HR-Toolbox & Forms

Some forms may be available as fillable PDF's in the Adobe Sign library accessible via the SSO portal.
 
Forms specifically for Classified, Faculty or MSC have been moved to the Employee Groups page.
Complaint Reporting Forms

Title IX/Discrimination Reporting Form (Informal Complaints)

Unlawful Discrimination Complaint Form (Formal)

Employee Person of Concern Form

Student Support Referral Form (EVC)

Student Support Referral Form (SJCC)

Whistleblower Complaint Form AP-7700

Human Resources Board Consent Agenda Deadlines

Deadlines for the Consent Items for Human Resources:

  1. The board agenda meeting dates are determined and approved yearly by the District's Governing Board. 
     
  2. The governing board meeting dates are used in determining the Human Resources deadline dates. 
     
  3. The Human Resources Department will notify district staff of its deadlines via the attached calendar. 
     

Arleene Miranda 
Human Resources Specialist 
Arleene.Miranda@sjeccd.edu 
408.270.6465

Employee Forms & Information  (FMLA, Name Change etc.)
Address Change RequestEmployment Information
Class Enrollment Fee WaiverFamily Medical Leave Application
Direct Deposit EnrollmentName Change Request
Administrator Evaluation Process

Human Resources Responsibilities

  1. Human Resources Department will notify all supervising administrators annually. 
     
  2. Compiling, maintaining, communicating, and disseminating the Administrator Performance Evaluation List and Schedule for all administrators in the District. 
     
  3. Ensuring principles of confidentiality in the maintenance of Administrator Performance Evaluation materials according to District policies and procedures. 
     
  4. Facilitating a collaborative, systematic monitoring and assessment system of the Administrator Performance Evaluation Process, and recommending appropriate revisions, as needed. 
     
  5. Follow up with administrators who are delinquent in submitting timely completed evaluations. 
     
  6. Receiving completed evaluations for filing into the employee’s personnel file. 
     

Arleene Miranda 
Human Resources Specialist 
Arleene.Miranda@sjeccd.edu 
408.270.6465

How to Add a Dependent

Adding a Dependent

  1. Spouse - Employees may add a new spouse by notifying the Benefits Analyst in Human Resources and by submitting the proper plan enrollment/change forms and a copy of the Certified Marriage Certificate to Human Resources within 30 days of the marriage. Failure to notify the Benefits Analyst timely and/or submit the proper documentation will result in your new spouse not being eligible for enrollment until the next regular Open Enrollment period (typically held each October). 
     
  2. Domestic Partner - Except where required by law, an employee may enroll their same-sex domestic partner by notifying the Benefits Analyst in Human Resources and by 
    submitting a completed (must be notarized) Affidavit of Domestic Partnership or a Certificate of Registration of Domestic Partnership from the State, along with the proper 
    plan enrollment/change form(s) to Human Resources within 30 days of the certification. 
    If your spouse/domestic partner is not currently enrolled in a District Plan because they have their own coverage (other than COBRA) and they lose that other coverage, 
    you can enroll them as your spouse/partner by submitting proper enrollment form(s) and a certified Marriage Certificate, the District's Affidavit of Domestic Partnership or 
    a Certificate of Registration of Domestic Partnership, as applicable, within 30 days from the date they lost coverage. 
     
  3. Newborn - Employees ay add their newborn child by notifying the Benefits Analyst in Human Resources and submitting the proper plan enrollment/change form(s) to 
    Human Resources within 30 days of the child's birth. A copy of the child's Certified Birth Certificate from the county they were born in is required upon enrollment. 
    Once the child's social security number is received (they typically take longer than 30 days to receive) the employee must provide it to the Benefits Analyst in Human 
    Resources. 
     
  4. Adoption/Court Order - Employees may add a child placed with them for adoption or by court order by notifying the Benefits Analyst in Human Resources and submitting the proper plan enrollment/change form(s) to Human Resources within 30 days of the adoption or order. 
     
  5. Stepchild - Step children may be enrolled upon the marriage/domestic partnership to their biological parent by notifying the Benefits Analyst in Human Resources and 
    submitting the proper plan enrollment/change form(s) to Human Resources within 30 days of the marriage/partnership. Along with the documentation required above for adding a new spouse or domestic partner, the child's certified birth certificate from the county in which he/she was born is also required. 
     
  6. Adult Child - Adult children between the ages of 19 to 25 who are full-time students at an accredited institution may be covered by your dental, vision and or EAP until the 
    last day of the month they turn 25, and up to age 23 for life insurance. To enroll your adult child, age 19 - 24, you must submit the District's Student Certification form and proof they are a full time student at an accredited institution to enroll in dental, vision and/or EAP coverage, life insurance to age 22. Adult children who are not full-time students but later go back to school may added back on to your coverage by following the instructions above once reenrolled in an accredited institution.  
    Adult children may be covered by your medical plan 
    (Kaiser or Anthem Blue Cross) until age 26 regardless of 
    student or dependent status.

 

Michelle McKay 
Benefits Analyst 
michelle.mckay@sjeccd.edu 
408.223.6713

How to Authorize a Volunteer

A volunteer is defined as an individual who provides services by personal choice without financial gain.

Responsibilities of Manager/Supervisor Accepting the Volunteer Services: 
 

  1. Complete the Volunteer Service form and obtain appropriate signatures. Direct volunteer to complete all forms in the New Volunteer Packet. 
     
  2. Send Volunteer Service Form and all documents in the New Volunteer packet to Samantha Vo. 
     
  3. Direct volunteer to obtain the fingerprints and tuberculosis clearance included in the New Volunteer Packet. 

    (Fingerprints and tuberculosis form applies to outside volunteers ONLY. Student volunteers do NOT need fingerprints and tuberculosis).  
     

Diana Ruano 
Human Resources Technician 
Diana.Ruano@sjeccd.edu 
408. 223.6709

How to Complete a Personnel Action Form (PAF)

The Personnel Action Form (PAF) must be completed for the following 
reasons:

  • change to a person’s status (i.e. promotion, working out of class) 
     
  • change to a position (i.e. create/eliminate/general ledger account change)

Completing the PAF for a Person’s Status Change

  1. The PAF is generated at the department level by the manager/supervisor. 
     
  2. List the person’s name, employee ID and effective start date and end date (if applicable). 
     
  3. Check the box for type of employee (i.e. Classified, Supervisor). 
     
  4. From the list of reasons for the change, select the one that is appropriate. The explanation area can also be used to explain the change if needed. 
     
  5. In the “FROM” column complete all fields for the person’s current position. 
     
  6. In the “TO” column complete all fields for the person’s new position. 
     
  7. Signatures – the employees must sign any PAF related to their employment (except for general ledger account changes). The next required signatures are Department Administrator, College/Site Business Services (if this is a District position, this signature is not needed) and College President or Vice President. 
     
  8. Once the PAF is signed by all parties at the college, the PAF is forwarded directly to Fiscal Services for signature by the Controller. When the Controller reviews and signs the PAF, it will be forwarded to Human Resources. If the PAF is incomplete, the Controller may return it to the department to make corrections which will delay processing by Human Resources. 
     
  9. After the signed PAF is forwarded from the Controller to Human Resources, it will be processed.


Completing the PAF to Eliminate or Establish a Position

  1. The PAF is generated at the department level by the manager/supervisor. 
     
  2. From the list of reasons for change, select the appropriate one and use the explanation field if needed. 
     
  3. List the effective date of the position change. 
     
  4. Check the box for position type (i.e. Classified, Supervisor). 
     
  5. If the PAF is to establish a new classification or to add another position to an existing classification place the information in the “TO” column. 
     
  6. If the PAF is to eliminate one position to create another position, in the “FROM” column list all the details of the position to be eliminated. In the “TO” column, list all the details about the new position. 
     
  7. Signatures – The PAF is signed by the Department Administrator, College/Site Business Services (if this is a District position, this signature is not needed) and College President or Vice President. 
     
  8. Once the PAF is signed by all parties at the college, the PAF is forwarded directly to Fiscal Services at the District Office for signature by the Controller. When the Controller reviews and signs the PAF, it will be forwarded to Human Resources. If the PAF is incomplete, the Controller may return it to the department to make corrections which will delay processing by Human Resources. 
     
  9. After the signed PAF is forwarded from the Controller to Human Resources, it will be processed. 
     

The following forms are linked to Adobe Sign and require login credentials to access.   
 

Sample PAF's

Eileen Luna 
Human Resources Specialist 
eileen.luna@sjeccd.edu 
408.223.6758

How to Fill a Faculty Vacancy

Scenario 1 (Vacant Position & Funded)

  1. Begin at college (Academic Senate recommends & President approve position(s) to fill) 
     
  2. Contact Human Resources to request the position ID number 
     
  3. Complete Personnel Action Form (PAF) 
     
  4. Develop a job announcement(s)in conjunction with Employment Services (if there is a need for changes) 
     

Scenario 2 (Vacant Position & Not Funded)

  1. Begin at college (Academic Senate recommends & President approves position(s) to fill) 
     
  2. Contact Human Resources to request the position ID number 
     
  3. Contact Campus Business Services for general ledger account number 
     
  4. Complete Personnel Action Form (PAF) 
     
  5. Develop a job announcement(s) in conjunction with Employment Services (if there is a need for changes)

Steven Geraci 
Sr. Human Resources Specialist 
Steven.Geraci@sjeccd.edu 
(408) 270-6422

How to Propose a New Classification

When it becomes necessary, a new classification should be initiated by a division/department manager:

  1. Contact Human Resources Analyst to propose a new classification including draft job description. 
     
  2. Human Resources Analyst shall review and make recommendations on the job description and consult with hiring manager. 
     
  3. Human Resources Analyst makes recommendations on salary range and finalizes job description after surveying similar positions in Bay 10 community college districts. 
     
  4. Job description is forwarded to Vice Chancellor of Human Resources for review. 
     
  5. New classification is forwarded to constituency group for review. 
     
  6. Final version of the new classification will be placed on the Board Agenda for approval. 
     
  7. After board approval, it is the hiring manager’s responsibility to initiate the recruiting process to fill the position. Please refer to other HR Tutorials to complete the process: 

      a. How to Complete a Personnel Action Form 
      b. How to Form a Screening Committee

 

Yi (Tina) Xiao 
Human Resources Analyst 
yi.xiao@sjeccd.edu 
408.223.6766

How to Remove a Dependent
  1. Divorce - Once a marriage has been dissolved by the court, the employee has 30 days to notify the Benefits Analyst in Human Resources. Failure to notify the Benefits 
    Analyst timely will result in a loss of continuation of coverage rights (COBRA) as well as the employee being billed for any overpaid premium/benefits to the carrier(s). 
    To remove an ex-spouse and step-child/ren (if applicable) a copy of the Dissolution of Marriage is required (typically just page one with the date stamp and judge's signature) 
    and completion of the proper plan enrollment/change forms. 
     
  2. End of Domestic Partnership - Once a domestic partnership has ended the employee has 30 days to notify the Benefits Analyst in Human Resources. Failure to notify the Benefits Analyst timely will result in a loss of continuation of coverage rights (COBRA), when applicable, as well as the employee being billed for any overpaid premium/benefits to the carrier(s). If the couple is registered with the State, a copy of the Notice of Termination of Domestic Partnership is required.
  3. Death - Upon the death of your spouse/domestic partner, a copy of the Certified Death Certificate must be provided to the Benefits Analyst in Human Resources who 
    will assist you with the completion of the proper plan enrollment/change forms. In addition, the Benefits Analyst can assist you with filing any life insurance claims that may 
    be available through the District's plan(s).

     

Child/Adult Child

  1. No Longer a Full-Time Student - Beginning at age 19 (through age 25) your covered child/adult child must be a full-time student at an accredited institution for his/her 
    dental, vision, and EAP coverage to continue (beginning at age 21 through 23 for life insurance). You must certify them annually, during their birth month, however, if midyear they no longer qualify, it is the employee's responsibility to notify the Benefits Analyst in Human Resources within 30 days of their loss of student status. Failure to notify the Benefits Analyst timely will result in a loss of continuation of coverage rights (COBRA as well as the employee being billed for any overpaid premium/benefits to the carrier(s). 
     
  2. Married - Once your child/adult child gets married, he/she is are no longer qualified for the District's dental, vision, EAP and life insurance coverage. It is the employee's responsibility to notify the Benefits Analyst in Human Resources within 30 days of their marriage. Failure to notify the Benefits Analyst timely will result in a loss of continuation coverage rights (COBRA) as well as the employee being billed for any overpaid premium/benefits to the carrier(s). 
     
  3. Death - Upon the death of your child/adult child, a copy of the Certified Death Certificate must be provided to the Benefits Analyst in Human Resources who will assist you with the completion of the proper plan enrollment/change forms. In addition, the Benefits Analyst can assist you with filing any life insurance claims that may be available 
    through the District's plan(s).

Note: Eligible children may be covered under the employee's medical plan (Anthem Blue Cross or Kaiser Permanente) until the last day of the month they turn 26 years old. They are not required to be the employee's dependent, can be married and do not have to be fulltime students.

For this and any other benefit need, please contact:  
Michelle McKay  
Benefits Analyst 
michelle.mckay@sjeccd.edu 
408.223.6713

How to Request a Family Medical Leave

Purpose

Family Medical Leave allows an eligible employee to take time off for specific qualifying reasons, while protecting their employment and medical benefits for a specific period of 
time. 

Maximum Amount of Leave 

The Family and Medical Leave Act (FMLA) allows eligible employees to take unpaid leave, or to substitute appropriate paid leave if the employee has accrued it, for up to a total of 12 weeks in a 12 month period. Leave of up to 26 weeks is available for an employee who is the spouse, son, daughter or parent or next of kin for a covered military service member who requires care.

Eligibility 

An employee is qualified for job protection under FMLA if she or he has at least 12 months of service and worked at least 1250 hours within the 12 month period preceding the leave. 

Qualifying Reasons 

Leave may be taken for any of the following reasons:

  1. The employee’s own serious health condition which renders the employee unable to perform the essential functions of his/her position. 
     
  2. Pregnancy-related disability (when eligible, runs concurrently with Pregnancy Disability Leave). 
     
  3. Bonding with a newborn, an adopted child or a child placed in foster care with an employee. 
     
  4. Caring for a family member (parent, child, spouse) with a serious health condition. 
     
  5. To care for an injured service member of the US Armed Forces. 
     
  6. A qualifying exigency relating to a close family member’s military service


Application and Medical Certification 

Complete the Family Medical Leave Application and submit it to Human Resources as soon as you know you will need a leave. The application also includes a medical certification form that you will need to give to the physician in charge of the patient’s care. The application and the medical certification need to be returned to Human Resources. Your application will be reviewed and your Human Resources Specialist will inform you if it is approved.

Arleene Miranda 
Human Resources Specialist 
Arleene.Miranda@sjeccd.edu 
408.270.6465 

How to Request Catastrophic Illness Leave

Faculty ~ Article 13.21 
The applicant (or agent) for CIL must submit an Application for Leave Request form (see appendix J) in writing to the Vice Chancellor of Human Resources. All requests must be accompanied by a physician’s statement which verifies catastrophic illness or injury of 
the faculty member or the faculty member’s immediate family member.

Both the Vice Chancellor of Human Resources and the President of the AFT 6157 will recommend approval of CIL only in the cases of catastrophic illness or injury.


CSEA ~ Article 13.12 
An applicant shall submit an Application for Leave request to the Vice Chancellor of Human Resources. All requests must be accompanied by a physician’s statement verifying the Catastrophic Illness or Injury.  

The Vice Chancellor of Human Resources and the CSEA President shall review the application and determine if the applicant is eligible for CIL.


MSC ~ Section 11.11 
The applicant or his/her designated agent for CIL must submit an Application for Catastrophic Illness Leave - MSC form (Appendix I) to the Benefits Analyst in Human 
Resources. All requests must be accompanied by a health care provider’s statement verifying the catastrophic illness or injury of the MSC employee or his/her immediate family 
member. 

The Benefits Analyst will provide the Vice Chancellor of Human Resources and the Chancellor relevant information and documentation for approval of CIL. 

The identity of the employee receiving CIL will be kept confidential unless the unit member authorizes release of his or her identity. Other information related to the circumstances of the Catastrophic Illness or Injury will remain confidential.

Michelle McKay 
Benefits Analyst 
michelle.mckay@sjeccd.edu 
408.223.6713

How to Request a Verification of Employment
  1. Verification Request form letters are provided by the institution requesting the information.  
     
  2. All Verification Requests must be accompanied by a signed Authorization to Release Information form, from the employee. 
     
  3. Fax, email or deliver the Verification Request and signed Authorization to Release Information forms to: 

    Attn: Human Resources 
    Fax number: 408-239-8825 
    HrEmploymentServices@sjeccd.edu 

    Adjunct Employee: 
    EVC: Stacy Alvarez - Stacy.Alvarez@evc.edu 
    SJCC: Sandra Gonzalez - Sandra.Gonzalez@sjcc.edu 
     
  4. Human Resources will respond to the request within 24 hours of receiving the Request and Authorization forms. 
     

Human Resources Assistant 
HrEmploymentServices@sjeccd.edu 
408-270-6404

How to Complete the Formal Discrimination Complaint Form

Any student or employee who believes they have been subjected to discrimination on the basis of their national origin, language/accent, disability (physical or mental), religion, ancestry, race, age (over 40), sexual orientation, color, immigration status, veteran status, ethnic group identification, marital status, gender identity, sex, medical condition, or perceived to be in any of the above protected category or associated with those in a protected category, may complete this form to seek redress.

Please note this form is fillable and should be type written in adobe acrobat. The form can be printed when completed and then e-mailed to the appropriate Title IX Coordinator. Individuals may also choose to print out the form and complete it by hand with written attachments as necessary.  Once the form is completed it should be submitted to Human Resources at the District Office room 212.

  1. Date- Make sure to date the form with the date you submit the formal complaint to Human Resources. 
     
  2. Complainant-This section is information from the individual who is completing the form. In most cases this should be the individual who experienced the discriminatory action.  However, it is possible for a third-party to submit a complaint on behalf of another person. Your full name with last name, first name and middle name or initial should be placed on the first line.  Your position title or student should be placed on the second line.  Next, select the designation that most closely fits your association with San José Evergreen Community College District.  Please note job applicants, vendors, contractors or community members may also file a formal complaint. You will need to check the location where the discrimination occurred. 
     
  3. Complaint is Filed Against- This space is for you to identify (name) those individuals or entities that subjected you to discrimination.  This may be an individual, several people acting together, or a particular group (examples: student club, academic division or department, hiring committee, etc.) If you have contact information for this individual (address, cellphone number, or e-mail address) this information should also be provided. 

    Please be aware that SJECCD can only investigate discriminatory acts against people within its direct control (students, faculty, or staff members) or those contracted to perform services on its properties.  However, SJECCD will attempt to provide alternative resources to individuals experiencing discrimination from other sources, please contact Human Resources for further assistance. 
     
  4. Identification of dates, specific location, activity or program in which the alleged discrimination occurred- These three lines provided are for you to provide brief summary information about the discriminatory actions. Please add additional pages as necessary. 
     
  5. Basis of Discrimination- Check every box that you believe may apply to the discriminatory actions you experienced. Please review SJECCD Administrative Policy 3430 for guidance on these terms.  Further assistance regarding the meaning and definitions of various types of discrimination can be found at Discrimination by Type | U.S. Equal Employment Opportunity Commission (eeoc.gov) 
     
  6. Written statement-You can use the space provided to provide a detailed explanation of the harassment or discrimination you experienced.  Please feel free to attach additional sheets as necessary to provide a detailed explanation.  The statement should include responses to: who, what where, when and how. This statement should include any witnesses to each incident.  If more than one incident occurred, please make sure to recount each incident of harassment or discrimination that you remember for the past year (if not employment case) or 180 day (for employment cases).  Please note that AP3435 restricts all complaint look back periods to one year. 
     
  7. Informal Complaint Resolution- Please attach a separate piece of paper to explain the outcome regarding any informal complaint procedure. If you have previously engaged in the informal complaint resolution process and were not satisfied with the outcome of that process, please explain what occurred and why you are filing a formal complaint.  If you did not previously engage in the informal complaint procedure, please explain why you believe that was not an appropriate method to pursue. 
     
  8. Specific Action Requested- In this space you should state either what remedy for yourself you are seeking, or what sanction \ disciplinary action you believe should be imposed on the individual causing the discrimination or harassment. 
     
  9. Signature- Please remember to sign the complaint.  Complaints received without a signature will be retuned with a request to sign before being deemed officially filed. 
     
  10. Contact Information of Complainant- At the bottom of page two, please provide your name, address, and at least one phone number.  If you prefer to be contacted by e-mail, please use the second telephone number spot to place your e-mail address. Please feel free to place a * (star) by the contact method you prefer. 
     
  11. Witness information- On page 3 please identify any witnesses to the discrimination/ harassment.  Please provide as much contact information (name, address, telephone and e-mail) as you know for each witness.  If there are more than three witnesses, please use additional sheets to continue identifying witnesses. 
     

 

Lisa Owen 
HR Analyst 
lisa.owen@sjeccd.edu 
408.274.6700 ext. 6586

How to Respond When an Employee Claims a Work Related Injury or Illness

Michelle McKay 
Benefits Analyst 
michelle.mckay@sjeccd.edu 
408.223.6713

How to Offer an Internal Professional Development Opportunities for Classified Employees

The classified employee collective bargaining agreement, CSEA Chapter 363 provides opportunities that allow classified unit members the chance to gain some professional experience in a higher level classification on a temporary basis. 

Below is the step-by-step process for offering an Internal Professional Development Opportunities for Classified Employees. 

15.2 INTERNAL PROFESSIONAL DEVELOPMENT OPPORTUNITIES 
From Article 15 “Hiring and Advancement” in the CSEA CBA 
 

When a new bargaining unit position is established or an existing position is to be filled for a minimum of two (2) months and a maximum of one (1) year, it will be posted internally. Internal Professional Development Opportunities are to be offered according to the following guidelines:

  1. Offer to unit members within the department. When more than one member within a department meets the needs of the position, notice of the opportunity shall be distributed within the department. A three (3) working day response window shall be provided. 
     
  2. Offer to unit members outside the department. Notice of the opportunity shall be distributed to current unit members. A three (3) working day response window shall be provided. 
     
  3. When a unit member is not available to perform the necessary assignment, notice shall be listed externally.  

    The selection process shall include the following guidelines: 
     
  4. Notice shall generally mean email notification. 
     
  5. Interested unit members are to submit a resume and letter of interest to the appropriate supervisor. 
     
  6. Upon receipt, the supervisor shall interview. 
     
  7. Interview shall include the supervisor and an appropriate unit member designee. Supervisor may make a recommendation as to the designee. 
     
  8. A unit member selected for the position will accrue seniority in his/her regular classification, not the temporary classification. 
     
  9. At the end of the position, the unit member will return to his/her regular position (at the same campus, department, classification, and pay rate). 
     
  10. If the unit member would have been entitled to a step increase during the period of time in the position, the unit member will be reinstated at that step which 
    he/she would have been due. 
     
  11. The unit member shall be placed on the new salary range at the first step which provides a salary increase of at least a 7.5%, however the salary cannot go 
    beyond the “E” step of the new salary range. 
     
  12. Unit members will apply for such opportunities by submitting an updated application by the posted deadline. 
     
  13. Unit members will be selected by following the regular screening committee process for external postings with the following exceptions: 
     
  14. Those unit members who meet the minimum qualifications will be interviewed automatically; if after the interviews the committee determines that more 
    than one candidate still meet the minimum qualifications, the hiring administrator will make the final selection; if there is only one candidate determined to meet the minimum qualifications, that candidate is automatically selected for the opportunity. 
     
  15. Nothing contained herein shall prevent the District from assigning or reassigning a bargaining unit member to a different position within the District. 
     
  16. Article 14 establishes procedures for intra-District transfers. 
     

Below is a sample email to send to classified unit members announcing an internal professional development opportunity


Dear Classified Unit Members: 

There is an opportunity within the BLANK Department working in an out of class temporary position as POSITION (Range Step). The POSITION will report to the MANAGER/SUPERVISOR and will assist within the scope of the duties in the BLANK job description attached. Please review the job description to ensure you meet the minimum qualifications. 

Interested unit members are to submit a resume and letter of interest to me DATE HERE. Please contact me if you have any questions. The position is available now through DATE with possibility of extension. 

Respectfully,

NAME

 

Eileen Luna 
Senior Human Resources Specialist 
Eileen.luna@sjeccd.edu  
408.223.6758

Information on Mandated Reporters of Child Abuse

California Penal Code section 11165.7 requires all full-time and adjunct faculty members and employees of public schools to report any known or suspected instances of child abuse or neglect to the county child welfare department or to a local law enforcement agency (local police/sheriff’s department). In California, a child is anyone under the age of 18 years old. A report must be made immediately, or as soon as practically possible, with a follow up 
written report within 36 hours.

  1. Written reports may be submitted on the California Suspected Child Abuse Report Form (Form below)  
     
  2. Reports may also be made by phone to the Santa Clara County Emergency Response Child Abuse Reporting telephone numbers: South Santa Clara: 408-683-0601, Central 
    Santa Clara County: 408-299-2071 
     
  3. Please visit the California Department of Education Child Abuse Identification & Reporting Guidelines for more information at: http://www.cde.ca.gov/ls/ss/ap/ 
    childabusereportingguide.asp  
     

Child Abuse and/or Child Neglect Can Be Any of the Following:

  • A physical injury inflicted on a child by another person other than 
    by accidental means. 
     
  • The sexual abuse, assault, or exploitation of a child. 
     
  • The negligent treatment or maltreatment of a child by a person responsible for the child’s welfare under circumstances indicating harm or threatened harm to the child’s health or welfare. This is whether the harm or threatened harm is from acts or omissions on 
    the part of the responsible person. 
     
  • The willful harming or endangerment of the person or health of a child, any cruel or inhumane corporal punishment or any injury resulting in a traumatic condition. 

One does not have to be physically present or witness the abuse to identify suspected cases of abuse, or even have definite proof that a child may be subject to child abuse or neglect. Rather, the law requires that a person have a “reasonable suspicion” that a child has been the subject of child abuse or neglect. Under the law, this means that it is reasonable for a person to entertain a suspicion of child abuse or neglect, based upon facts that could cause a 
reasonable person, in a like position, drawing, when appropriate, on his or her training and experience, to suspect child abuse or neglect.

Maxient Training Guide