be on one page or one screen, and it must appear in type that is at least 14 points in size (California Dental Practice Act, 2021a). Mandatory reporter obligations and identifying abuse Originally passed in 1980, California Penal Code Sections 11164 through 11174.3, known collectively as the Child Abuse and Neglect Reporting Act, were instituted to protect children from abuse and neglect, and to consider the physical and psychological needs of the child victim. Under Section 11166 of this code, certain healthcare professionals are mandated to report known or suspected child abuse or neglect. Such professionals include dentists and dental hygienists, and any other person who is currently licensed under Division 2 (commencing with Section 500) of the B&P (Child Abuse and Neglect Reporting Act, 2021). Any such dental professional who “has knowledge of or observes a child, in his or her professional capacity or within the scope of his or her employment whom the mandated reporter knows or reasonably suspects has been the victim of child abuse or neglect” must report the known or suspected abuse to certain specified agencies (including any police department or sheriff’s department or the county welfare department) immediately or as soon as practically possibly by telephone and prepare and send a written report within 36 hours of receiving the information concerning the abuse (Child Abuse and Neglect Reporting Act, 2019). For purposes of reporting, “reasonable suspicion” is defined to mean that “it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on the person’s training and experience, to suspect child abuse or neglect.” Reasonable suspicion does not require certainty of the abuse or neglect, nor does it require a specific medical indication of such abuse or neglect (Child Abuse and Neglect Reporting Act, 2019). Signs of child abuse may include: ● Withdrawal from friends or activities. ● New behaviors such as aggression, anger, hostility, or hyperactivity. ● Changes in school performance. ● Depression, anxiety, or unusual fears. ● A sudden loss of self-confidence. ● A seeming lack of supervision. ● Frequent absences from school. ● Reluctance to leave school activities, which may be a reluctance to go home. ● Trying to run away. One sign of abuse that a dentist might find is evidence of sexually transmitted disease in the oral cavity of a minor below the age of consent. According to California Penal Code Section 11171.2(a), a dentist may take X-rays of suspected abuse of the oral cavity without the consent of a parent or guardian. Any mandated reporter who fails to report an incident of known or reasonably suspected child abuse or neglect as required by law is guilty of a misdemeanor punishable by up to 6 months in jail, or a fine of one thousand dollars ($1,000), or both (Child Abuse and Neglect Reporting Act, 2009). As cited above, conviction of a crime is unprofessional conduct and subjects a licensee to sanctions. Furthermore, violation of reporter mandates can subject a healthcare provider to civil liability. Poster requirements The Dental Practice Act requires that the dentist place in various locations within the dental office or place of practice a variety of posters providing patient information and information from the Dental Practice Act. An authorized poster of the Dental Practice Act must be placed in a common area, such as a lunchroom or ● Rebelliousness or defiance. ● Self-harm or suicide attempts. (Mayo Clinic, 2018)
Appendix D of this course reproduces the required document as it appears in the California Dental Code.
Under the Welfare and Institutions Code (Section 15600 et seq.), the State of California recognizes that elders and dependent adults may be subjected to abuse, neglect, or abandonment, and that this state has a responsibility to protect these persons. Section 15630 of that code extends mandatory reporter status to health practitioners in cases of known or suspected instances of elder abuse or neglect. Broadly defined, elder abuse may include: ● Physical abuse : Which is defined as inflicting physical pain or injury, can involve restraining through physical or chemical means, in addition to actual physical violence. ● Sexual abuse : Which is non-consensual sexual contact of any kind. ● Neglect : Which can involve the failure by those responsible to provide a vulnerable older adult with food, shelter, health care, or protection. ● Exploitation : Which is the illegal taking, misuse, or concealment of funds, property, or assets of an older adult, not for the benefit of the older adult. ● Emotional abuse : Which involves inflicting mental pain, anguish, or distress on an older adult through verbal or nonverbal acts such as humiliation, intimidation, or making threats. ● Abandonment : Which is the desertion of a vulnerable elder by anyone who has assumed the responsibility for the person’s care or custody. ● Self-neglect : Which is the failure of a vulnerable older person to perform essential self-care tasks to the extent that his or her health or safety are in danger (U.S. Department of Health and Human Services, 2019) Telltale signs of elder abuse may include: ● Bruises, pressure marks, broken bones, abrasions, or burns. ● Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression. ● Bruises around the breasts or genital area (sexual abuse). ● Sudden changes in financial situations (exploitation). ● Bedsores, unattended medical needs, poor hygiene, and unusual weight loss (neglect). ● Spouse’s belittling, threatening, or other controlling behaviors. ● Strained or tense relationships and frequent arguments between the caregiver and the older adult. (U.S. Department of Health and Human Services, 2019) Reports must be made to an adult protective services agency or the local law enforcement agency. Failure of a mandated reporter to report suspected elder abuse and/or neglect is a misdemeanor. Any mandated reporter who willfully fails to report physical abuse, abandonment, isolation, financial abuse, or neglect of an elder or dependent adult, in violation of this section, where that abuse results in death or great bodily injury, will be punished by not more than 1 year in a county jail or by a fine of not more than five thousand dollars ($5,000), or by both a fine and imprisonment (Elder Abuse and Dependent Adult Civil Protection Act, 2014). In the event that the licensee makes a good-faith and confidential report of suspicion of child abuse to the appropriate agency, such as child protective services or the police department, and such suspicions prove to be false, the reporter is immune from claims of defamation (Penal Code section 11172). This same holds true for mandated reporters of elder abuse, per Welfare and Institutions Code Section 15634. break room, attended by staff. This would generally be the same location as other posters required by the labor laws of the State of California (CCR 1068). In addition, at entrances to offices with more than 10 employees, the licensee dentist employer who uses mercury-based filling material, nitrous oxide, or bisphenol
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