Child Abuse Central Index Forms

Child Abuse and Neglect Reporting Forms

The following forms are for use by government agencies and mandated reporters pertaining to child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or local law enforcement agency.

• Child Abuse or Severe Neglect Indexing Form
  This form is for use by government agencies mandated to submit child abuse case information pursuant to Penal Code (PC) section 11169.
  
  
  • Form BCIA 8583, pdf
  • Instructions, pdf
• Suspected Child Abuse Report Form
  This form is for use by mandated reporters, as defined in PC section 11165.7, to notify a reporting agency (local law enforcement, county probation or county welfare department) about suspected cases of child abuse. This form may also be used to cross-report to another reporting agency.
  
  
  • Form BCIA 8572, pdf
  • Form BCIA 8572 (Korean), pdf
  • Form BCIA 8572 (Russian), pdf
  • Form BCIA 8572 (Simple Chinesse), pdf
  • Form BCIA 8572 (Traditional Chinese), pdf
  • Form BCIA 8572 (Vietnamese), pdf
  • Form BCIA 8572 (Armenian), pdf
  • Form BCIA 8572 (Spanish), pdf

  CACI Inquiry Forms

  The following forms must be completed for inquiries of CACI information.

  Authorized Agencies Only

  • Facsimile Inquiry for Child Abuse Central Index (CACI) Search
    This form is for use by Law Enforcement and authorized agencies seeking information in the CACI.
    
    
    • Form BCIA 4084, pdf
  • Child Abuse Central Index Inquiry Request for Out-of-State Foster Adoption Agencies
    This form is for use by out-of- state foster and adoption agencies requesting information from the CACI.
    
    
    • Form BCIA 4057, pdf
    • Instructions, pdf

  Public

  • Child Abuse Central Index Self Inquiry Request
    This form is for use by private citizens. Pursuant to PC section 11170(f), "Any person may determine if he or she is listed in the CACI by making a request in writing to the Department of Justice."
    
    
    • Form BCIA 4056, pdf
    • Form BCIA 4056 (Spanish), pdf

  If you have questions regarding the use of the forms, contact the CACI at: CACI-Inquiry@doj.ca.gov

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