Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.4 Health Protection in Child Care

3.4.4 Child Abuse and Neglect Recognizing and Reporting Suspected Child Abuse, Neglect, and Exploitation

Content in the STANDARD was modified on 05/29/2018.

Caregivers/teachers should receive initial and ongoing training to assist them in preventing child abuse and neglect and in recognizing signs of child abuse and neglect. Programs are encouraged to partner with primary health care providers, child care health consultants, and/or child protection advocates to provide training and to be available for consultation. Caregivers/teachers are mandated reporters of child abuse and neglect. Each facility should have a written policy for reporting child abuse and neglect.

The facility should report any instance in which there is reasonable cause to believe that child abuse and/or neglect has occurred to the child abuse reporting hotline, department of social services, child protective services, or police as required by state and local laws. Every staff member should be oriented to what and how to report. Phone numbers and reporting system, as required by state or local agencies, should be clearly posted in a location accessible to caregivers/teachers.

Employees and volunteers in centers and large family child care homes should receive an instruction sheet about child abuse and neglect reporting that contains a summary of the state child abuse reporting statute and a statement that they will not be discharged or disciplined because they have made a child abuse and neglect report. Some states have specific forms that are required to be completed when abuse and neglect is reported. Some states have forms that are not required but assist mandated reporters in documenting accurate and thorough reports. In those states, facilities should have such forms on hand and all staff should be trained in the appropriate use of those forms.

Parents/guardians should be notified on enrollment of the facility’s child abuse and neglect reporting requirement and procedures.


While caregivers/teachers are not expected to diagnose or investigate child abuse and neglect, it is important that they be aware of common physical and emotional signs and symptoms of child maltreatment (see Appendix M, Recognizing Child Abuse and Neglect) (1,2).

All states have laws mandating the reporting of child abuse and neglect to child protection agencies and/or police. Laws about when and to whom to report vary by state (3).  Failure to report abuse and neglect is a crime in all states and may lead to legal penalties.


Child abuse includes physical, sexual, psychological, and emotional abuse. Other components of abuse include shaken baby syndrome/acute head trauma and repeated exposure to violence, including domestic violence. Neglect occurs when the parent/guardian/caregiver does not meet the child’s basic needs and includes physical, medical, educational, and emotional neglect (4). Caregivers/teachers and health professionals may contact individual state hotlines where available. While almost all states have hotlines, they may not operate 24 hours a day, and some toll-free numbers may only be accessible within that particular state. Childhelp provides a national hotline: 1-800-4-A-CHILD (800/422-4453).

Many health departments will be willing to provide contact for experts in child abuse and neglect prevention and recognition. The American Academy of Pediatrics ( can also assist in recruiting and identifying physicians who are skilled in this work.

Caregivers/teachers are still liable for reporting even when their supervisor indicates they don’t need to or says that someone else will report it. Caregivers/teachers who report in good faith may do so confidentially and are protected by law.

For more information about specific state laws on mandated reporting, go to the Child Welfare Information Gateway Mandated Reporting Web site,

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Child Care Health Consultants Stress Management for Staff Immunity for Reporters of Child Abuse and Neglect Preventing and Identifying Shaken Baby Syndrome/Abusive Head Trauma Care for Children Who Have Experienced Abuse/Neglect Records of Injury
Appendix M: Recognizing Child Abuse and Neglect
Appendix N: Protective Factors Regarding Child Abuse and Neglect
  1. Rheingold AA, Zajac K, Chapman JE, et al. Child sexual abuse prevention training for childcare professionals: an independent multi-site randomized controlled trial of Stewards of Children. Prev Sci. 2015;16(3):374–385

  2. Smith M, Robinson L, Segal J. Child abuse and neglect: how to spot the signs and make a difference. Web site. Updated October 2017. Accessed January 11, 2018

  3. Darkness to Light. Reporting child sexual abuse. Accessed January 11, 2018

  4. Child Welfare Information Gateway. What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms. Washington, DC: Child Welfare Information Gateway; 2013. Accessed January 11, 2018


Content in the STANDARD was modified on 05/29/2018.