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.
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 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).)
Completing the Form
Enter your 19 digit referral number that was issued to you by Child Protection Hotline.
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. You will have the option to
change the number of victims inside the form in Section E.
It is important to indicate whether or not the child is developmentally delayed or has some disability.
If most of the information you are reporting is similar or the same as the previous victim, the
system will generate a new SS8572 form with sections A,B,D and E completed.
To create additional victims, click on the "ADD NEXT VICTIM" button.
To delete the current victim's data and remove it from the report, click on the
"DELETE THIS VICTIM CREATE REPORT" button.
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
When you have completed the form for each victim, you can create the report by clicking
on the "CREATE REPORT" button. You must submit the report to the database
in order to be able to download it on your computer and print it.
Once the report has been submitted to the database, a confirmation page will be
created which will include your referral number and a tracking number. You will
need both numbers to access the report online. You will also have the option to
print the confirmation page.
The report will be created in Adobe Acrobat format, and you will need to have the
free "Adobe Acrobat Reader Plug-In" installed on your computer. If you
don't have the Acrobat Reader installed , please click
To create the report and save it on your computer, click on the "VIEW/SAVE
REPORT" button from the confirmation page.
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.
Review the questions below before completing the narrative. By providing the information requested,
you will assist the Children's Social Worker and law enforcement official assigned to investigate
the allegations you have reported. If you don't have all the information, do your best to include
as much information as possible. 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 and address and/or current
Is the victim developmentally disabled?
Does the victim have any disability?
Provide any known details.
Provide specific dates and/or time frames.
Provide the specific location (address if known) of the incident.
Who if anyone was a witness to the event?
Is there anyone else who may know about the incident or who may be able to provide
information about the victim or the victim's family?
Provide the identifying information (name, address, telephone, etc.) and relationship
of the person to the victim/family.
Reporting Party: After completing Form SS 8572, retain one copy for your records.
(Note: It will not be necessary for you to mail a copy of this online report to
law enforcement, the district attorney's office or Children's Services. Upon receipt
of the Form SS 8572, within 36 hours, DCFS will distribute a copy of the form to
the appropriate agencies.)