DEPARTMENT OF JUSTICE FORMS | DEPARTMENT OF SOCIAL SERVICES FORMS | OFFICE OF CRIMINAL JUSTICE PLANNING FORMS
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These forms are for use by government agencies and certain individuals to report information required by law in child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or your local police department or sheriff's office.
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DEPARTMENT OF JUSTICE (DOJ) FORMS
If you have questions regarding the use of the forms, contact the DOJ Child Protection Program
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Form Number |
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Form Title |
SS 8583
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Child Abuse Investigation Report Form. For use by specified investigating agencies to report to the state Department of Justice. Instructions.
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SS 8572
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Suspected Child Abuse Report Form. For use by mandated reporters to notify a reporting agency (local law enforcement, county probation or county welfare department) about suspected cases of child abuse. Also may be used to cross-report to another reporting agency. Instructions.
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Live Scan
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Live Scan Applicant Forms. For use by authorized agencies and nonprofit groups to request criminal background checks for prospective child placement and employment purposes. More information available from the Fingerprint Submissions Program
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DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS
The Department of Social Services has developed and maintains these forms pertaining to child abuse background checks for licensed childcare facilities. If you have questions or need more information, visit the DSS web site.
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Form Number |
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Form Title |
| LIC 198/LIC 198A |
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Child Abuse Central Index Check For County/State-Licensed Facilities Forms. This form is supplied by the Department of Social Services for licensing and/or foster care purposes. See DSS On-Line Forms and Publications - "L Forms" to download by form number. http://www.dss.cahwnet.gov/cdssweb/On-lineFor_293.htm
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OFFICE OF CRIMINAL JUSTICE PLANNING (OCJP) FORMS
The Office of Criminal Justice Planning has developed and maintains forms for reporting evidence of sexual assault. The forms below pertain to child abuse. If you have questions or need more information, visit the OCJP web or contact the OCJP Business Services Branch-Medical Protocol at 1130 K Street, Suite LL30, Sacramento, CA 95814.
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Form Number |
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Form Title |
| OCJP 925 |
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Forensic Medical Report : Non acute (72 Hours) Child/Adolescent Sexual Abuse Examination Form. Used by physicians for reporting evidence of child sexual abuse. Form should be used in lieu of DOJ Form 900 for cases of chronic sexual abuse of minors. See MEDICAL PROTOCOL COMPONENTS at OCJP to download the form and instructions.
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| OCJP 930 |
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Forensic Medical Report: Acute (72 Hours) Adult/Adolescent Sexual Assault Examination Form. Used by physicians who conduct a medical exam for evidence of adolescent sexual abuse. See MEDICAL PROTOCOL COMPONENTS at OCJP to download the form and instructions. |
REFERENCE MATERIALS
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