REPORT OF SUSPECTED DEPENDENT ADULT ELDER 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Section A, where you will input the victim's details. Fill in their name, age, gender identity, and other relevant information. Ensure accuracy as this is crucial for proper reporting.
  3. In Section B, provide information about the suspected abuser. Include their name, address, and relationship to the victim. Check any applicable boxes regarding their mental state or living situation.
  4. Move to Section C to document your observations and any statements made by the victim. This section is vital for understanding the context of the abuse.
  5. Complete Section D with your details as the reporting party. Include your name, relation to the victim, and contact information.
  6. Fill out Sections E through K with incident information and types of abuse reported. Be thorough in checking all applicable boxes to ensure comprehensive reporting.

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Fact: APS clients are adults and have the right to refuse services unless there is a possible threat to their safety.
Self-neglect: e.g. Failure to provide food, clothing, shelter, or health care for oneself. Mental suffering: e.g. Verbal assaults, threats, causing fear. Abduction: e.g. Removal from this state and restraint from returning to this state of any elder of dependent adult.
Call the police or 9-1-1 immediately if someone you know is in immediate, life-threatening danger. If the danger is not immediate, but you suspect that abuse has occurred or is occurring, please tell someone. Relay your concerns to the local adult protective services, long-term care ombudsman, or the police.
By telephone immediately, or as soon as practically possible, to the local ombudsman or the local law enforcement agency. By written report, Department of Social Services Form (SOC Form 341), Report of Suspected Dependent Adult/Elder Abuse sent within two (2) working days.
WHAT DOES APS DO? Receives reports of alleged abuse, neglect, self-neglect or financial exploitation and determines if the client is eligible. Investigates the allegations through interviewing the client, collateral contacts, alleged abuser(s) and through examining evidence such as medical and bank records.

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People also ask

The exact cause of APS is not known. Both certain gene changes and other factors (such as an infection) may cause the problem to develop. It is often found in people with other autoimmune diseases, such as systemic lupus erythematosus (SLE). The condition is more common in women than in men.
California Adult Protective Service Agency: call (833) 401-0832 or visit the APS website for a list of county APS contacts. Attorney Generals Elder and Dependent Adult Abuse Hotline: (888) 436-3600. Long-Term Care Ombudsman/CRISISline: (800) 231-4024.

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