Child Abuse and Neglect Reporting Forms
The following forms are for use by government agencies and mandated reporters pertaining to child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or local law enforcement agency.
- Child Abuse or Severe Neglect Indexing Form
This form is for use by government agencies mandated to submit child abuse case information pursuant to Penal Code (PC) section 11169.
- Suspected Child Abuse Report Form
This form is for use by mandated reporters, as defined in PC section 11165.7, to notify a reporting agency (local law enforcement, county probation or county welfare department) about suspected cases of child abuse. This form may also be used to cross-report to another reporting agency.
CACI Inquiry Forms
The following forms must be completed for inquiries of CACI information.
Authorized Agencies Only
- Facsimile Inquiry for Child Abuse Central Index (CACI) Search
This form is for use by Law Enforcement and authorized agencies seeking information in the CACI.
- Child Abuse Central Index Inquiry Request for Out-of-State Foster Adoption Agencies
This form is for use by out-of- state foster and adoption agencies requesting information from the CACI.
- Child Abuse Central Index Self Inquiry Request
This form is for use by private citizens. Pursuant to PC section 11170(f), "Any person may determine if he or she is listed in the CACI by making a request in writing to the Department of Justice."
If you have questions regarding the use of the forms, contact the CACI at: CACI-Inquiry@doj.ca.gov
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