CA16

If the SCR accepts the report, WRITE DOWN THE CALL ID # given by the CPS Specialist at the SCR. On the upper right corner of the 2221A there is a place to RECORD THE CALL ID #.
After you complete your call to the SCR, immediately notify the person in charge of the institution
Provide the information reported to the SCR, including the names of other persons identified as having direct knowledge or the alleged abuse or maltreatment.
The person in charge or designated agent, once notified that a report has been made to the SCR, becomes responsible for all preparation and submission of the form LDSS-2221A.
As suggested earlier, if time permits, it may be helpful to fill out the form before placing your call to the SCR. This enables you to organize the required information.
REMEMBER: The safety of the child must come before the completion of the form.
Send written reports – LDSS-2221A to the local CPS office within 48 hours of making the oral report. (Refer to participant handouts for a list of local CPS office mailing and contact information.)
Two copies of the form, an original and a duplicate must be forwarded to the local CPS agency within 48 hours.
A third copy should be kept on file by the reporter.
Additional copies of the LDSS-2221A are available at the OCFS Website www.ocfs.state.ny.us