California mandated reporters, including health practitioners, use SOC 341 to report suspected abuse or neglect of an elder (60 or older) or a dependent adult (18 to 59) under Welfare and Institutions Code sections 15630 and 15658(a)(1). It records the victim, suspected abuser, reporter's observations, abuse types and the agencies notified. Most reports go to county Adult Protective Services or local law enforcement.
The reporting party completes sections A to J, entering 'unknown' for any item not known; mandated reporters must give their names, while others may stay anonymous.
Download the current version from the source each time; forms change without notice.
Report of Suspected Dependent Adult/Elder Abuse
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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For most abuse, report by phone or a confidential internet tool to APS or law enforcement immediately or as soon as practicably possible. If reported by phone, the written or internet report is due within two working days. Abuse in long-term care facilities and state hospitals has 2-hour and 24-hour timelines.
Under WIC 15630(a), anyone who has assumed full or intermittent care or custody of an elder or dependent adult is a mandated reporter, including health practitioners, care custodians, licensed facility staff, clergy, and APS and law enforcement employees.