MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1301
08/01/05
J-6250 © JLF
REPORTING CHILD ABUSE /
CHILD PROTECTION
Any school personnel or any other person who reasonably believes that a
minor is or has been the victim of physical injury, child abuse, or neglect that
appears to have been inflicted upon the minor by other than accidental
means or that is not explained by the available medical history as being
accidental in nature or who reasonably believes there has been a denial or
deprivation of necessary medical treatment or surgical care or nourishment
with the intent to cause or allow the death of an infant who is protected
under A.R.S. 36-2281 shall immediately report or cause reports to be made of
such information to a peace officer or to the Child Protective Services (CPS) of
the Department of Economic Security, except if the report concerns a person
who does not have care, custody, or control of the minor, the report shall be
made to a peace officer only. Such reports shall be made immediately by
telephone or in person and shall be followed by a written report within
seventy-two (72) hours. Pursuant to A.R.S. 13-3620, such reports shall
contain:
The names and addresses of the minor, the parents, or the person or
persons having custody of such minor, if known.
The minor's age and the nature and extent of the minor's abuse, child
abuse, or physical injuries or neglect, including any evidence of previous
abuse, child abuse, physical injury or neglect.
Any other information that such person believes might be helpful in
establishing the cause of the abuse, child abuse, physical injury or
neglect.
A person who furnishes a report, information, or records required or
authorized under Arizona Revised Statutes or a person who participates in a
judicial or administrative proceeding or investigation resulting from a report,
information or records required or authorized under Arizona Revised
Statutes is immune from any civil or criminal liability by reason of that
action unless such person has acted with malice or unless such person has
been charged with or is suspected of abusing or neglecting the child or
MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1302
08/01/05
children in question.
A report is not required under A.R.S. 13-3620 for conduct prescribed by
A.R.S. 13-1404 and 13-1405 if the conduct involves only minors who are
fourteen (14), fifteen (15), sixteen (16) or seventeen (17) years of age and
there is nothing to indicate that the conduct is other than consensual.
A person who fails to report abuse as provided in A.R.S. 13-3620 is guilty of a
class 1 misdemeanor, except if the failure to report involves a reportable
offense, the person is guilty of a class 6 felony.
Any certificated person or Governing Board member who reasonably suspects
or receives a reasonable allegation that a person certificated by the
Department of Education has engaged in conduct involving minors that
would be subject to the reporting requirements of A.R.S. 13-3620 shall report
or cause reports to be made to the Department of Education in writing as
soon as is reasonably practicable but not later than three (3) business days
after the person first suspects or receives an allegation of the conduct.
Any school employee who has orally reported to CPS or a peace officer a
reasonable belief of an offense to a minor must provide written notification to
the principal of the oral report not later than the next workday following the
making of the report.
Adopted: date of Manual adoption
LEGAL REF.: A.R.S. 8-201
13-1404 et seq.
13-1410
13-3019
13-3212
13-3506
13-3506.01
13-3552
13-3553
13-3608
13-3619
13-3620
13-3623
15-514
46-451
46-454
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SCHOOL DISTRICT
NO. 6 -------------------------------Page 1303
08/01/05
CROSS REF.: GBEB - Staff Conduct
GBEBB - Staff Conduct With Students
JKA - Corporal Punishment
MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1304
08/01/05
J-6261 © JLF-R
REGULATION REGULATION
REPORTING CHILD ABUSE /
CHILD PROTECTION
Abuse means the infliction or allowing of physical injury, impairment of
bodily function, or disfigurement, or the infliction of or allowing another
person to cause serious emotional damage as evidenced by severe anxiety,
depression, withdrawal, or untoward aggressive behavior, and which
emotional damage is diagnosed by a medical doctor or psychologist pursuant
to A.R.S. 8-821, and which is caused by the acts or omissions of an individual
having care, custody, and control of a child. Abuse shall include inflicting or
allowing sexual abuse pursuant to A.R.S. 13-1404, sexual conduct with a
minor pursuant to A.R.S. 13-1405, sexual assault pursuant to A.R.S. 13-1406,
molestation of a child pursuant to A.R.S. 13-1410, commercial sexual
exploitation of a minor pursuant to A.R.S. 13-3552, sexual exploitation of a
minor pursuant to A.R.S. 13-3553, incest pursuant to A.R.S. 13-3608, or child
prostitution pursuant to A.R.S. 13-3212.
Child, youth, or juvenile means an individual who is under the age of
eighteen (18) years.
Abuses classified by statute as "reportable offenses" are:
Indecent exposure [A.R.S. 13-1402]
Public sexual indecency to a minor [A.R.S. 13-1403]
Sexual abuse [A.R.S. 13-1404]
Sexual conduct with a minor [A.R.S. 13-1405]
Sexual assault [A.R.S. 13-1406]
Molestation of a child [A.R.S. 13-1410]
Furnishing items that are harmful to a minor via the internet [A.R.S.
13-3506.01]
Surreptitious photographing, videotaping, filming, or digitally recording
of a minor [A.R.S. 13-3019]
Incest [A.R.S. 13-3608]
MARANA UNIFIED
SCHOOL DISTRICT
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Child prostitution [A.R.S. 13-3212]
Commercial sexual exploitation of a minor [A.R.S. 13-3552]
Sexual exploitation of a minor (concerning visual depiction of a minor
engaged in exploitive exhibition or other sexual conduct) [A.R.S. 13-
3553]
Luring a minor for sexual exploitation [A.R.S. 13-3554]
Admitting a minor to public displays of sexual conduct [A.R.S. 13-3558]
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SCHOOL DISTRICT
NO. 6 -------------------------------Page 1306
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J-6281 JLF-EA
EXHIBIT EXHIBIT
REPORTING CHILD ABUSE /
CHILD PROTECTION
SUSPECTED ABUSE, PHYSICAL INJURY, CHILD ABUSE,
REPORTABLE OFFENSE OR NEGLECT
To: Child Protective Services, D.E.S. (or law enforcement agency)
ACYF Central Intake Reporter's name___________________________
P.O. Box 44240 Reporter's position__________________________
Phoenix, AZ 85064-4240 School__________________________________
1-800-330-1822
Section A
Child's name__________________________ Date of birth __________
Child resides with
__________________________________________________________
Mother's name _____________________________ Home phone
____________________
Address ___________________________ City____________ State _____ Zip________
Mother's employer__________________________________ Work phone __________
Father's name _____________________________ Home phone
____________________
Address ___________________________ City____________ State _____ Zip________
Father's employer___________________________________ Work phone __________
Siblings living with above-named child:
Name DOB School Name DOB School
_______________ ______ __________ _______________ ______
__________
_______________ ______ __________ _______________ ______
__________
_______________ ______ __________ _______________ ______
MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1307
08/01/05
__________
_______________ ______ __________ _______________ ______
__________
_______________ ______ __________ _______________ ______
__________
Section B
Symbols: Severity:
A = Abrasion (1) = Mild
Bl = Blister (2) = Moderate
Bu = Burn (3) = Severe
Br = Bruise
La = Laceration
Le = Lesions
S = Scar
R = Rash
V = Vermin
O = Other
Section C
Date of verbal report _________________ Time of verbal report ____________
Date written report mailed ______________ Intake worker's name ________
Custody taken? Yes_____ No_____ Date ____________ Time ________
Agency name __________________________ Agency official _______________
Case No. ______________________________
Parental notification of the investigation, including the removal of the child
from school is the responsibility of the agency taking custody of the child,
pursuant to A.R.S. 8-823.
__________________________________________________________________
Reporter's signature Date
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SCHOOL DISTRICT
NO. 6 -------------------------------Page 1308
08/01/05
__________________________________________________________________
Agency signature Date
Child's name ________________________________ Date ___________________
Physical indicators observed:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Behavioral indicators observed:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Summary (attach additional pages):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1309
08/01/05
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
MARANA UNIFIED
SCHOOL DISTRICT
NO. 6 -------------------------------Page 1310
08/01/05
J-6282 JLF-EB
EXHIBIT EXHIBIT
REPORTING CHILD ABUSE /
CHILD PROTECTION
MANDATORY REPORTING FORM
FOR REPORTABLE OFFENSES, CHILD ABUSE,
NEGLECT, AND PHYSICAL ABUSE
The above referenced document(s) may be viewed at the appropriate District
or School Office.
Sunday, November 18, 2012
REPORTING CHILD ABUSE / CHILD PROTECTION MARANA UNIFIED SCHOOL DISTRICT
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