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Child Protection Services Mandated Reporter Form

REPORT OF ABUSE OR NEGLECT OF CHILDREN

This report is prepared in connection with the mandatory reporting laws of the State of Minnesota, MN Statutes Section 626.556. This report is made with the understanding that immunity from liability, civil or criminal, is given for any report made in good faith. This statute also states that a person required to report who negligently or intentionally fails to report is liable for damages caused by the failure.

This report is also made with the understanding that the Southwest Health and Human Services shall investigate the circumstances and offer protective services to the abused or neglected child. It is understood that this written report will also be shared with Law Enforcement and the appropriate licensing agency or agencies. Voluntary reporters have access, upon request, to a concise summary of our assessment; mandated reporters have access to a summary of the assessment.

When making a report, please be specific in identifying the child, the caretaker, the nature and extent of the suspected abuse or neglect, any evidence of previous abuse or neglect, and any information that might be helpful in the investigation of the suspected abuse or neglect.

Following are pertinent definitions:

1. "Neglect" means failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, or medical care when reasonably able to do so, failure to protect a child from conditions or actions which imminently and seriously endanger the child's physical or mental health when reasonably able to do so, or failure to take steps to ensure that a child is educated in accordance with state law. Nothing in this section shall be construed to mean that a child is neglected solely because the child's parent, guardian, or other person responsible for the child's care in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the child in lieu of medical care; except that there is a duty to report if a lack of medical care may cause imminent and serious danger to the child's health. This section does not impose upon persons, not otherwise legally responsible for providing a child with necessary food, clothing, shelter, education, or medical care, a duty to provide that care. "Neglect" includes prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 25, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in the child at birth, results of a toxicology test performed on the mother at delivery or the child at birth, or medical effects or developmental delays during the child's first year of life that medically indicate prenatal exposure to a controlled substance. Neglect also means "medical neglect" as defined in section 260C.007 subd 6, clause (5).

2. "Physical abuse" means any physical or mental injury or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means, or any physical or mental injury that cannot reasonably be explained by the child's history of injuries, or any aversive and deprivation procedures that have not been authorized under section 245.8257.

3. "Sexual abuse" means the subjection of a child by a person responsible for the child's care, or by a person in a position of authority, as defined in section 609.341, subdivision 101, to any act which constitutes a violation of section 609.342, 609.343, 609.344, or 609.345². Sexual abuse also includes any act which involves a minor which constitutes a violation of sections 609.321 to 609.3243 or 617.2464. Sexual abuse includes threatened sexual abuse.

Anybody who suspects or has reason to believe a child has been maltreated can make a report. Others are mandated to report by MN Statute (MN Stat. 626.556).

If you suspect child maltreatment, an oral report should be made immediately to social services or the local Law Enforcement Agency no later than 24 hours after concerns that child maltreatment may have occurred. A written report should follow within 72 hours of the oral report.

  • To make an oral report during business hours, please call 1-888-964-8407 to speak to a Children’s Intake Worker.
  • After hours or on weekends and holidays, call your local Law Enforcement Agency and ask to make a Child Protection Report.

If you feel the child/ren is in immediate danger, please call 911.

Child Protection Services Mandated Reporter Form

for Lincoln, Lyon, Murray, Pipestone, Redwood and Rock counties in Minnesota

Step 1 of 5

  • Identification of person making report

  • If mandated reporter, facility address
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