Recognize and Report: Child Care Providers Have the Power to Prevent

RECOGNIZE AND REPORT:

CHILD CARE PROVIDERS HAVE THE POWER TO PREVENT CHILD ABUSE

A White Paper of Regulatory Recommendations

By Laurie Furstenfeld, Staff Attorney California Health and Safety Regulatory Workgroup

October 2014 Updated January 2015

EXECUTIVE SUMMARY

In 2013, child protective services (CPS) agencies in California received more than 80,000 substantiated reports of child abuse and neglect.1 Almost half concerned children 5 and younger, who are at highest risk for maltreatment. Many of these children were among the approximately one million attending licensed child care homes and centers in our state.2 Very young children spend more time with child care providers than with any adults other than family members.

Recognizing the close relationship between child care providers and the children in their care, California law includes child care providers among “mandated reporters”— professionals who are legally obligated to report suspected abuse or neglect to CPS agencies.3 Proper CPS intervention following a CPS report is a key deterrent to recurring child abuse and neglect.4 And yet in 2013 only 1.6 percent of substantiated reports of abuse and neglect of children through age 5 came from “day care and foster care.”5 This disproportionately small number strongly suggests that child care providers underreport suspected abuse.

Despite their status as “mandated reporters,” California does not require that child care providers receive any training in recognizing signs of child maltreatment or in how to navigate the complicated reporting system.6 In fact, a national evaluation ranked California’s standards for child care regulations and oversight near the bottom.7 We are one of only two states that require no annual training for child care providers.8 California Community Care Licensing Division offers family child care home licensees and child care center directors only the most basic information on the role of mandated reporters; other child care staff do not receive even that.

Child care providers themselves express confusion about their legal reporting obligations.9 Child care providers worry that reporting will undermine their close relationships with the families they serve, provoke retaliation from families, intensify the abuse, jeopardize future business, or even subject them to lawsuits.

California should require comprehensive child abuse prevention training for all child care providers. Such training will offer child care providers tools for supporting families, including those who present risk factors for child maltreatment, possibly preventing child abuse before it occurs. It will also empower child care providers to become proactive reporters when they recognize signs of abuse and neglect, helping eradicate child abuse, and in turn dramatically reduce costs to the state for medical and mental health services.10 Moreover, training will decrease the number of unsubstantiated reports, sparing agencies from spending limited resources on investigating unfounded allegations or reports containing insufficient information.11

AB 1432, recent legislation requiring child abuse training for school employees, offers a model for similar requirements in the child care setting. Additionally, a free online training for child care providers already exists on the California Department of Social Services website.12

Child care providers are a critical component of the early care and education system. Requiring them to be trained in recognizing and reporting child maltreatment will help them be fully effective in carrying out this role. “When I taught preschool, I decided to take child abuse prevention training given by the Stockton Family Resource and Referral agency. When I returned to my school and shared the information with other teachers, I explained that we were all mandated reporters--none of them knew that, or even what it meant. A few weeks later, a two-year-old arrived at our school with a handprint-shaped bruise on his face. His teacher brought the child to my classroom and asked for advice. I walked her through how to make the required report, and CPS arrived within the hour. They interviewed the little boy, took him from school, and opened a CPS case. Although the experience was traumatic, we knew the child would now be protected and that his family would receive much-needed intervention and support.” --Lucy Chaidez, EMSA Child Care Training Coordinator and former early childhood educator and social worker.

INTRODUCTION

Children under five are the most vulnerable to child abuse and neglect. In 2013, California child protective services (CPS) agencies received 81,381 substantiated reports of child abuse and neglect, almost half regarding victims from birth to age 5.13 And in 2012, 49 states reported a total of 1,593 child fatalities due to maltreatment; nearly three-quarters of these victims were under age 3. Eighty percent of the deaths were caused by one or both parents.14

Approximately one million children are currently in licensed child care in California.15 Although our youngest children are at highest risk for maltreatment and spend more time with child care providers than with anyone else outside their families, child care providers are the least likely professionals to report suspected child abuse to the proper authorities.16 In 2013, California CPS agencies received, regarding children through age 5, approximately 95,601 reports that required an investigation.17 Of those reports, only 1,516 came from “day care and foster care” (the state does not track data for “day care” alone).18 And nationally, of CPS reports from professionals who encounter children as part of their occupations – child care providers, teachers, law enforcement and medical personnel, and others – only .4 percent come from child care providers.19 The large number of young children in child care and the small proportion of CPS reports from that source combine to suggest strongly that child care providers greatly underreport suspected abuse and require training to meet their obligations.

Reporting is crucial because proper CPS intervention remains a key deterrent to recurring child abuse and neglect.20 Even though all licensees, administrators, and employees of licensed child care facilities and employees of any child care institution are mandated reporters--required under state law to report suspected child abuse and neglect--California does not require that they be trained in recognizing signs of child maltreatment or in how to report suspected abuse.21 And yet failure to report can increase the probability that the abuse will continue and even extend to other children.22 One expert notes that “sex offenders who have been ‘caught’ abusing a child without a report being made to the authorities or without any meaningful consequences often feel emboldened, giving them the sense of invincibility.”23

Reporting by child care providers and their employees, who work daily on the front lines with children and families, can effectively interrupt this dynamic.24 Comprehensive training of child care staff on the signs and symptoms of child abuse will help child care providers intervene early, support families, and create supportive environments for both children and families.

Unfortunately, due to a lack of training and vague regulations, few child care providers fully understand their role as mandated child abuse reporters, reducing the likelihood that they will make reports.25 Many child care providers do not know whom to call if they suspect abuse or neglect or whom to consult for guidance about whether a report is warranted.26

To protect children, California must require training for child care employees in how to support families, especially those who present risk factors for child maltreatment. A comprehensive training will also teach child care providers how to recognize child abuse and neglect, when and how to make a CPS report, and how to work with families following a report. Having undergone comprehensive training, California’s child care providers will better understand their vitally important role as mandated reporters and be more confident in navigating the reporting process. The result will be more “appropriate care, referrals, screenings, and fewer illnesses” for young children, enhancing their overall development, mental health, and learning readiness.27

STATEMENT OF THE PROBLEM

A comprehensive national evaluation of state child care regulations and oversight, We Can Do Better, ranks California near the bottom in child care standards: 46th in the nation for “Child Care Center Requirements” and next to last in the comprehensive category “Total Child Care Center Scores and Ranks.”28 These disturbing rankings are based in part on lack of training, including a lack of mandated reporter training, for child care providers. Moreover, California is one of only two states that does not require any annual training for child care providers.29

California Law Does Not Require Mandated Reporter Training for Child Care Providers

California’s Health and Safety Code obligates one director or teacher at a daycare center, and all family child care provider licensees who care for children, to receive 15 hours of health and safety training before obtaining a child care license. The training must include courses in:  Pediatric first aid  Pediatric cardiopulmonary resuscitation (CPR),  Preventative health practices, such as recognizing and preventing infectious diseases, and 30  Childhood nutrition, if licensed after January 1, 2016.

The law does not require training on recognizing the signs of child abuse or neglect or how to comply with mandated reporter requirements.31 The California Penal Code only requires mandated reporters to “sign a statement” attesting to their knowledge of and willingness to comply with the reporting obligation.32 Pursuant to this law, California Community Care Licensing Division (Licensing) issues a form to child care licensee applicants entitled “Statement Acknowledging Requirement to Report Child Abuse.”33 The one-and-a-half page form generally informs child care providers that they are mandated reporters, briefly describes what, when, and where to report, and explains that reporters are immune from civil or criminal liability and their identity is confidential. The form also explains the criminal and civil penalties for failure to report.

The only information that accompanies the form is in Licensing’s orientation training for family child care home licensees and child care center directors. This training touches on the mandatory reporting requirement and lists several agencies to which reports should be directed (law enforcement, CPS or Child Abuse Hotline, and/or Licensing). Trainees are informed that they must sign and keep a copy of the signed Licensing form on file. The orientation training is not required for family child care staff other than the licensee or center staff other than the director. Without instruction or guidance on how to recognize the signs of child abuse and neglect, how to support a child, and work with a family during or after a report, or the process of how to make a report, these child care providers can be unaware of what being a mandated reporter entails.34

Barriers To Reporting Child Abuse And Neglect

Many California child care providers express lack of understanding of their legal obligations as mandated reporters.35 A survey of 76 child care providers in California found that while most know about their duty to report child abuse, they have only a vague idea of what the obligation means and some are too fearful to make a report.36 Some child care providers shared that, when faced with making a child abuse report, they worried about retaliation from families. While California law requires CPS and law enforcement to keep a reporter’s identity confidential, providers know that parents are often able to deduce the source of a report.37 Child care providers also fear that reporting could cause the abuser to retaliate by intensifying the abuse, or that a mistaken report could lead to a lawsuit by the child’s family. Moreover, child care providers do not want to tarnish their relationships with the families they serve. Not least, they worry about losing income and future business if they report.38

Making a Child Abuse Report Is Complicated and Requires Training

Even when Licensing complies with its obligation to give licensees a copy of Penal Code provisions governing mandated reporting, those provisions are very general and offer no guidance specific to child care providers.39 Moreover, the actual reporting process is complicated--reports must be made both by telephone and in writing and the agency to which the report must be directed varies by where the abuse took place. And yet child care providers are expected to navigate the process with little or no training.

CHILD CARE PROVIDERS ARE UNIQUELY POSITIONED TO REDUCE AND PREVENT CHILD ABUSE

As noted above, no one but family members spends more time with the million young children attending licensed child care in California than child care providers. Infants and toddlers who are not yet school-aged make up the largest proportion of children in out-of-home child care. These very young children are the most likely to be victims of child abuse and neglect; their limited verbal skills make reporting abuse difficult and they require continuous supervision they may not be receiving. Moreover, infants and toddlers likely do not receive daily oversight from school teachers and other staff who may notice signs of abuse and neglect and are mandated to

4 report.40 Therefore, educating child care providers in their duty as mandated reporters is especially important because they care for the most vulnerable children. Child care providers also commonly have close relationships with families and are thus privy to family dynamics. Over time, child care providers often become de facto extended family to the children in their care, uniquely positioned to recognize and respond to families’ needs for information and support. Given the proper skills and training, child care providers can form partnerships with parents--relationships that can enhance child care program quality, strengthen families, and help reduce the risk of child maltreatment.41 Conversely, many parents recognize child care providers as a resource in caring for their young children and may share family challenges affording the child care provider a view into a child’s behavior.42 A child care provider who offers a sympathetic ear, a helping hand, and referrals to appropriate services can contribute substantially to parents’ capacity to become more nurturing and sensitive with their children.43

Comprehensive child abuse prevention training not only teaches child care providers to recognize signs of abuse but gives providers insight into how family stressors can lead to abuse and offers tools for reducing the impact of those stressors. Joint discussions between child care providers and parents about positive intervention strategies that both parties can use consistently with children can enhance the abilities of both to nurture young children and keep them safe.

THE SOLUTION: REQUIRE COMPREHENSIVE CHILD ABUSE PREVENTION AND REPORTER TRAINING FOR CHILD CARE DIRECTORS AND EMPLOYEES

“The child care center director was not happy when I made CPS reports. After my first report, he threatened to fire me and said that at our school, these kinds of problems are handled with prayer. He also said that when the angry parents came to school he would send them to my classroom and let them do whatever they wanted to me. He told me never to report abuse again, or I would lose my job.” --Child Care Provider

The American Academy of Pediatrics recommends that child care providers receive regular comprehensive child abuse and neglect education, designed specifically for them, noting that “(e)ducation about the manifestations of child maltreatment can increase the likelihood of appropriate reports to child protection agencies and law enforcement agencies.”44 Training can enhance child care providers’ knowledge and confidence about detecting signs of abuse. As a result, the current low proportion of CPS reports coming from child care providers should become more nearly in line with the extent of abuse that providers, who spend many hours per week with the children they care for, are in a position to see.

Licensing offers only limited support to child care providers who want to report child abuse or neglect. If a child care licensee has questions about reporting abuse, a licensing analyst can respond and walk the licensee through the reporting process. However, this assistance is not clearly available to other child care providers, support staff, and employees who do not have a direct relationship with a licensing analyst. Two advocates in Licensing’s “Child Care Advocate Program” answer general questions from child care providers, parents, and other interested individuals statewide about child care licensing regulations. The Child Care Advocates can guide a child care provider about how and where to make a child abuse report, but this help is offered

5 only if requested. This limited support available from Licensing makes child abuse training especially vital for child care providers, who must be largely self-reliant when assessing whether and how to report abuse.

Leading experts recommend that comprehensive child abuse prevention training include:

 Instruction on the symptoms, particularly subtle, non-visible signs, of abuse and neglect, and when to call for emergency medical attention to prevent further injury or death,45  Explanation of the law, including the requirement to report suspected child abuse and neglect, civil and criminal penalties for failing to report, immunity from liability for an unfounded report, and protections against retaliation by an employer,  Step-by-step guidelines on how to make a report, and to which enforcement agency,  Strategies for supporting a family under stress and working with a family before and after a report is made,  Special considerations and protocols for when abuse is by child care provider and/or takes place in a child care home or child care center,  How to ensure that all staff in a child care facility receive information about child protection policies and procedures,  Education on protective factors to prevent abuse (i.e., dangers of shaking a child, safe sleep practices, psychological effects of repeated exposure to domestic violence, safe and age-appropriate forms of discipline),  Child development education to help child care providers understand the difference between behaviors of concern that are “within normal range” and those that may point to abuse,  How to promote children’s social/emotional health, caring for children with special needs, and recognizing that these children are at higher risk for abuse and neglect,  How to support positive parent-child relationships, concrete family support measures,  How to recognize risk factors that may lead to abuse, such as stress and social isolation, and resources that a child care provider can offer a family to help prevent abuse, and  Information on child abuse prevention community resources.46

Training must also be translated into as many languages as possible to ensure that it is accessible to a wide variety of populations. Moreover, it should include a cultural sensitivity component to educate child care providers about how to appropriately and effectively work with families from different cultural backgrounds, and common cultural practices that may and may not be considered abuse.

Giving child care providers a solid foundation with a comprehensive training will help them identify risk factors before abuse or neglect occurs, recognize signs of abuse and neglect, overcome their reluctance to report and empower child care providers to become proactive reporters of any abuse they suspect. Comprehensive training will make clear that investigating suspected child abuse or neglect is the job of CPS, Licensing, or the police, not the child care provider, and that only 1 percent of child abuse reports lead to removal of the child from the home, thus easing the emotional burden of reporting. Comprehensive training would also convey that reports are stored and then referenced in the event of subsequent reports. A history of reports

6 on an individual may persuade an investigating officer to look more closely into a report that might otherwise not appear worthy of investigation, making every report important. Mandated Reporter Training Will Help Eradicate Child Abuse

Victor Vieth, child abuse prevention expert and founder of the National Child Protection Training Center, asserts that child abuse can be eradicated through proper training of professionals who work with children. A main component in “the battle plan for ending child abuse” includes annual training on detecting the signs of child abuse and mandated reporters’ obligation to report.47 Research shows that a primary obstacle to ending child abuse is that, due to lack of adequate training, mandated reporters simply are not reporting.48

Training on how to communicate with a child who has been abused is also essential to prevent future abuse. Children often fail to reveal abuse; when they do, the adult to whom they disclose must know how to respond properly:  Children who disclose sexual abuse often first tell a trusted adult other than a parent.  To gauge adult reaction, children may tell “parts” of what happened or pretend it happened to someone else.  If the adult’s response is emotional or negative, children will often “shut down” and refuse to tell more.49

Proper Training Will Foster Greater Accuracy in Reporting

While too few abuse and neglect cases are reported, the high number of “unsubstantiated” reports that are investigated and then dismissed due to insufficient evidence—by adding to investigators’ workloads—likewise undercut CPS’ capacity to protect children. 50 In 2013, California CPS agencies received 170,345 reports alleging abuse or neglect of children from birth to age 5; only 23 percent of those reports were substantiated.51

Few unsubstantiated reports are knowingly false.52 In most of these cases, reporters had good intentions but offered insufficient details or relied on vague information. Unfortunately, “the current flood of unsubstantiated reports is overwhelming the limited resources of child protective agencies, endangering children who are really abused …. As a result, children in real danger get lost in the press of inappropriate cases.”53

Moreover, an appropriate finding that a CPS report is unsubstantiated does not necessarily mean that a child is not being abused or neglected. CPS investigators’ heavy caseloads frequently mean that the investigators lack the time and resources to investigate a report thoroughly, especially when the report contains misinformation or insufficient details.54 With proper training, child care providers will have the tools to make more informed decisions about whether to report and, when they do, will give more useful information that will foster a more effective investigation.

Mandated Reporter Training Will Save Billions in Health Care and Administrative Costs

Aside from the direct safety, social, and psychological benefits of mandated reporter training, investing in the training for child care providers would result in vast savings for California. Survivors of violence and abuse have significant short- and long-term negative health consequences that cost the health care system billions of dollars each year due to increased use of mental health services, prescription psychotropic medication, and visits to general practitioners, emergency rooms, and hospitals.55 Research dating back to 1992 shows that those who experienced abuse sought health care services at least twice as often as others.56 And according to the Centers for Disease Control and Prevention, [m]altreatment causes stress that can disrupt early brain development, and serious, chronic stress can harm the development of the nervous and immune systems. As a result, children who are abused or neglected are at higher risk for health problems when they become adults. These problems include alcoholism, depression, drug abuse, eating disorders, obesity, high-risk sexual behaviors, smoking, suicide, and certain chronic diseases.57

A study of over 17,000 Kaiser patients found links between childhood abuse and neglect and liver disease, chronic obstructive pulmonary disease, coronary artery disease, and autoimmune disease. After controlling for conventional risk factors such as smoking and obesity, the research also found that individuals who experienced childhood abuse and neglect were almost twice as likely as others to develop heart disease.58

The State’s Cost for Training Will Be Minimal

California’s Office of Child Abuse Prevention (OCAP) provides free online training to mandated reporters, including training specifically for child care providers, in English and Spanish.59 Free online training is particularly appealing to child care providers who live in rural areas and for whom attending in-person trainings would be difficult, and to child care providers who cannot afford in-person trainings. OCAP also periodically offers free in-person mandated reporter training throughout California. Moreover, many counties offer mandated child abuse training through their child welfare services departments, and some offer the training through non-profit child abuse prevention councils and Resource and Referral Agencies.

Assembly Bill (AB) 1432, Child Abuse Training Requirements for School Employees, Offers a Model

By passing AB 1432 in September 2014, California lawmakers recognized the importance of requiring training for mandated reporters who work in schools. The bill requires that:

 Mandated reporter employees and contractors of school districts, county offices of education, state special schools, and diagnostic centers operated by the State Department of Education receive annual mandated reporter training within the first six weeks of every school year;  These employees submit, to the applicable governing body, proof of completion of the training;

 Information on detecting and guidelines on reporting child abuse be disseminated to all school districts, county offices of education, and charter schools, and their school personnel, and that the California Department of Education consult with the Office of Child Abuse Prevention in the State Department of Social Services in developing this information;  A state-mandated local program be instituted to absorb requirements of the bill.

Assemblymember Mike Gatto, author of AB 1432, explained that [d]espite the Child Abuse and Neglect Reporting Act's clear reporting requirements, school districts are merely 'encouraged' rather than required to provide employees who qualify as mandated reporters with training on either abuse identification or abuse reporting. The absence of training is a failure of our system that leaves millions of students at risk every single day.60

Young children in child care are at even greater risk for abuse and neglect than are school-age children. California law must be amended to require that mandated reporters in child care be trained, just as school employees are, in recognizing the signs of child abuse and neglect and how to report the suspected abuse.

CONCLUSION

With recent resounding national calls for high quality child care, education of child care providers in California on their role as mandated CPS reporters is crucial. If child care providers are left unaware of their duty to report or are unsure of the signs and symptoms of child abuse and neglect, hundreds of thousands of children and families will continue to be at risk of failing to receive the services that would strengthen their families.61

During a mandated child abuse reporter training, one child care provider recalled a child in her care some years earlier who, based on the physical and behavioral indicators she’d learned in the training, appeared neglected. She had suspected as much, but because of the lack of apparent physical abuse or bruises she didn’t think she could report, nor did she know how to do so. At the time she hadn’t realized there were so many categories of abuse. Now, with training, she knows that she must report suspected child abuse and neglect and has the skills to do so. She is thankful for the training and is convinced of the importance of mandated reporter training for all child care providers. –Gina Roberson, The Child Abuse Prevention Center Associate Director

1 Lucille Packard Foundation, Substantiated Cases of Child Abuse and Neglect, http://www.kidsdata.org (last visited October 10, 2014); substantiated child abuse and neglect reports means the reports have been verified. 2 U.S. Dep’t of Health & Human Servs., Child Maltreatment 52 (2012) available at http://1.usa.gov/1FMvK0o 3 Cal. Penal Code § 11165.7(a)(14) (employees of a “child care institution” are mandated reporters).

4 See Victor Vieth, Unto the Third Generation: A Call to End Child Abuse in the United States Within 120 Years, Journal of Aggression, Maltreatment & Trauma (2004) 14-17, available at http://bit.ly/1tHw38I ; see Appendix C, Victor Vieth et al., Lessons From Penn State: A Call to Implement a new Pattern of Training for Mandated Reporters and Child Protection Professionals 1, 5 Centerpiece, Vol. 3, Issues 3 &4 (2012), available at http://bit.ly/1tUasuG; see Aileen McKenna, Reluctant to Report: The Mandated Reporter Practices of Child Care Providers, Western Michigan University (2010) 1 (Ph.D. dissertation explaining why child care providers are the professionals least likely to report suspected child abuse and neglect. McKenna states “the failure to report abuse and neglect can have fatal consequences (Besharov, 1990). Studies in Texas, Colorado, and North Carolina revealed that over 40% of child fatalities attributed specifically to child maltreatment had not been reported prior to their death. This was despite the fact that these children had been seen by a public or private agency around the time of their death). 5 University of California at Berkeley, Child Maltreatment Allegations/Child Count, http://bit.ly/1smT4Y1, (last visited October 10, 2014). 6 Cal. Penal Code § 11165.79(a)(10) (“A licensee, an administrator, or an employee of a licensed community care or child care facility” are mandated reporters), (a)(14)(“An employee of a child care institution, including but not limited to, foster parents, group home personnel, and personnel of residential care facilities” are mandated reporters), (b) (employers are strongly encouraged, but not required, to train employees who are mandated reporters on their duty to report suspected child abuse or neglect); Cal. Health & Safety Code § 1598.866(a)(3) (required health and safety training for “at least one director or teacher at each day care center, and each family day care home licensee who provides care,” may include identification and reporting of signs and symptoms of child abuse). 7 Appendix D, Child Care Aware of America, We Can Do Better: Child Care Aware of America’s Ranking of State Child Care Center Regulations and Oversight 2013 Update 60-61, at 7 (2013), available at http://bit.ly/1uWcmWe (state rankings include the District of Columbia and Department of Defense child care centers). 8 Id., Update 35 (2013). Hawaii is the other state that does not require annual training. 9 See Appendix A, “Child Care Provider Surveys: Child Abuse Training Needs” (2013). 10 Theresa Dolezal et al., Academy on Violence and Abuse , Hidden Costs in Health Care: The Economic Impact of Violence and Abuse 9 (March 2009), available at http://bit.ly/1tUaZgi 11 Douglas Besharov, Responding to Child Sexual Abuse: The Need for a Balanced Approach 137, 139-144 Sexual Abuse of Children, Vol. 4, Number 2 (1994), available at http://futureofchildren.org/futureofchildren/publications/docs/04_02_07.pdf. 12 Cal. Dep’t of Social Servs, Child Abuse Mandated Reporter Training California, Child Care Providers, http://bit.ly/1DhYvxY (last accessed October 10, 2014). 13 Lucille Packard Foundation, Substantiated Cases of Child Abuse and Neglect, http://www.kidsdata.org (last visited October 10, 2014); substantiated child abuse and neglect reports means the reports have been verified. 14 U.S. Dep’t of Health & Human Servs., Child Maltreatment 52 (2012), available at http://1.usa.gov/1FMvK0o. 15 Based on number of child care slots; see Lucille Packard Foundation, Number of Child Care Slots in Licensed Facilities, by Type of Facility, http://www.kidsdata.org (last visited October 10, 2014). 16 See B. Needell et al., University of California at Berkeley California Child Welfare Indicators Project (2014) (last visited October 10, 2014) available at http://bit.ly/1nNuSzt. 17 Id. 18 University of California at Berkeley, Child Maltreatment Allegations/Child Count, http://bit.ly/1smT4Y1, (last visited October 10, 2014). 19 U.S. Dep’t of Health & Human Services, Child Maltreatment 29, Table 3-3 (2011), available at http://1.usa.gov/1s18X7R (children in foster care already have an open CPS case, which may contribute to foster care providers being least likely to make a subsequent CPS report).” 20 See Victor Vieth, supra note 4; Aileen McKenna, supra note 4. 21 Cal. Penal Code § 11165.7(a)(10) (“A licensee, an administrator, or an employee of a licensed community care or child care facility” is a mandated reporter), (a)(14)(“An employee of a child care institution, including but not limited to, foster parents, group home personnel, and personnel of residential care facilities” is a mandated reporter), (b) (employers are strongly encouraged, but not required, to train employees who are mandated reporters on their duty to report suspected child abuse or neglect); Cal. Health & Safety Code § 1598.866(a)(3) (required health and safety training for “at least one director or teacher at each day care center, and each family day care home licensee who provides care,” may include identification and reporting of signs and symptoms of child abuse).

22 Appendix C, Victor Vieth et al., Lessons From Penn State: A Call to Implement a new Pattern of Training for Mandated Reporters and Child Protection Professionals 2 Centerpiece, Vol. 3, Issues 3 &4 (2012), available at http://bit.ly/1tUasuG; see Theresa Dolezal, supra note 10, at 9. 23 Victor Vieth et al., supra note 22. 24 See Cal. Health & Safety Code § 1596.791 (defining “provider” as “a person who operates a child day care facility and is licensed pursuant to Chapter 3.5 (commencing with Section 1596.90) or 3.6 (commencing with Section 1597.30)” and Cal. Code Regs. tit. 22 § 10235 (p)(2) (defining “provider” as “anyone providing care to children as authorized by these regulations and includes the licensee, assistant provider or substitute adult.”) 25 Victor Vieth et al., supra note 22. 26 See Child Care Provider Surveys, supra note 9. 27 Crowley, et al., Health and Safety of Child Care Centers: An Analysis of Licensing Specialists’ Reports of Routine, Unannounced Inspections, American Journal of Public Health 1, vol. 102, n. 10 (2013), available at http://bit.ly/1oHGtEk. 28 Child Care Aware of America, We Can Do Better: Child Care Aware of America’s Ranking of State Child Care Center Regulations and Oversight 2013 Update 60-61, at 7 (2013), available at http://bit.ly/1uWcmWe (state rankings include the District of Columbia and Department of Defense child care centers). 29 Id., Update 35 (2013). Hawaii is the other state that does not require annual training. 30 Cal. Health & Safety Code §1596.866 (a), (c)(1). The only required ongoing training, for certain child care employees, is in first aid and pediatric CPR. See Cal. Health & Safety Code §1596.866 (b) (requiring “at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR”); the injury prevention part of the training requirements only need to be taken once in a lifetime. 31 Cal. Penal Code § 11165.7(b) (employers are strongly encouraged, but not required, to train employees who are mandated reporters on their duty to report suspected child abuse or neglect); Health & Safety Code § 1598.866(a)(3) (required health and safety training for “at least one director or teacher at each day care center, and each family day care home licensee who provides care,” may include identification and reporting of signs and symptoms of child abuse). 32 Cal. Penal Code §11166.5 (a). 33 Cal. Dep’t. Soc. Servs., Statement Acknowledging Requirement to Report Child Abuse, available at http://bit.ly/ZRCOrD. 34 Despite the lack of any training requirement, as a mandated reporter, a child care provider who “fails to report an incident of known or reasonably suspected child abuse or neglect … is guilty of a misdemeanor punishable by up to six months confinement in a county jail or by a fine of one thousand dollars ($1,000) or by both that imprisonment and fine.” Cal. Penal Code, § 11166 (c)). The law does, however, protect child care providers and other mandated reporters if they mistakenly make an unfounded report. Unless a false report is made intentionally, a child care provider will not be civilly or criminally liable. Cal. Penal Code, 11172(a). 35 Aileen McKenna, Reluctant to Report: The Mandated Reporter Practices of Child Care Providers 33-34, 38, Western Michigan University (2010); See Child Care Provider Surveys, supra note 9, indicating need for comprehensive training. 36 See Child Care Provider Surveys, supra note 9, indicating need for comprehensive training. 37 Cal. Penal Code § 11167 (d)(1) (“The identity of all persons who report under this article shall be confidential[l].” 38 Child Care Provider Surveys, supra note 9. 39 See Cal. Dep’t. Soc. Servs., supra note 33. 40 See Kathy Karageorge & Rosemary Kendal, U.S. Dep’t of Health & Human Services et al., The Role of Professional child Care Providers in Preventing and Responding to Child Abuse and Neglect 7 (2008), available at http://1.usa.gov/1t3m3E7. 41 Nancy Seibel, et al., Zero to Three, The Role of Child Care Providers in Child Abuse Prevention 33 (2008), available at http://bit.ly/1FNol0K. 42 See Maril Olson & Marilou Hyson, National Association for the Education of Young Children, Early Childhood Educators and Child Abuse Prevention: Perspective, Findings, Actions 6-7 (2003), available at http://bit.ly/1wscrnL. 43 Nancy Seibel, et al., supra note 41, at 40 (2008). 44 American Academy of Pediatrics et al., Caring for Our Children 30 (2011), available at http://cfoc.nrckids.org/. 45 Training is particularly essential to identify symptoms of non-obvious physical injuries such as head trauma, internal bleeding, and other injuries that require immediate medical attention.

46 See American Academy of Pediatrics et al., supra note 44; Vieth et.al., supra note 22; see also Appendix B, California Child Care Resource and Referral Network – Partners in Prevention, Making a Difference, A handbook for child care providers (1986) for example of comprehensive child abuse prevention training handbook for child care providers; see Child Care Provider Surveys, supra note 9, indicating need for comprehensive training. 47 Victor Vieth, Unto the Third Generation: A Call to End Child Abuse in the United States Within 120 Years, Journal of Aggression, Maltreatment & Trauma 2 (2004), available at http://bit.ly/1tHw38I . 48 Id. 49 Kids First Inc., 7 Ways to Prevent Child Abuse, http://bit.ly/1oMWCZ2 (last visited October 10, 2014). 50 Douglas Besharov, supra note 11, at 139. 51 University of California at Berkeley, Child Maltreatment Allegations/Child Count, http://bit.ly/1smT4Y1, (last visited October 10, 2014). 52 Douglas Besharov, supra note 11, at 140. 53 Id. 54 Id. 55 Theresa Dolezal, supra note 10, at 1; see Carole Jenny & James E. Crawford-Jakubiak & Committee on Child Abuse and Neglect, The Evaluation of Children in the Primary Care Setting When Sexual Abuse is Suspected, American Academy of Pediatrics e558 (2013), available at http://bit.ly/12Mds0c. 56 Theresa Dolezal, supra note 10, at 1. 57 National Center for Injury Prevention and Control, Division of Violence Prevention, Essentials for Childhood Prevention 6 (2014), available at http://1.usa.gov/1tzUyn9. 58 Ruth Lanius, The Impact of Early Life Trauma on Health and Disease 77 (2010). 59 Cal. Dep’t of Social Servs, Child Abuse Mandated Reporter Training California, Child Care Providers, http://bit.ly/1DhYvxY (last accessed October 10, 2014). 60 Bill Analysis, AB 1432, http://bit.ly/1tp9nJy. 61 See Victor Vieth et al., supra note 22.

Written by Laurie Furstenfeld, Staff Attorney, Child Care Law Center

Acknowledgements

We thank the following individuals for their extensive contributions to this publication. Without the dedicated efforts of each person, this work would not have been possible:

Lucy Chaidez, Emergency Medical Services Authority Lisa Chan, Lead Researcher and Writer Gwen Edelstein, Community Volunteer Ronda Garcia, Child Care Advocate Eliana Gil, Gil Institute for Trauma Recovery & Education Marcia Henry, Legal Editor Maria Luz Torre, Parent Voices at Children’s Council of San Francisco Mara Mahmood, Child Care Advocate and Professional Researcher Judge Donna Petre, Yolo County Superior Court Mary Beth Phillips, California Child Care Resource and Referral Network Cathy Ralph, UC Berkeley School of Social Welfare Gina Roberson, The Child Abuse Prevention Center Debra Silverman, First 5 California Karen Shelby, Child Care Resource Service, YMCA of San Diego County Patty Siegel, California Child Care Resource and Referral Network Desiree Soto, First 5 California Marcy Takeum, Alameda County Children and Family Services Victor Vieth, National Child Protection Training Center

This publication is a collaborative effort of the California Health and Safety Regulatory Workgroup, a statewide stakeholder group whose goals are to: (1) support best practices and improve child care health and safety standards in California; and (2) recommend reforms to California’s child care health and safety regulations.

Child Care Law Center is a nonprofit law firm working to ensure that high quality, affordable child care is available to all families, particularly low-income families, those with children with disabilities, families who need care for infants and toddlers, immigrant families and others who face barriers securing child care. This White Paper is funded in part by First 5 LA.

APPENDICES

Appendix A: Child Care Provider Surveys: Child Abuse Training Needs (2013) Appendix B: California Child Care Resource and Referral Network – Partners in Prevention, Making a Difference, A handbook for child care providers (1986) Appendix C: Victor Vieth et al., Lessons From Penn State: A Call to Implement a New Pattern of Training for Mandated Reporters and Child Protection Professionals (2012) Appendix D: Child Care Aware of America, We Can Do Better: Child Care Aware of America’s Ranking of State Child Care Center Regulations and Oversight 2013 (2013)

Available on the Child Care Law Center website: http://childcarelaw.org/resource/recognize-and- report-child-care-providers-have-the-power-to-prevent-child-abuse/