Reporting and Recording Child Fatalities and Near Fatalities
0050-504.25 | Revision Date: 2/8/2018

Overview

This policy guide provides instructions on creating referrals and documenting information related to child fatalities and near fatalities in the Child Welfare Services/Case Management System (CWS/CMS) and provides information on the creation and submission of the SOC 826, Child Fatality/Near Fatality County Statement of Findings and Information by the Senate Bill (SB) 39 Section to the California Department of Social Services (CDSS).

Table of Contents

Policy

Procedure

Approvals

Helpful Links

Version Summary

This policy guide was updated from the 07/01/14 version to clarify the roles and responsibilities of staff when receiving and processing child fatality and near fatality reports / referrals. Additionally, the policy title "Reporting Child Death, Serious Injury or Illness" was revised to align with the revisions herein.

POLICY

Reporting and Recording Child Fatalities or Near Fatalities

The CDSS collects a statement of findings and information for both child fatalities and near fatalities that are a result of abuse or neglect via notifications submitted by DCFS.

This information comes from a record in CWS/CMS that DCFS creates on all cases of child fatalities or near fatalities, and from law enforcement and the coroner, where applicable. Reports are taken on all children, including stillbirths, who die in Los Angeles County, whether or not they are served by DCFS. During the course of an investigation or supervision of a case, when the CSW becomes aware of a child fatality that has not been previously reported to the CPH, it is the CSW's responsibility to obtain as much information as possible to confirm the death and report it to the CPH, even when the child fatality or near fatality is not suspected to be related to abuse and/or neglect.

For child fatality and near fatality cases reported to the CPH that do not have an open CWS referral or case, the county in which the incident occurred has the responsibility for reporting the fatality or near fatality to the CDSS and to the public (if a request has been received).

Near Fatality Reports

As of January 1, 2017, federal and state law redefined "near fatality" as an act that, as certified only by a physician, places the child in serious or critical condition. There is no time limit or requirement on how long a child must be in "serious" or "critical" condition.

A nurse, hospital employee, or other person cannot make the certification that a child is in "serious" or "critical " condition, but may verbally confirm or provide documentation that a physician has done so.

The CDSS added the requirement that the certifying physician's identifying information must be included in the referral.

Cross-Reporting

DCFS must cross report all child fatalities to law enforcement.

When a CSW on an open case is informed by law enforcement or medical personnel that a suspicion of abuse and/or neglect exists on a fatality or near fatality that initially appeared to be unrelated to abuse and/or neglect, the CSW is to instruct the mandated reporting party to contact the CPH at 1-800-540-4000.

PROCEDURE

Child Fatality Report

CPH CSW Responsibilities

  1. As soon as the conversation with a reporting party is complete, immediately inform the designated CPH SCSW that you received a report involving a child fatality.
  2. Complete the CalSAWS and CWS/CMS clearances on:
    • All known family members
    • Substitute caregivers (if applicable)
    • The family's address
    • The address where the incident that led to the fatality occurred.
  3. Create and screen a referral for every report of a child fatality (even if no abuse or neglect is suspected). Collect all required information from the reporting party.
    • When another reporter is calling in the same child fatality, generate a secondary referral.
  4. Record appropriate information on the Referral “ID” and “Reporter” pages.
  5. Perform a search on all clients involved in the referral. Attach any matching client notebooks found in the search results to the new referral.
    • An abstract must be open before you can attach.
  6. If there are no matching search results, create the clients in the “Client Management” section.
    • Go to the “Related Clients” page and create the client relationships as appropriate.
  7. Complete the referral allegation page.
  8. Record information regarding the child fatality in the "Deceased" section of the deceased child's CWS/CMS Demographics Page in the Client Notebook. Complete the Demographic Page with the following information:
    1. Date of death
      1. If the actual date is unknown, use the date of the referral as the date of death and indicate this in the “Death Circumstances Comment Field”.
    2. Death Circumstances Type
      1. Select the appropriate Death Type Circumstances from the drop down menu. If needed, discuss the child’s cause of death with the designated CPH SCSW or designee in order to make a determination regarding the selection of “Death Circumstances Type", as follows:
        • "Accidental": Select only if the information provided by the reporting party indicates that the fatality was the result of an accident.
        • "Confirmed abuse": Select only if law enforcement, the Coroner, or DCFS has concluded their investigation and determined that the fatality was the result of abuse and/or neglect.
        • "Homicide": Select only if law enforcement or the Coroner have completed their investigation and determined that the fatality was the result of a homicide.
        • "Natural Causes": Select only if information provided by the Coroner or other medical professional, or law enforcement indicate that the cause of death (COD) was the result of natural causes or a medical condition and there is no suspicion of abuse and/or neglect.
        • "Suicide": Select only if information provided by the Coroner or other medical professional, or law enforcement indicates the COD was the result of a suicide and there is no suspicion of abuse and/or neglect.
        • "Suspected Abuse": Select if the information provided by the reporting party leads to a suspicion that the fatality was the result of abuse and/or neglect.
        • "Undetermined": Select if the circumstances surrounding the fatality are unknown or if none of the above criteria apply.
    3. Death Circumstances Comments
      1. Provide a brief summary of the circumstances surrounding the fatality and how you reached the determination for the "Death Circumstances Type".
    4. Place of Death
      1. Provide the location where the incident that led to the fatality occurred (e.g., home of parent, foster home, relative's home). Do not use the medical facility as the location unless the child was born and died at the medical facility.  
  9. At the top of the Screener Alert and Screener Narrative sections of the referral, enter “Child Fatality Referral.”
  10. Complete the Screener Narrative and include the following information:
    • Does the family currently have an open referral or case with DCFS? 
      • If yes, provide the name of the CSW and telephone number.
      • If the child and/or siblings are in placement, indicate the type of placement (E.g., foster home, group home).
    • Does the family have prior history, including whether or not there is history on the mother and/or father when they were minors?
      • If the family has a prior history, include the number of referrals and provide the date “range” for the prior referrals/cases (e.g., 1998-2002).
      • If no history is found, document that search efforts failed to reveal a history of prior referrals or cases generated, investigated, or serviced by the Department.
    • Circumstances of the child fatality, including the date of death, place of death, and if there is suspicion of abuse and/or neglect.
    • Are there other children in the home who need to be assessed?
    • CalSAWS findings
  11. Create a Suspected Child Abuse Report (SCAR).
    • The SCAR should be cross-reported to the law enforcement agency in the jurisdiction where the incident that led to the fatality occurred. 
  12. Generate the Emergency Response Referral Documents.
  13. If there is no suspicion of abuse and/or neglect, evaluate out the referral.
    • When there is no suspicion of abuse and/or neglect regarding the fatality, but there are concerns regarding the siblings unrelated to the fatality, generate two separate referrals: one (1) for the fatality, to be evaluated out; and, one (1) for the siblings, to reflect applicable allegations and a response time.
  14. If there is suspicion that the child fatality is due to abuse and/or neglect and there are surviving siblings, assign the referral to the appropriate in box for investigation. If there are no surviving siblings, evaluate out the referral and indicate the reason the referral was evaluated out.
  15. Print the Live Call Sheet, Emergency Response Referral Document, and Screener Narrative and attach all required printouts.
  16. Submit the assembled documents to the designated CPH SCSW or designee for review.

CPH SCSW Responsibilities

  1. Review all referral documents and all associated documents.
  2. Confirm that all children in the family (as reflected in the CWS/CMS database and CalSAWS printouts) are accounted for in the referral documents.
  3. Confirm that the CWS/CMS Demographics Page of the Client Notebook has been completed accurately.
    • If the referral is incomplete, return it to the CSW for corrective action.
    • If the referral is complete and accurate, approve the referral and give the hard copy to the CPH ARA or their designee
    • If the referral is evaluated out, give the hard copy to the CPH ARA or their designee for review and approval prior to SCSW approval
  4. Notify the CPH the CPH ARAs and RA via e-mail that a Child Fatality referral has been received and processed.
  1.  

CPH ARA and/or Designee Responsibilities

  1. Review the e-mail notification and referral to ensure that appropriate action has been taken.
  2. Confirm that the CWS/CMS Demographics Page in the Client Notebook has been completed accurately.
  3. By the end of the next business day, notify those parties on the Child Fatality Distribution list (as designated by the Director) via e-mail that a Child Fatality referral has been received. The e-mail must include all pertinent information reported to the CPH (E.g., referral name and number, victim's name).

CPH RA and/or Designee Responsibilities

  1. If the referral was received during business hours, notify the applicable office RA via e-mail of the Child Fatality referral by the end of the business day.
  2. If the referral was received after business hours, inform the CPH Deputy Director via e-mail of the Child Fatality referral no later than 9 AM the next business day, following receipt of the referral.

SB 39 Section Responsibilities

  1. For cases where it is determined that the child fatality occurred as a result of abuse and/or neglect, the SB 39 Section must submit the SOC 826 to the CDSS within ten (10) business days of the determination being made.
    1. Complete Parts A and B of the SOC 826 and fax it to the CDSS, Children's Operation Bureau.
    2. If the referral was evaluated out, update the deceased fields of the CWS/CMS Demographics page in the Client Notebook after the investigations by law enforcement and the Coroner have been completed.

Near Fatality Reports

As of January 1, 2017, federal and state law redefined "near fatality" as an act that, as certified only by a physician, places the child in serious or critical condition. There is no time limit or requirement on how long a child must be in "serious" or "critical" condition.

A nurse, hospital employee, or other person cannot make the certification that a child is in "serious" or "critical " condition, but may verbally confirm or provide documentation that a physician has done so.

The CDSS added the requirement that the certifying physician's identifying information must be included in the referral.

CPH CSW Responsibilities

  1. Collect all required information from the reporting party and enter that information in CWS/CMS.
  2. If the reported circumstances meet the definition of a near fatality, designate it as such in the “Near Fatality” grid on the CWS/CMS Demographics page of the Client notebook and enter the near fatality date.
  3. Generate the referral and submit it for approval.

CPH SCSW Responsibilities

  1. Immediately inform the CPH RA and CPH ARAs, or their designees via e-mail that a Near Fatality referral has been received.

CPH ARA and/or Designee Responsibilities

  1. Upon review, verify that the Near Fatality referral is designated as such in the "Near Fatality" grid on the CWS/CMS Demographics Page in the Client Notebook.
  2. By the next business day, notify those parties on the Near Fatality Distribution list (as designated by the Director) via e-mail that a Near Fatality referral has been received.  The e-mail must include all pertinent information reported to the CPH (E.g., referral name and number, victim's name).

SB 39 Section Responsibilities

  1. For cases where it is determined that the near fatality occurred as a result of abuse and/or neglect, the SB 39 Section must submit the SOC 826 to the CDSS within ten (10) business days of the determination being made.
    1. Complete Parts A and C of the SOC 826 and fax it to the CDSS, Children's Services Operations Bureau.

Completing the Client Disposition and Closure Reason on a Child Fatality Referral

It is the responsibility of the CPH CSW to complete the deceased fields of the CWS/CMS Demographics Page in the Client Notebook even when there is an open case or referral. 

However, if the referral is opened or already assigned to an ER/ERCP CSW, it is that CSW’s responsibility to ensure that the information on the CWS/CMS Demographics Page in the Client Notebook is accurate and updated at the conclusion of the investigation

If the case is open to a case-carrying CSW, it is that CSW’s responsibility to ensure that the information on the CWS/CMS Demographics Page in the Client Notebook is accurate and updated.

If the case is open to a case-carrying CSW and an ER/ERCP CSW, it is the responsibility of case-carrying CSW to ensure that the information on the CWS/CMS Demographics Page in the Client Notebook is accurate and updated.

ER CSW Responsibilities

  1. If the child fatality occurred prior to the referral date and there was no current open case or referral, select “Child Dead Prior to Referral Date” under “Client Disposition” in the CWS/CMS Client Notebook.
  2. If the child fatality occurred during an investigation (I.e., where there is an open referral), select “Child Died during Investigation” under “Client Disposition” in the CWS/CMS Client Notebook.  
  3. Contact the Public Health Nurse (PHN) for assistance in obtaining current and past medical information and determining any need for a joint home visit regarding any children remaining in the home or any children associated with the family at the time of the child fatality.

PHN Responsibilities

  1. Document relevant information (e.g., fatality date; cause of death, if known; medical conditions, including date of onset and hospital admissions, if any) related to the child fatality in the CWS/CMS Health and Education Passport.
  2. Discuss any recommendations for completion of a joint home call regarding any children remaining in the home or any children associated with the family at the time of the child fatality

Case-Carrying CSW Responsibilities

  1. If the child fatality occurred while the case is open, regardless of the service component identified in CWS/CMS, select the reason “Death of Child” under “Case Closure Reason” in the CWS/CMS Client Notebook.

PHN Responsibilities

  1. Document relevant information (e.g., fatality date; cause of death, if known; medical conditions, including date of onset and hospital admissions, if any) related to the child fatality in the CWS/CMS Health and Education Passport.
  2. Discuss any recommendations for completion of a joint home call regarding any children remaining in the home or any children associated with the family at the time of the child fatality

Investigation Subsequently Determines Reasonable Suspicion Exists that a Child Fatality or Near Fatality May Have Been the Result of Abuse and/or Neglect

In some cases a child fatality or near fatality may initially appear unrelated to abuse and/or neglect; however, the investigation subsequently determines suspicion exists that the child fatality or near fatality may have been the result of abuse and/or neglect.

CSW Responsibilities

  1. Immediately call the CPH at (800) 540-4000.
    1. Advise the CPH CSW that new information has been obtained that a Child Fatality or Near Fatality that was initially reported as unrelated to abuse and/or neglect has been determined to be suspicious of abuse and/or neglect.
    2. If there are other children in the home, identify those children to the CPH CSW.

CPH CSW Responsibilities

  1. Create a referral.
    1. If an Evaluated Out referral was previously created, reference the Evaluated Out referral number in the Screener Alert and Screener Narrative.

CPH SCSW Responsibilities

  1. Confirm that the CSW completed the referral accurately.
  2. Notify the CPH ARAs, RA, and their designees via e-mail that:
    1. A new referral has been received and processed on a previous child fatality or near fatality which appeared to be unrelated to abuse and/or neglect and has now been determined to be a result of abuse and/or neglect.

CPH ARA and/or Desginee Responsibilities

  1. Review the e-mail notification and referral to ensure that appropriate action was taken.
  2. By the end of the next business day, notify the parties on the Child Fatality or Near Fatality Distribution list (as designated by the Director) via e-mail that updated information related to a Child Fatality or Near Fatality has been received and a new referral has been generated as a result. This e-mail must include pertinent information reported to the CPH (E.g., referral name and number, victim's name).

CPH RA and/or Designee Responsibilities

  1. By the end of the next business day, e-mail the applicable office RA and/or their designee and inform them of the current circumstances .

SB 39 Section Responsibilities

  1. For cases where it is determined that the child fatality occurred as a result of abuse and/or neglect, the SB 39 Section must submit the SOC 826 to the CDSS within ten (10) business days of the determination being made.
    1. Complete Parts A and B of the SOC 826 and fax it to: CDSS, Children's Services Operations Bureau

Referral Not Initially Designated as a Near Fatality but Subsequently Determined to Meet the Definition of a Near Fatality

CSW Responsibilities

  1. Immediately notify your SCSW that you have identified a Near Fatality on your caseload that was not previously designated as such.
  2. Immediately contact the CPH Child Fatality/Critical Incident Liaison at (800) 540-4000 and notify them that a referral that was not initially designated as a Near Fatality has subsequently met the definition of a Near Fatality.

SCSW Responsibilities

  1. Immediately notify your ARA of the Near Fatality that was not previously designated as such.

CPH Child Fatality/Critical Incident Liaison Responsibilities

  1. Collect all required information from the reporting party and enter the information in CWS/CMS.
  2. If the reported circumstances meet the definition of a near fatality, designate it as such in the "Near Fatality" grid on the CWS/CMS Demographics Page in the Client Notebook .

CPH ARA (and/or Designee) Responsibilities

  1. By the next business day, notify those parties on the Near Fatality Distribution list (as designated by the Director) via e-mail that a Near Fatality referral has been received.  The e-mail must include all pertinent information reported to the CPH (E.g., referral name and number, victim's name).

SB 39 Section Responsibilities

  1. For cases where it is determined that the near fatality occurred as a result of abuse and/or neglect, the SB 39 Section must submit the SOC 826 to the CDSS within ten (10) business days of the determination being made.
    1. Complete Parts A and C of the SOC 826 and fax it to the CDSS, Children's Services Operations Bureau.

Cause of Death on a Child Fatality Referral Received After the Referral is Closed

CPH Child Fatality/Critical Incident Liaison Responsibilities

  1. If determination of death is received after the referral is closed, CPH staff are required to update the death information in the CWS/CMS Client Notebook. To update the closed referral:
    1. In the “Client Services” section, search for the client.
    2. In the “Deceased” section of the deceased child's Demographic Page, update the appropriate “Date”, "Place of Death", and “Death Circumstances Type” fields.

Documenting a Child Fatality/Near Fatality

CPH Child Fatality/Critical Incident Liaison Responsibilities

  1. On the CWS/CMS Special Projects Page select the appropriate Special Project Code.
    1. If the referral is being evaluated out enter an end date for the Special Project Code selected.

Name

Description

Child Fatality

  • Child fatalities reported to DCFS

Near Fatality

  • A near fatality is defined as an act that, as certified only by a physician, places the child in serious or critical condition.  There is no time limit or requirement on how long a child must be in "serious" or "critical" condition.

ER CSW Responsibilities

  1. When closing the referral or promoting the referral to a case, enter an end date for the Special Project Code on the CWS/CMS Special Projects Page.

PHN Responsibilities

  1. Document relevant/applicable information, as follows:
    • Known medical conditions
    • Date of onset of illness
    • Date of hospital admission(s)
    • Date of fatality / near fatality
    • Cause of death, if applicable / known
    • For near fatalities, name of attending physician who certified the child to be in serious or critical condition
    • For near fatalities, enter the child's condition as either "serious" or "critical" in the "hospitalization comments" on the "hospitalization" tab
APPROVALS

SCSW Approval

  • Approve the Referral
HELPFUL LINKS

Forms

CWS/CMS

SS 8572, Suspected Child Abuse Report (SCAR)

Demographics Page of the Client Notebook

Health and Education Passport of the Client Notebook

Screener Alert on the I.D. Page

Screener Narrative

LA Kids

SOC 826, Child Fatality/Near Fatality County Statement of Findings and Information

REFERENCED POLICY GUIDES

0050-502.10 , Child Protection Hotline (CPH)

0070-559.10, Clearances

0300-503.75, Reporting Child Death, Serious Injury, or Illness

STATUTES AND OTHER MANDATES

All County Letter (ACL) 08-13 (March 14, 2008) - Summarizes the requirements for reporting and public release of records as outlined in Senate Bill (SB) 39 regarding child fatalities and near fatalities resulting from abuse or neglect. Also, defines a "near fatality" as "a severe childhood injury or condition caused by abuse or neglect which results in the child receiving critical care for at least 24 hours following the child's admission to a critical care unit."

Penal Code (PEN) Section 11166(a)(2) – States that the agency shall be notified and a report shall be prepared and sent, faxed, or electronically transmitted if the child has expired, regardless of whether or not the possible abuse was a factor contributing to the death, and even if suspected child abuse was discovered during an autopsy.

PEN Section 11174.34(a) – States in pertinent part, that it is the intent of the Legislature to ensure that records of child abuse or neglect related fatalities are entered into the State Department of Social Services, Child Welfare Services/Case Management System.

PEN Section 11174.34(k) – States that law enforcement and child welfare agencies shall cross-report all cases of child death suspected to be related to child abuse or neglect whether or not the deceased child has any known surviving siblings. Further, County child welfare agencies must create a record in the Child Welfare Services/Case Management System (CWS/CMS) on all cases of child death suspected to be related to child abuse or neglect, whether or not the deceased child has any known surviving siblings.

PEN Section 11174.34(l) - Upon notification that a death was determined not to be related to child abuse or neglect, the child welfare agency shall enter that information into the Child Welfare Services/Case Management System (CWS/CMS)