Reporting Child Abuse and Neglect: Responding to a Cry for Help

Dentists, registered dental hygienists, and registered dental assistants are designated by law as mandated reporters who are required to report suspected cases of abuse and neglect while in their professional capacities. By taking a proactive role in the detection and reporting of child abuse and neglect, dental mandated reporters may save the lives of young victims and assist agencies in helping families in the community. It is vitally important that mandated reporters become aware of their legal obligations regarding the reporting of abuse and neglect. This article is designed to serve as a dental team in-service training program for the detection and reporting of child abuse and neglect. Many of the concepts discussed can be applied to the other forms of family violence.

Child abuse and neglect are components of the cycle of family violence, which is not age-specific. Violence in the family can occur with children, adults, and elders. Often a family with one component of violence will have the strong possibility for other forms. As mandated reporters in California, health professionals have the responsibility of reporting suspected child abuse and neglect, elder abuse and neglect, and domestic violence where physical assault has occurred. A child is defined as a person under the age of 18. In addition to the child abuse reporting law requirement, health practitioners must also report cases of abuse of individuals 65 years of age or older (Welfare and Institutions Code 15610[a]) or individuals between the ages of 18 and 64 whose physical or mental limitations restrict their abilities to protect their own rights (W&IC 15616 [b] [1]). Many of the laws that pertain to abuse and neglect can be located in either the W&IC or the California Penal Code (CPC).

By taking a proactive role in the detection and reporting of child abuse and neglect, dental mandated reporters may save the lives of young victims and assist agencies in helping families in the community. The California Dental Association’s Council on Community Health encourages dental team members to participate in a mandated reporter training program that provides information on how to detect and report child abuse and neglect, elder abuse and neglect, and domestic violence. Dentists, registered dental hygienists, and registered dental assistants are designated by law as mandated reporters and are required to report suspected cases of abuse and neglect while in their professional capacities.

Consider for a moment the following scenario: a young boy is waiting for an emergency examination for a fractured tooth and is accompanied by his mother. The boy is wearing a turtleneck with long pants. His appearance is neat but his attire seems odd since the temperature outside is 98 degrees. He walks guardedly to the operatory and sits tentatively in the dental chair. As the exam begins, a dental team member notices a series of varying colored bruises on the boy’s wrists. In addition, there is a bruise on his right cheek directly over the fractured first molar. As a mandated reporter, a dentist thinks he or she may need to file a report of suspected child abuse but is unsure of who to call and what information must be provided. Now what?

Using This Article in the Dental Practice

It is vitally important that mandated reporters become aware of their legal obligations regarding the reporting of abuse and neglect. This article is designed to serve as a dental team in-service training program for the detection and reporting of child abuse and neglect. Many of the concepts discussed can be applied to the other forms of family violence.

It is suggested that a team leader utilize this article in conducting a team meeting to apprise staff of their legal obligations regarding the reporting of child abuse and neglect. Making a report of suspected child abuse is difficult. There are always nagging doubts about how the parents will react, what the outcome will be, and whether the report will put the child in greater risk.¹

The best way to minimize the difficulty of reporting is to be fully prepared for the experience and to feel reasonably comfortable with the reporting requirements and the process that is triggered by making a report.¹ Some questions that will be answered in this in-service training program include: If I suspect abuse do I need to report it? Who do I report to? Do I have to provide my name? Am I legally protected? What could happen if I don’t report? In addition to this article, there are excellent resources available (Table 1). Of particular note for California are the first four booklets and the Internet address for California Law listed under "Publications and Articles."

The first step in becoming aware of one’s obligations regarding the reporting of child abuse and neglect starts with understanding the law. This article provides three forms, Reporter Responsibility and Sample Employee Form (Figure 1), Child Abuse Reporting Requirements Employee Acknowledgment Form (Figure 2), and Suspected Child Abuse Form SS8572 (Figure 3) to encapsulate information to assist the dental office in educating its team. (The official form is printed on four-part NCR paper. This copy is provided for use only as a "working copy" and is not to be submitted to any agencies.)

Figures 1 and 2 are currently used as employee statements acknowledging mandated reporter responsibility in California. Figure 1 is from the California Department of Social Services Office of Child Abuse Prevention. The benefit of this form for the dental office is the ease of training new employees in the responsibilities of being a mandated reporter by reviewing the printed information. Figure 2 is from the California Medical Association. The strength of this form is the reproduction of Section CPC 11166.5 of the Child Abuse and Neglect Reporting Act, which identifies what provisions must be in the employee statement. It also provides greater definition of who is identified as a mandated reporter in California. By using both forms, in combination, the employer can provide education for the mandated reporters on staff and meet the intent of the California law. It is suggested that the mandated reporter employee sign both forms.

Any person entering employment that makes him or her a mandated reporter must sign a statement, provided and retained by the employer, to the effect that he or she has knowledge of the reporting law and will comply with its provisions (CPC 11166.5[a]). Most employers are unaware that any dentist, registered dental hygienist, or registered dental assistant whom they employ must sign a statement acknowledging mandated reporter responsibilities. At the conclusion of a team meeting, the employer should provide a copy of both forms to each mandated reporter. The forms should be signed and dated with the employing dentist or supervisor serving as the "Witness." The originals should then be placed in the employee’s personnel file, with copies being provided to the employee.

To assist employers in fulfilling their legal obligations, this article will discuss in detail the Reporter Responsibility and Sample Employee Form that details the California Child Abuse and Neglect Reporting Act. Throughout this discussion, the term abuse pertains to both abuse and neglect. The following is a detailed description of each section of the form and how it relates to the practice of dentistry.

Definitions

Definitions cover two important aspects of the law. First are the types of abuse that are reportable. To better understand what each of the reportable conditions entails, it is recommended that mandated reporters attend a training session or conduct further research into the clinical aspects of abuse. A list of resources (Table 1) is included. For example, what are the signs of abuse? Becoming familiar with the types of abuse will greatly assist a mandated reporter in determining if an abuse report needs to be filed. Physical abuse is described as a physical injury inflicted by other than accidental means on a child (CPC 11165.6). Child sexual abuse includes both sexual assault and sexual exploitation. Sexual assault includes sex acts with children, intentional masturbation in the presence of children, and child molestation. Sexual exploitation includes preparing, selling, or distributing pornographic materials involving children, performances involving obscene sexual conduct, and child prostitution (CPC 11165.1).

Neglect of a child, whether "severe" or "general," must also be reported if the perpetrator is a person responsible for the child’s welfare. It includes acts or omissions harming or threatening to harm the child’s health or welfare (CPC 11165.2). Unlawful corporal punishment or injury is described as a willfully inflicted injury, resulting in a traumatic condition (CPC 11165.4). Willful cruelty or unjustified punishment includes inflicting or permitting unjustifiable physical pain or mental suffering or the endangerment of the child’s person or health (CPC 11166[b]). "Mental suffering" in and of itself is not required to be reported. However, it may be reported (CPC 11166[b]).

The second important aspect of the law is who is mandated to report. In the dental practice, dentists, registered dental hygienists, and registered dental assistants fall within the category of "health practitioner" and are thus mandated to report suspected child abuse as defined in CPC 11165.6.

Reporting

This form (Figure 1) is an excellent summary tool for understanding when and to whom to report. Again it is important that mandated reporters become familiar with the process of reporting long before they are faced with a suspicion of abuse. "Reasonable suspicion" occurs when "it is objectively reasonable for a person to entertain such a suspicion, based upon facts that could cause a reasonable person in a like position, drawing when appropriate on his or her training and experience, to suspect child abuse" (CPC 11166[a]). Although wordy, the intent of this definition is clear: if you suspect, report.³

When a child is present in the dental practice and there is reasonable suspicion of abuse, a mandated reporter is required by law to contact (via phone) a child protective agency immediately or as soon as reasonably possible (CPC 11166[a]). The phone number for Child Protective Services (CPS) in each area can be located in the county listing of the telephone directory white pages. If a person is witnessing the abuse actually being perpetrated and a child's life may be in danger, local law enforcement may be the best way to report. Local law enforcement can be contact via telephone by dialing 911. It is recommended that mandated reporters check with their local CPS agency to determine their county’s preferred protocol.

Once a verbal report is received, the Suspected Child Abuse Report Form SS8572 (an unofficial example that may be used as a working copy appears as Figure 3) must be completed and returned within 36 hours of the initial telephone report (CPC 11166[a]). The report form is available from local child protective agencies such as CPS (CPC 11168). Form SS8572 may also be requested directly from the Department of Justice through the following address: California Department of Justice, Bureau of Criminal Identification and Information, P.O. Box 90317, Sacramento, CA 94203-4170. The best preparation is to obtain the forms in advance and have them on file. Further discussion of this form is included in a subsequent section of this article.

Often the dental team works together to determine if reasonable suspicion exists. When a report needs to be filed, only one mandated reporter needs to file the report on behalf of the team. If the designated person fails to report, then the mandated reporter has the responsibility to follow-up and report. When a report is made, the mandated reporter is required by law to provide his or her name since it validates that he or she has fulfilled the legal obligation to report. CPS is required to keep the mandated reporter’s name confidential and disclose it only to child protective agencies and entities identified in CPC 11167.

Legal

There are many aspects of California law that protect a mandated reporter. Immunity from criminal and civil liability is provided to the mandated reporter when a report is filed (CPC 11172[a]). If a civil suit is filed against a mandated reporter, the state will reimburse for legal fees incurred in the suit up to $50,000. (CPC 11172[c]). In addition, no mandated reporter can be dismissed, disciplined, or harassed for making a suspected child abuse report (CPC 11166[h]). However, if a mandated reporter refuses to report suspected abuse, he or she becomes criminally liable. Refusal to report is considered a misdemeanor and is punishable by up to six months in county jail and a fine of not more than $1,000, or both (CPC 11172[e]).

Mandated reporters are not legally obligated to notify the parents or care providers that a report is being filed. One should keep in mind that parents are not always the perpetrators in an abuse case and may not be aware that their child exhibits signs of abuse. Abusers can include other family members, childcare providers, neighbors, etc., so discussing the suspicions in a nonjudgmental fashion with the parents or care provider may be beneficial. The current Child Abuse and Neglect Reporting Act, which is contained within the California Penal Code at sections 11164-11174.3, can be acquired by accessing the Internet site titled California Law at www.leginfo.ca.gov/calaw.html.

Suspected Child Abuse Report Form

The Suspected Child Abuse Form SS8572 is one of the appropriate forms to report child abuse and neglect. The second is the Medical Report-Suspected Child Abuse Form DOJ 900. The latter form is two pages and is designed more for hospitals, physicians, and full-body examinations. The Form SS8572 is a single-page report form and the one most utilized by dental professional mandated reporters. This article discusses the components of the single-page form.

After presenting mandated reporter workshops throughout California since 1994, Dr. Shanel-Hogan has had the opportunity to speak to many individuals involved in CDA, Prevent Child Abuse-California, CPS, California Department of Social Services Office of Child Abuse Prevention, local child abuse prevention councils, California Department of Justice Office of Attorney General, and district attorneys. People have shared ways to increase the effectiveness of the Suspected Child Abuse Report Form SS8572. The following ideas and suggestions are accumulated from personal experience and five years of her working with the above organizations and agencies.

When suspicion of child abuse and/or neglect arises, there is often concern about how to make the report. By using a copy of the actual form to collect the information in an organized manner, it will be easier and less stressful on the mandated reporter. The individual at CPS will be asking for the information as if it were coming right from the form. If the mandated reporter responds to clarifying inquiries of the CPS caseworker, the information provided can be noted on the copy of the form. This document then becomes the "working draft" of the report. It becomes much simpler to transfer information from the "working draft" to the formal report.

The Suspected Child Abuse Report Form SS8572 will now be discussed section by section. This method of review can be very helpful in explaining to the team how to make an effective and objective report. The italicized statements are printed on the reverse of the single-page Form SS8572.

Section A. Case Identification

Enter the victim name, report number or case name, and date of report.

This section is to be completed by the investigating child protective agency. However, a case number or an identification number will be assigned to the report. For follow-up purposes, the mandated reporter should ask for this number and the name of the intake worker taking the report. The name of the intake worker should also be recorded in Section C. Counties may provide follow-up by letter or telephone. Upon completion of the investigation or after there is a final disposition of the matter, the investigating agency shall inform the mandated reporter of results and actions taken (CPC 11170[b]2). If the reporter has not heard from the agency after a while, he or she should call the agency and inquire. Due to confidentiality of the investigation process, the mandated reporter may at times only be informed of the case status as unfounded, substantiated, or inconclusive.

These terms are defined in Section 11165.12 of the CPC "Unfounded" means a report that is determined by a child protective agency investigator to be false, to be inherently improbable, to involve an accidental injury, or not to constitute child abuse or neglect, as defined in Section 11165.6. "Substantiated" means a report that is determined by a child protective agency investigator, based on some credible evidence, to constitute child abuse or neglect as defined in Section 11165.6. "Inconclusive" means a report that is determined by a child protective agency investigator not to be unfounded, but the findings are inconclusive and there is insufficient evidence to determine whether child abuse or neglect, as defined in Section 11165.6, has occurred.

Section B. Reporting Party

Enter your name/title, address, phone number, date of report, and signature.

This section appears very straightforward. It is important that the name of the mandated reporter making the report is entered. The address listed should be where the investigating agency can contact the mandated reporter in case of need for further information and follow-up. It is suggested that the reporter’s work address be listed here. In the rare occasions of court prosecution, the address could be released to the court. Most mandated reporters feel more comfortable with the work address being listed. The date of the report is the date the report is filled out. The date the initial call is made is placed in Section C.

Section C. Report Sent To

(1) Check the appropriate box to indicate which child protective agency (CPA) this report is being sent; (2) Enter the name and address of the CPA to which this report is being sent; and (3) Enter the names of the official contacted at the CPA, phone number, and date/time contacted.

This reporting form may be used to submit suspected child abuse and neglect mandated reports to any of the agencies listed in Section C. When one is making a report, he or she should ask the intake caseworker to indicate which box should be checked. In most counties, suspected child abuse and neglect reports are made to CPS. However, if the mandated reporter is witnessing the abuse taking place and the person is in immediate danger, the reporter should call 911. The report is then made to local law enforcement. The best way to be sure of the local protocol for making a report is to contact the local CPS office in the county listing of the telephone directory white pages. This will allow the reporter to determine the appropriate way to make an effective report for the county by accessing the established system and to build collaborative communication links. The various child protective agencies communicate through the sharing of reports. Since the reporter will be retaining a copy of the filed report, the information regarding the contact person will assist in requesting report follow-up.

Section D. Involved Parties

There are three subsections to Section D.

a. Victim: Enter the name, address, physical data, present location, and phone number where victim is located (attach additional sheets if multiple victims).

An important component of this section is to identify the present location of the child. For example, if the child is at school, identify the school. CPS encourages reporters -- if the determination of suspicion is made on a school day -- to make the report as early in the day as possible. This will allow CPS the ability to contact the child at the school during school hours. A report on Friday at 3:30 p.m. may make it more difficult to locate the child.

Also the indication of the sex of the child is important. Some names do not readily identify the child's sex. For example, names such as Pat and Chris in addition to other culture-specific names could be misleading.

b. Siblings: enter the name and physical data of siblings living in the same household as the victim.

If the reporter is knowledgeable about siblings of the victim, he or she should indicate the information requested. This information will assist CPS in evaluating the risk situation. There may be previously filed reports regarding the other children. This information can facilitate cross-reference. If there is the potential of drugs or weapons involved, CPS will be better prepared to assist all the children in the environment. Mandated reporters are often unaware of what has been previously reported or what investigations are in progress. The information provided by a mandated reporter may seem insignificant, but it may be the powerful missing piece of information or linkage that will assist the child protective agency in breaking the cycle of child abuse.

c. Parents: Enter the names, physical data, addresses, and phone numbers of father/stepfather and mother/stepmother.

Often, dental offices will have information on the parents of the child, especially when it relates to dental insurance coverage. In the extended families of divorce and separation, dental office information may be more current than other sources. This form does not have a place to indicate which parent(s) the child resides with, so one should indicate this information in this section if known.

E. Incident Information

(1) Enter the date/time and place the incident occurred or was observed, and check the appropriate boxes; (2) Check the type of abuse; (3) Describe injury or sexual assault (where appropriate, attach Medical Report - Suspected Child Abuse Form DOJ 900 or any other form desired); (4) Summarize what the child or person accompanying the child said happened; and (5) Explain any known prior incidents involving the victim.

This is the section where information that has been gathered will be objectively reported. This is why the mandated reporter suspected child abuse report is a report and not an accusation. Investigation will be handled by the appropriate agency. As mandated reporters, dental professionals work collaboratively with the agencies to assist families. In the process of collecting data and information for differential diagnosis of dental/medical problems, red flag suspicions of child abuse and neglect maybe raised. The ability to collect nonjudgmental observations greatly assists the efforts to help children and families. If there is the potential of drugs or weapons involved, this should be indicated on the report. This will assist CPS in determining the appropriate participation in the response and investigation.

Section E begins with a small line saying "If necessary, attach extra sheet or other form and check this box." To establish the presence of additional documentation attached to the report form, it is imperative that this box be checked. If it is not, the admission of any information provided on attached documentation could be disqualified in the off chance of litigation. Form SS8572 is a four-page NCR document. It should be filled out with a ballpoint pen utilizing legible handwriting and pressing hard or with a typewriter. Upon arrival at CPS, the report form will be separated and each page sent to a different agency. Therefore, it is suggested that four copies be made of any additional documentation being attached to the report to expedite the processing. The mandated reporter’s copy is the last NCR page. A prudent mandated reporter will make a photocopy of the front of the report and any additional documentation and attach it to the retained yellow copy of the form. This will facilitate easier reading of the report later.

The information in Box 1 of Section E should be answered to the best of the mandated reporter’s ability. But this does not mean that the mandated reporter should interrogate the child or accompanying person to gather information. This is when the need to gather data for diagnostic purposes crosses the line into investigation. For the sake of court-admissible data, it is important for the responsible authorities to collect this data which will then become evidence.

The boxes identifying if the child is in out-of-home care is important because it will assist in directing where the report should be additionally sent. The licensing agencies have a responsibility for being aware of potential violations of child abuse and neglect.

Box 2 requests that the mandated reporter identify the type of abuse. The request is for what is recognized and does not exclude the presence of other forms of abuse that have not been revealed to the mandated reporter.

Box 3 is the location to provide a narrative description of the abuse or neglect observed by the mandated reporter. Record location, size, color, pattern, and shape of presented abuse or neglect signs and symptoms. Use diagrams, radiographs, and/or photographs to illustrate observations if necessary. Photographs and radiographs may be taken of children in the cases of suspected child abuse and neglect without parental permission (CPC 11172 [a]) and (CPC 11171 [a]). Suggestions for taking photographs are included in one of the listed resources.⁴ If additional documentation is attached, the box in Section E should be checked to indicate that this is the case.

It is key that the mandated reporter remember that the report is an account of observations to authorities and not an accusation. The report form is considered a legal document. The mandated reporter should refrain from offering opinions and conclusions. When faced with the suspicion of abuse or neglect, a normal human response is to experience strong emotions and feelings. A person may feel angry and upset, but it is important that the emotion remain out of the report. The report most effective for assisting child protective agencies is the objective report that communicates observations and accurately relates verbal information. The responsibility of the mandated reporter is to report child abuse and neglect, not to be an investigator.

Box 4 is the location to provide a summary of what the abused child or person accompanying the child said. Direct quotes included in the report by the mandated reporter can be critically important. For example, a mother states the following regarding the patterned mark on her daughter’s cheek: "Her father hit her with a wire brush." The appropriate way to objectively report this example would be to describe the patterned mark in Box 3 and quote the mother directly in Box 4. The following language is suggested: "The mother stated, ‘Her father hit her with a wire brush.’" The reporter should avoid summarizing the statement as in "The father hit the daughter with a wire brush" without identifying who made the statement. It is important that the mandated reporter not offer opinions or conclusions in the report. This maintains the report language as an observation and not an accusation.

Box 5 is the location to "explain known history of similar incident(s) for this child." This is the location to identify past patterns and occurrences that have been observed. Descriptions, dates, and reasons for the injuries or circumstances can be provided here. Previous reports made can be documented here to assist in cross-referencing of reports.

Organized Dentistry’s Efforts to Answer the Cry for Help

The California Dental Association has been a proactive coalition partner against child abuse since 1994 when Delta Dental Plan of California introduced the California P.A.N.D.A. program. P.A.N.D.A. is an educational program coordinated through the efforts of a coalition of organizations that are associated with the dental profession and those directly involved in the prevention of child abuse and neglect. The goal of the P.A.N.D.A. program is to provide education to dental professionals on how to recognize and report suspected cases of child abuse and neglect and to promote awareness of child abuse prevention. The P.A.N.D.A. name was conceived by Delta Dental Plan of Missouri, which began a similar program in 1992.⁵ The California P.A.N.D.A. Coalition can be credited with training more than 5,500 dental professionals from 1994 to 1997 on how to detect and report child abuse and neglect.

CDA accepted the transfer of the administrative and financial responsibility of the P.A.N.D.A. program from Delta Dental in 1997. The association’s Council on Community Health saw this as a significant opportunity not only to become the new sponsor of the P.A.N.D.A. program but also to incorporate P.A.N.D.A. into a larger, more comprehensive abuse detection and reporting program. In 1998, the Council on Community Health launched its Abuse Detection and Education Program encompassing the detection and reporting of child abuse and neglect, elder abuse and neglect, and domestic violence. The current CDA web page includes narrative materials on child abuse and neglect and elder abuse and neglect. Since the program’s inception, the council has provided mandated reporter training on all forms of abuse and neglect to more than 4,300 dental health care providers. In addition, it has sponsored four continuing education presentations at CDA Scientific Sessions and a statewide abuse detection and education conference.

Through ongoing mandated reporter train-the-trainer seminars, the council would like to have mandated reporter trainers in each of the association’s 32 local components. In addition it would like to have trainers in each of the California dental hygiene programs, registered dental assisting programs, and five dental schools. This would greatly assist with the education of mandated reporters and contribute to the collaborative effort within the community to prevent abuse and neglect.

Community Capacity

The effect of the P.A.N.D.A. program has been far-reaching. Dental professionals have been trained through the seminars at CDA Scientific Sessions, local dental societies, dental schools, and dental hygiene and dental assisting schools. More people were reached through mailing of materials and videos. As awareness grew of CDA’s program, requests for information and seminars increased. The Abuse Detection and Education Program materials have been distributed, discussed, and/or presented to Headstart groups, the University of California Davis Medical Center Child Protection Center, Americorps, family support workers, district attorneys, State Conference of Child Abuse Prevention Council executive directors, regional child abuse prevention council leadership conferences, the California School-Age Consortium Statewide Conference, Interfaith leadership, CPS agencies, the California Youth Authority, and others. The effect of this program crosses dental lines to include the rest of the community.

Dentistry is well-respected in the child abuse prevention field for its awareness and focused interest in working collaboratively with other agencies in the field of child abuse and neglect prevention. It is through this combined communication and collaboration that community capacity can be fostered and built. Community capacity encompasses the community’s ability to cooperatively work together on a common goal, which in this case is the prevention of child abuse and neglect.

Involvement of dental professionals in the community effort to foster change in family violence can make a difference. Sixty-five percent of child abuse and neglect is physically manifested in the head and neck region. Dental professionals have the challenge to increase the awareness of how to detect abuse, especially oral abuse, and to join the community effort. Community capacity to prevent abuse and neglect depends on the communication and collaboration of the entire community.

So, now that the dental team has been trained, what else can a dentist do? A dentist can contact CDA and become a trainer of mandated reporters for his or her community. He or she can contact the local Child Abuse Prevention Council and ask how to join the community’s effort to prevent child abuse and neglect and assist in building community capacity.

This is a great opportunity for dentistry to be passionately involved in communities. The effect will be to positively affect children and their families. The victims of abuse often speak in nonverbal language through signs and symptoms. Dental professionals have the opportunity to become their voice. Dentistry can make a difference. Now is the time.

Authors/

Kathleen A. Shanel-Hogan, DDS, is a consultant, educator, and facilitator for family violence prevention and serves on the Board of Directors of Prevent Child Abuse-California.

Julie A. Jarrett, RDA, BS, is coordinator of CDA’s Council on Community Health.

References/

1. The California Child Abuse and Neglect Reporting Law: Issues and Answers for Health Practitioners, Publication 132(4-91), p 1.

2. Ramos-Gomez F, Rothman D, Blain S, Knowledge and attitudes among California dental care providers regarding child abuse and neglect. J Am Dent Assoc 129: 340-8, 1998.

3. The California Child Abuse and Neglect Reporting Law: Issues and Answers for Health Practitioners, Publication 132(4-91), pp 4-5.

4. Spencer DE, Recognizing and reporting child abuse. J Calif Dent Assoc 24(5):43-9, 1996.

5. P.A.N.D.A. Program promotional brochure, The P.A.N.D.A. Coalition, 1996.

6. The California Child Abuse and Neglect Reporting Law: Issues and Answers for Health Practitioners, Publication 132(4-91), p. 23.

7. California Medical Association’s California Physician’s Legal Handbook (1999), Vol 3:34:6.

8. Department of Justice Form SS 8572 (Rev. 1/93).

To request a printed copy of this article, please contact/ Julie Jarrett, RDA, BS, California Dental Association, 1201 K St., Sacramento, CA 95814.

Figure 3. A copy of the Suspected Child Abuse Report form. ⁸