions of injuries and descriptions by assailants Effect of severe shaking on brain movement Acute subdural ematoma ABUSIVE HEAD TRAUMA: IMPACT INJURY A few of the fatalities from 2002 Perpetrators Father Boyfriend Mother Babysitter Stepfather Other relatives 44% 23% 9% 8% 2% 2% Mongolian Spots 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 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 Judgement, 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 CHILD SEXUAL ASSAULT Warning: the following is extremely graphic; you may wish to leave the room or close your eyes. Sexual Assault of Teenager Grab bruises knees Fingerprint type bruises on thighs Vaginal bleeding Torn hymen Sexual Assault of Infant Grab bruises of knees Extensive genital rash Internal bruising and tearing Severe Abusive Head Acute Findings 9 year old, sexual assault, 7 hours prior Sexual Abuse: Fondling Subtle finding: Bruise in peri-urethral area Sexual Abuse: Acute Trauma Teenager Bruising Tearing Permanent changes 2 year old found with vaginal bleeding after bath bruise tear hymen Straddle Injury: Accidental event Sexual Abuse: Abnormal Exams Sexual Abuse: 13 year old Abused since 5 Clear Evidence of penetration Sexual Abuse More subtle findings vaginal penetration Foreign Bodies: 7 year old with self-inserted toy Anal Exam: Abnormal Thickened anal folds Poor anal tone; asymmetrical; Internal tear Grossly Abnormal Exam Without traction, gaping introitus noted and floor of vagina seen Where is the hymen? Every female is born with a hymen! Long term effects of child abuse include fear, anxiety, depression, anger, hostility, inappropriate sexual behavior, poor self esteem, tendency toward substance abuse and difficulty with close relationships. Source: Browne & Finkelhor, 1986. 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? AB 2337 (Beall) Makes addiction counselors mandated reporters Co-sponsored by CAADE Provides 50,000 dollars for legal defense if someone tries to sue you. As long as you make a good faith report you will be fine! (don’t use the law to mess with your ex brother-in-law!) Does not apply to elder abuse, but law should change soon. Still ethically mandated…. 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 a supervisor, or other person is NOT adequate ; if the other person says they will make a report you must document (on paper!) when the report was made. 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 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, except IDs of other clients Before hanging up, ask the worker if there are any other questions, since this is the only time you can chat as per Federal Law (42 CFR, part B) Remember, only make an initial report!!!!! 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 and inconclusive reports are forwarded to the CACI, or Child Abuse Central Index Unfounded reports are not forwarded 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