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UCLA Procedure 136.0 : Attachment B

UCLA Mandated Reporter Acknowledgement Statement

UCLA MANDATED REPORTER ACKNOWLEDGMENT STATEMENT

You have been given this form to sign because you have been identified as a “UCLA Mandated Reporter” of child abuse or neglect under California law or UCLA Policy 136 (which contains a summary of mandated reporter categories in its Attachment C). Submit the signed form to your department. Your department will forward it to your departmental human resources or academic personnel representative, who will keep the form in your personnel file. You should also keep a copy of this form for your records. Employees, volunteers, contractors, and interns of UCLA Health should contact UCLA Health Human Resources for the UCLA Health Acknowledgement Form and procedures.

WHEN IS REPORTING CHILD ABUSE REQUIRED?

Any UCLA Mandated Reporter who observes, has actual knowledge of, or reasonably suspects child abuse or neglect has occurred, will report the matter externally as required by CANRA and report internally as required by UCLA Policy 136.

A UCLA Employee, Official, or other position at UCLA who, by virtue of their licensure or profession, has a duty to report under CANRA or who, within the scope of their employment or other position at UCLA, has duties that bring them into direct and regular contact with a Child, will be considered a “UCLA Mandated Reporter.”

WHAT ABUSE MUST BE REPORTED?

For detailed definitions of reportable conduct, please see the definitions in California Penal Code §11165.1-11165.6 (https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=PEN&division=&title=1.&part=4.&chapter=2.&article=2.5#:~:text=11165.1.,as%20defined%20by%20the%20following%3A&text=(2)%20Sexual%20contact%20between%20the,or%20tongue%20of%20another%20person.)).

  • Physical injury inflicted by other than accidental means, but does not include “mutual affray” (e.g., fist fights) between minors. [CANRA § 11165.6]
  • Sexual abuse meaning sexual assault or sexual exploitation of a child. [CANRA § 11165.1]
  • Neglect meaning the negligent treatment, unjustified lack of treatment, or the maltreatment of a child by a person responsible for the child’s welfare under circumstances indicating harm or threatened harm to the child’s health or welfare. [CANRA § 11165.3]
  • Willful harming or injuring or endangering a child meaning a situation in which any person inflicts, or willfully causes or permits a child to suffer, unjustifiable physical pain or mental suffering, or causes or permits a child to be placed in a situation in which the child or child’s health is endangered. [CANRA § 11165.3]
  • Unlawful corporal punishment or injury willfully inflicted on a child and resulting in a traumatic condition. [CANRA § 11165.4]

HOW SHOULD CHILD ABUSE BE REPORTED?

  1. External Reports: Per California law, reports of suspected child abuse or neglect must be made externally to any police department or sheriff’s department, county probation department (if designated by the county to receive such reports), or county welfare department. UCLA Police Department accepts such reports For more information, see UCLA Policy 136, Section III.C.
  2. Internal Reports: Per University Policy, anyone who is required to make an external report must additionally make an internal report, except UCLA Health Mandated Reporters and other health care professionals. For more information, including exceptions, see UCLA Policy 136, Section III.C.

IMMUNITY AND CONFIDENTIALITY OF REPORTER AND OF CHILD ABUSE REPORTS

UCLA Mandated Reporters have immunity from criminal and civil liability for reporting as required or authorized by law. Reports are confidential and may be disclosed only to specified persons and agencies; the identity of a UCLA Mandated Reporter is confidential and disclosed only among agencies receiving or investigating reports and other designated agencies. Any violation of the confidentiality required by CANRA is a misdemeanor punishable by imprisonment, fine, or both.

PENALTY FOR FAILURE TO REPORT CHILD ABUSE

A UCLA Mandated Reporter found guilty of failing to make a report required under CANRA is punishable by up to six (6) months in jail, a fine of $1000, or both. A UCLA Mandated Reporter who fails to report child abuse or neglect, as required by UCLA Policy 136, may also be subject to disciplinary action under University policies or, as applicable, collective bargaining agreements. 

ACKNOWLEDGEMENT OF RESPONSIBILITY

I acknowledge my responsibility to report known or suspected child abuse or neglect in compliance with CANRA and University Policy. My employer has provided me with a hardcopy of, or web link, to UCLA Policy 136, Reporting Child Abuse and Neglect, and web link to CANRA sections 11165.7, 11166 and 11167 (https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=PEN&division=&title=1.&part=4.&chapter=2.&article=2.5)

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