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Severe Physical Abuse Child under Five300e Form

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CHILD'S NAME: CASE NUMBER: SEVERE PHYSICAL ABUSE(Child Under Five)§ 300(e) The child is under the age of five and has suffered severe physi cal abuse by a parent, or by any person known by the parent, an d the parent knew or reasonably should have known that the person was physically abusing the child. (State supporting facts concisely and number them e-1, e-2, e-3, etc.): Page of SEVERE PHYSICAL ABUSE Form Approved for Optional Use Welfare and Institutions Code, § 300; CaI. Rules of Court, rule 5.504 www.courtinfo.ca.gov Judicial Council of California § 300(e) JV-124 [Rev. January 1, 2007] JV-124

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