Statement and Acknowledgment of Mandated Reporter Status

Last UpdatedMarch 9, 2022
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Version2022

This acknowledgment form can be provided to employees who are mandated reporters. It includes a copy of the associated CA Penal Code section. The employee's signature establishes their receipt of the CA penal code section and awareness of the legal responsibilities as a mandated reporter.

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1646858410wpdm_NHF10007.3 Statement and Ack. of Mandated Reporter Status with CA Penal Code.pdf
Note: This sample form is provided as a tool for employers. This form is general in nature, and may not be required by law. ManagEase is not a law firm. This form does not constitute legal advice, nor is any attorney-client relationship created or implied. Prior to using this form, we recommend that you consult with an attorney knowledgeable in any potentially applicable federal and/or state laws regarding the specific intended use of this form.
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