How do I report?

  1. Call immediately or as soon as possible
  2. Provide a written report within two working days (they request a fax)
  3. 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
Adult Protective Services

(408) 975-4900
Fax (408) 975-4910

San Mateo County
Adult Protective Services

(800) 675-8437
Fax (650) 573-2310

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
LTC Ombudsman Program
(408) 944-0567
Fax (408) 944-0776

San Mateo County
Ombudsman Program
(650) 780-5707
Fax (650) 364-5399

What form do I use to report?

There are two State forms:

Form SOC-341
This is a one page form to which you can attach other pages as needed (such as a body map).

Optional additional detailed forensic form:
Form CalEMA 2-602
This is a 10 page forensic examination form with instructions.