STATE OF CALIFORNIA
DEPARTMENT OF JUSTICE
Page 2 of 2
BCIA 4056
(Orig. 10/2007; Rev. 08/2016)
CHILD ABUSE CENTRAL INDEX SELF INQUIRY REQUEST
Privacy Notice
As Required by Civil Code § 1798.17
Collection and Use of Personal Information. The California Justice Information Services (CJIS) Division in the
Department of Justice collects the information requested on this form as authorized by Penal Code section 11170(f). The
CJIS Division uses this information for the purpose of requesting a self inquiry of the Child Abuse Central Index (CACI).
In addition, any personal information collected by state agencies is subject to the limitations in the Information Practices
Act and state policy. The Department of Justice's general privacy policy is available at:
Providing Personal Information. All the personal information requested in the form must be provided.
Access to Your Information. You may review the records maintained by the CJIS Division in the Department of Justice
that contain your personal information, as permitted by the Information Practices Act. See below for contact information.
Possible Disclosure of Personal Information. In order to request a self inquiry of the CACI, we may need to share the
information you give us with any requesting person identifying the date of the report and the submitting agency who
reported the information.
The information you provide may also be disclosed in the following circumstances:
•
With other persons or agencies where necessary to perform their legal duties, and their use of your information is
compatible and complies with state law, such as for investigations or for licensing, certification, or regulatory
purposes;
•
To another government agency as required by state or federal law;
Contact Information. For questions about this notice or access to your records, you may contact the Record Review
Unit manager by phone at (916) 227-3835, by email at recordreview@doj.ca.gov, or via mail at:
California Department of Justice
Bureau of Criminal Information and Analysis
Record Review Unit
P.O Box 903417
Sacramento, CA 94203-4170
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