How do I report?
- Call immediately or as soon as possible
- Provide a written report within two working days (they request a fax)
- Contact police if there is immediate danger or sexual assault
To whom do I report?
You may call/send report to local police, or to one of two state protective services depending on where the abuse occurred.
A. If the abuse occurred as an inpatient in an acute care hospital, in a private residence, hotel, apartment, shelter, or location not otherwise listed.
Call and send report to County Adult Protection Services
in the county where the patient lives.
Santa Clara County |
San Mateo County |
B. If abuse occurred in a nursing home, adult residential facility, adult day program or day health care center:
Call and send report to Long Term Care Ombudsman in county where abuse occurred. (Ombudsman Crisis Line is (800) 231-4024)
| Santa Clara County Fax (408) 944-0776 |
San Mateo County Fax (650) 349-7009 |
What form do I use to report?
There are two State forms:
Required:
Form SOC-341
This is a one page form to which you can attach other pages as needed (such as a body mapOptional additional detailed forensic form:
Form CalEMA 2-602
This is a 10 page forensic examination form with instructions
