Making a Child Abuse Report
- http://www.ag.ca.gov/childabuse/pdf/ss_8572.pdf (this form may only be printed and manually filled out)
- Mail: CSOC/ACCESS, 101 Cirby Hills Dr. Ste 5, Roseville, CA 95678
- Fax: (916) 787-8915
- Email: firstname.lastname@example.org (see specific directions below)
To electronically fill out and email form: Click on this link to open form; SCAR_Suspected Child Abuse Report.doc; save to your hard drive; complete form and save. To submit completed form, click on email@example.com, attach and send.
Important information regarding confidentiality: Please be advised that should you choose to send your report via e-mail, to address confidentiality you must include the following language in your e-mail:
- CONFIDENTIALITY NOTICE: This communication contains legally privileged and confidential information sent solely for the use of the intended recipient. If you are not the intended recipient of this communication, you are not authorized to use it in any manner, except to immediately destroy it and notify the sender.
Please call 1–888–886–5401 if you have any questions regarding the reporting of child abuse, where our Client Services Assistants are available 24/7 to speak with you.
The Roseville Joint Union High School District is committed to equal opportunity for all individuals. District programs, activities and services shall be free from unlawful discrimination, harassment, intimidation, and/or bullying based on actual or perceived characteristics of race, color, ancestry, nationality, immigration status, age, ethnicity, religion, marital status, medical information, mental or physical disability, sex, sexual orientation, gender, gender identity, gender expression, genetic information, or any other legally protected status or association with a person or group with one or more of these actual or perceived characteristics. For inquiries/complaints, contact one of our Title IX Coordinators: Assistant Superintendent of Human Resources, Brad Basham at (916) 782-8663 or by email at firstname.lastname@example.org or Executive Director, Student Engagement, John Becker at (916) 782-5979 or by email at email@example.com.