Form LIC 9226 Request for Training Approval: Mandated Child Abuse Reporter Training - California

Form LIC9226 is a California Department of Social Services form also known as the "Request For Training Approval: Mandated Child Abuse Reporter Training". The latest edition of the form was released in May 1, 2018 and is available for digital filing.

Download an up-to-date Form LIC9226 in PDF-format down below or look it up on the California Department of Social Services Forms website.

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State of California – Health and Human Services Agency
California Department of Social Services
REQUEST FOR TRAINING APPROVAL:
MANDATED CHILD ABUSE REPORTER TRAINING
Individual trainees or Training Programs may complete this
request per Health and Safety Code §1596.8662 for approval of
Date: _________________
a training that will meet requirements of AB 1207, Chapter 414,
Statutes of 2015.
Training Program Contact Information (Please Print):
Telephone Number:
Email (Optional):
Street Address (P.O. Box):
City:
State:
Zip Code:
A request will be approved if the submitted training course curriculum, at minimum, includes the
guidance content required by law. Check each box to verify training course curriculum includes
required guidance content on the following:
Identification of child abuse and neglect, including recognition of behavioral signs
Reporting requirements for suspected abuse occurring inside or outside of a licensed facility,
including how to report and to which enforcement agency or agencies a report is required
Criminal misdemeanor punishment for failure to report an incident of suspected child abuse or
neglect (Penal Code Section 11166)
Mandated reporter duties are individual and no person shall be sanctioned for making a report
(Penal Code Section 11166) and a supervisor or administrator who impedes or inhibits the
duties of a mandated reporter shall be subject to punishment (Penal Code Section 11166.01)
Childhood stages of development to help distinguish whether a child’s behavior or physical
symptoms are within range for their age and ability, or are signs of abuse or neglect
Protective factors that may help prevent abuse, including dangers of shaking a child, safe
sleep practices, psychological effects of repeated exposure to domestic violence, safe and
age-appropriate forms of discipline, how to promote a child’s social and emotional health, and
how to support positive parent-child relationships
Recognizing risk factors that may lead to abuse, such as stress and social isolation, and
available family resources to help prevent child abuse and neglect
When it is necessary to call for emergency medical attention to prevent further injury or death
How a licensed child care provider, administrator, or employee of a licensed child day care
facility might communicate with a family before and after making a suspected child abuse
report
Department approval is limited to a determination that the training course curriculum includes the
above guidance content specified by Health and Safety Code Section 1596.8662(a)(2)&(3).
LIC 9226 (5/18)
Page 1 of 2
State of California – Health and Human Services Agency
California Department of Social Services
REQUEST FOR TRAINING APPROVAL:
MANDATED CHILD ABUSE REPORTER TRAINING
Individual trainees or Training Programs may complete this
request per Health and Safety Code §1596.8662 for approval of
Date: _________________
a training that will meet requirements of AB 1207, Chapter 414,
Statutes of 2015.
Training Program Contact Information (Please Print):
Telephone Number:
Email (Optional):
Street Address (P.O. Box):
City:
State:
Zip Code:
A request will be approved if the submitted training course curriculum, at minimum, includes the
guidance content required by law. Check each box to verify training course curriculum includes
required guidance content on the following:
Identification of child abuse and neglect, including recognition of behavioral signs
Reporting requirements for suspected abuse occurring inside or outside of a licensed facility,
including how to report and to which enforcement agency or agencies a report is required
Criminal misdemeanor punishment for failure to report an incident of suspected child abuse or
neglect (Penal Code Section 11166)
Mandated reporter duties are individual and no person shall be sanctioned for making a report
(Penal Code Section 11166) and a supervisor or administrator who impedes or inhibits the
duties of a mandated reporter shall be subject to punishment (Penal Code Section 11166.01)
Childhood stages of development to help distinguish whether a child’s behavior or physical
symptoms are within range for their age and ability, or are signs of abuse or neglect
Protective factors that may help prevent abuse, including dangers of shaking a child, safe
sleep practices, psychological effects of repeated exposure to domestic violence, safe and
age-appropriate forms of discipline, how to promote a child’s social and emotional health, and
how to support positive parent-child relationships
Recognizing risk factors that may lead to abuse, such as stress and social isolation, and
available family resources to help prevent child abuse and neglect
When it is necessary to call for emergency medical attention to prevent further injury or death
How a licensed child care provider, administrator, or employee of a licensed child day care
facility might communicate with a family before and after making a suspected child abuse
report
Department approval is limited to a determination that the training course curriculum includes the
above guidance content specified by Health and Safety Code Section 1596.8662(a)(2)&(3).
LIC 9226 (5/18)
Page 1 of 2
State of California – Health and Human Services Agency
California Department of Social Services
A request should ensure the training program will provide each trainee both of the following for their
records: 1) written proof of training completion documentation that displays the name of the training
program, name of the trainee, and the date of completion; AND 2) a copy of an approved LIC 9226
(or other Department approval letter) for trainees to retain at the facility.
Attach a copy of the training course curriculum to demonstrate required content.
Sign here in acknowledgment of the above:
Requestor Name (Print please):
Telephone Number:
Requestor Signature:
Email (Optional):
DEPARTMENT USE ONLY
Request is:
APPROVED
The department has determined this training submitted by ___________________________
on _______________ has met the minimum requirements of health and safety code section
1596.8662 and remains valid only if required content information is retained as submitted.
INCOMPLETE
Reason(s) for being incomplete: _________________________________________________
____________________________________________________________________________
In order to obtain approval, the requestor will need to show their training is in compliance with
the following guidance content requirements of health and safety code section 1596.8662.
Licensing Office Location:
Licensing Office Telephone:
Licensing Office Staff Name:
Licensing Office Staff Signature:
Date:
Additional comments:
NOTE: Persons who receive Department approval are responsible for preserving the approved LIC 9226. The
licensee is responsible for maintaining employee proof of training completion documentation on file at the
facility. For employees who take alternate trainings, the licensee should ensure the Department approved
LIC 9226 is attached to each employee’s proof of training, in order to facilitate compliance with law.
LIC 9226 (5/18)
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Download Form LIC 9226 Request for Training Approval: Mandated Child Abuse Reporter Training - California

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