AUTHORIZATION TO TREAT A MINOR
In the event of sudden illness, accident, or injury which may occur while the above named minor is engaged in the activity supervised by SAFE FJC/Riverside County PAL and its representatives, employees, agents or assignees, when neither the minor's parent(s), guardian(s) or designated family medical provider can be contacted, I hereby give my consent for emergency treatment as necessary under the circumstances by any medical provider licensed under the law of the State of California, I, the parent or legal guardian of the listed child, do hereby authorize and consent to any x-ray examination, anesthetic, medical, or surgical treatment rendered under the general or special supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medical Practice Act or a dentist licensed under the provisions of the Dental Practice Act and on the staff of any acute general hospital. or emergency care facility holding a current license to operate a hospital or emergency care facility from the State of California Department of Public Health. I understand that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power to render care, which the aforementioned physician, in the exercise of his/her best judgment may deem advisable of my child. Further, I understand my child will be participating in inherently dangerous activities and agree to pay for my child's medical expenses. I understand that all effort shall be made to contact me prior to rendering treatment to my child, but any of the above treatment will not be withheld if I cannot be reached. This authorization is given pursuant to the provisions of the California Civil Code. The consent shall remain in effect until such authorization is withdrawn.
RELEASE FROM LIABILITY
I, the undersigned, hereby give permission for the above named minor in my custody to participate In activities with SAFE FJC/Riverside County PAL for one calendar year from the date signed and hereby waive, release, and discharge any and all claims or rights to claims for damages for death, personal injury or property damage which I may have, or which may hereafter accrue to me, as a result of the minor's participation in the activity. This release is intended to discharge in advance the promoters, sponsors, officials, the City of Temecula/ city of Murrieta or other public entity, agents and employees from and against any and all liability arising out of or connected in any way the minor’s participation In the activity, even though that liability may arise out of negligence or carelessness on the part of any person or entity mentioned above.
I further understand that serious injuries occasionally occur during the activity and participants in the activity occasionally sustain mortal or serious personal injuries and/or property damage, as a consequence thereof. Knowing the risks of the activity, nevertheless, on behalf of the minor, I hereby agree to assume those risks and to release and hold harmless all of the persons or entities mentioned above who, through negligence or carelessness, might otherwise be liable to me, my heirs or
assigns for damages.
I further understand and agree that this waiver, release and assumption of risk are to be binding on my heirs and assigns.
I agree to accept and abide by the rules and regulations of SAFE FJC/Riverside County PAL.
In consideration of the acceptance of the application of my child, as a participant in any programs and/or activities of SAFE FJC/Riverside County PAL and/or its member chapters, my child and I hereby agree to assume all risks attendant upon myself and my child while participating in any SAFE FJC/Riverside County PAL programs and/or activities. My child and I hereby waive, release and discharge any and all claims for damages for death, personal injury, or property damage which I or my child may have or which may hereinafter accrue to me or my child as a result of my child's participation in SAFE FJC/Riverside County PAL and/or activity. I agree to indemnify an hold
harmless from liability the SAFE FJC/Riverside County PAL, its members, agents, servants or employees by reason of any accident, injury death or damages to persons or property which l or my child may suffer, from and against any and all liability arising out of or connected in any way with my or my child's participation in SAFE FJC/Riverside County PAL or activities even through that the liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above.
It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assigns, and the heirs and assigns of my child. l agree to assume all responsibility for any property damage or injury to any person caused by me or my child while participating in the SAFE FJC/Riverside County PAL and/or activities.
I have read, understand and approve the AUTHORIZATION TO TREAT A MINOR (with any restrictions I may have listed), RELEASE FROM LIABILITY on this page.
Child Protection Policy
Goal
It shall be the goal of SAFE Family Justice Center to provide a safe environment for the physical and emotional well-being of all children participating in the Police Activities League (PAL) program. Our goal as a service provider is to inform families and enforce policies to ensure that all children are safe and well protected while attending scheduled activities.
Definition of “Children”
The term “child” or “children” shall include all persons under the age of eighteen (18) years.
Selection and Screening Process
Pre-employment Procedures for Paid and Unpaid Workers
It is the goal of SAFE to adequately screen the applications of persons desiring to work with children participating in our PAL program. This includes individuals who desire to work with children enrolled in our Teen Anger management, Victim Awareness, and Substance Abuse Education courses.
Training Requirements
No intern will be allowed to work with children in any capacity until they have completed all required screening such as background check and live scan, mandated reporter certification, mentor training, and agency orientation. This time of interaction between our leadership and the applicant allows for better evaluation and suitability of the applicant for working with children.
This policy may be waived with the authorization of the Executive Director and supervisors, as in the case of a new staff member. If waived, program administrators must take additional steps to screen the applicant.
Supervisory Requirements
It is the policy of the agency to provide adequate supervisory control of persons working with children participating in all agency programs. The following regulations shall be applicable to all staff and non-staff workers having contact with children participating in all PAL programs:
Two Adult Rule
It is the policy of SAFE that a minimum of two workers will be in attendance at all times when children are being supervised during all PAL program activities regardless of the number of participants, location or activity. At least one of these must be a paid SAFE employee. At no time should an adult ever be in a room or an enclosed area alone with a child.
Observation of Children
At no time will an adult meet alone with a child in any room where the door is closed or in an area where they cannot be seen. One exception to this rule is during an intake appointment where confidential information is shared between the youth participating in direct services and the staff and/or intern completing the assessment.
Ratio of Workers to Children
It is required that a reasonable ratio of adults to children is maintained at all times involving the supervision of children. The PAL Supervisor and Youth Specialist shall be responsible for setting and maintaining a reasonable ratio of workers to children giving due regard to all factors present, including the number and age of the participants, the nature of the activities and the location where the activities are taking place.
Worker and Intern Training
Each new employee and intern will be required to complete the mandated child abuse reporting training, Victim Assistance training, and introductory training to working within a trauma-informed service delivery model. They will need to complete all requirements before working with children.
Reporting Obligation
By California law, anyone who has reasonable cause to believe that a child is being physically abused, sexually abused, neglected or is dependent is required to report this information. If you suspect abuse, you should call 1-800-442-4918 for Riverside County. Outside the Riverside area call: Child Help National Child Abuse Hotline at 1-800-422-4453. Mandated reporters must immediately report abuse to the Child Abuse Hotline at 1-800-442-4918. Within 36 hours, mandated reporters are required to submit a written follow up report.
Confidentiality
All reports of child abuse or neglect shall be held in absolute confidence. No person shall communicate any information concerning the alleged event to any person except as necessary to cooperate with any official investigation. Any breach of this confidentiality by an intern shall be cause for immediate dismissal. No person shall attempt to conduct a detailed investigation either through examination or interrogation of the child, the accused person or a witness.