Special Incident Reporting

LIC 624 Unusual Incident

Death Report


Medication Error Form

NLACRC SIR Reporting Form

Title 17 Reporting Requirements

SIR TiP Sheet

Abuse Reporting

SOC 341

Mandated Reporting Flow Chart

Please be advised that Adult Protective Services has eliminated its Centralized fax number, and the procedure for reporting suspected Elder and Dependent Adult Abuse and Neglect to Adult Protective Services (APS) has changed.

You may report an incident of suspected Elder and Dependent Adult Abuse and Neglect to APS, by choosing one of the two options listed below:

1. Verbally report the incident by calling the:
a) 24-hour Elder Abuse Reporting Hotline at (877) 477-3646 or
b) APS Mandated Reporter Hotline at (888) 202-4248.

2. Complete the SOC 341 form and mail it to:
Adult Protective Services – Center Intake
Community & Senior Services
3333 Wilshire Blvd., 4th floor
Los Angeles, CA 90010


1. Submit an Electronic Report.
Please note: if you submit a report electronically, you do not need to verbally report the incident. Additionally, currently there is no option to print the electronic report, and once submitted, you will not be provided with a confirmation number. APS is currently working on adding a print option and other improvements.

Follow-up Instructions:
After submitting the written report, please call APS after a couple days at (213) 351-5401 to inquire about the status of the case.