Vehicle Damage Reimbursement, Third Party Liability Coverage

Management Directive, 17-02 (Rev. 05/10/2021) Page 1 of 14

Vehicle Damage Reimbursement, Third Party

Liability Coverage and Reporting

Responsibilities

Management Directive, 17-02 (REV) | Revision Date: 05/10/2021

Overview

This Management Directive applies to any employee designated as a mileage permittee

who receives mileage reimbursement, including one who is designated as an

occasional driver.

TABLE OF CONTENTS

Policy

Permittee’s Private Auto Liability Insurance

Damage Reimbursement Component

Third Party Liability Costs

Providing Proof of Personal Auto Liability Insurance and Driver’s License Information

Procedure

An Employee/Driver is Involved in an Auto Accident

Employee Responsibilities

Supervisor Responsibilities

Regional Administrator/Office Head/Division Chief Responsibilities

Office of Health and Safety Management (OHSM) Responsibilities

Filing for a Vehicle Damage Claim

Employee Responsibilities

Supervisor Responsibilities

Regional Administrator/Office Head/Division Chief Responsibilities

Office of Health and Safety Management (OHSM) Responsibilities

Approvals

Helpful Links

Attachments

Forms

References

Version Summary

This management directive was updated from the 06/01/2018 version. Additional steps

have been added for the Employee and Supervisor when an employee/driver has been

in an auto accident involving clients. The title has been changed from: Vehicle Damage

reimbursement and Third-Party Liability Coverage to: Vehicle Damage Reimbursement,

Third-Party Liability Coverage and Reporting Responsibilities.

Management Directive, 17-02 (Rev. 05/10/2021) Page 2 of 14

POLICY

Policy

The County assumes the following costs which result from mileage permittees’ use of

their vehicle:

Damage Reimbursement for Permittee Vehicle

The County will reimburse mileage permittees for the cost of repair to their vehicle, and

other incidental expenses, when their vehicle is damaged while driving on County

business. The vehicle must be owned or leased by the permittee; otherwise, the

damage will not be reimbursable.

Third Party Liability Costs

The County will pay damages for personal injury, or property loss incurred by a third

party in accidents involving DCFS mileage permittees while driving on County business,

providing such liability does not result from fraud, corruption, or actual malice on the

part of the permittee. The County does not maintain commercial auto liability insurance

– these costs are paid from each department’s operating budget. Back to Policy

Permittee’s Private Auto Liability Insurance

A permittee who is involved in an accident while driving on County business, does not

have to submit a claim to his/her private insurance company in order to receive

reimbursement for damage to his/her vehicle. However, the employee is responsible for

complying with any and all duties, including accident reporting requirements by the

State of California Department of Motor Vehicle, which are required under his/her

private auto insurance policy.

Back to Policy

Damage Reimbursement Component

Whenever a mileage permittee’s vehicle is damaged while driving on County business,

the County will reimburse the permittee for the reasonable cost to repair the vehicle.

The county will reimburse permittees for damage resulting from an accident (regardless

of fault). Other types of covered damages include, but are not limited to, a broken

window, slashed tires, or for expenses needed to clean or repair a vehicle resulting from

the required transportation of other persons relevant to County business, (i.e.

transporting DCFS children/youth, and the child/youth causes damage to the vehicle). If

Management Directive, 17-02 (Rev. 05/10/2021) Page 3 of 14

the permittee’s vehicle is stolen while on County business, the County will reimburse the

permittee for the fair market value of the vehicle.

 This Vehicle Damage Reimbursement does not cover damage to or loss of

personal property inside the vehicle.

Permittees are eligible for this reimbursement while driving on County business or

parked while on County business, but are not eligible while commuting to and from

home to work. All persons receiving mileage reimbursement, including those

designated as occasional drivers are eligible for damage reimbursement. However,

unlike regular permittees, occasional drivers are not eligible for damage which occurs

while parked at the permittee’s headquarters’ parking lot.

The County will reimburse a permittee for the actual cost of a rental car, not to exceed

$40.00 per day, up to a maximum of thirty (30) days for each day the employee is

without his/her vehicle that was damaged and is covered by this program, and actual

towing charges to move an inoperable vehicle, limited to 50 miles in towing. Also, the

County will reimburse vehicle storage costs, not to exceed $10.00 per day, for

reasonable storage needs.

To obtain reimbursement for damage to his/her vehicle, a permittee must fill out and

submit the, Claim for Damage to Personal Vehicle, within 10 business days from the

date of the damage, along with two estimates of repair costs, and, a copy of permittee’s

mileage certification. Instructions for completing the forms are included. If the damage

was the result of an accident, the employee must also complete the County of Los

Angeles Vehicle Accident and Incident Report within 3 (three) business days from the

date of the accident.

 Permittees may not claim or receive reimbursement from the County and also

from his/her private auto liability policy, nor from any other source, including any

third party who caused the accident, or that party’s insurance company.

When requesting reimbursement by filling out the Claim for Damage to Personal

Vehicle, a mileage permittee acknowledges that they are obligated to reimburse the

County one hundred percent of any other payments received from another source for

the same damages. If the reimbursement from another source is greater than the

County reimbursement amount, the permittee must reimburse only the County

reimbursement amount.

 A Permittee who attempts to obtain county reimbursement as well as

reimbursement from another source may result in disciplinary action, up to and

including discharge.

The Office of Health and Safety Management (OHSM) will conduct a random sampling

of approved vehicle damage reimbursement claims to ensure that double dipping is not

taking place. In some instances, in order to fully evaluate a claim, the employee’s

private insurance carrier will be contacted. If it is reported that double dipping has

occurred or suspected, a referral will be made to the Auditor Controller’s Office of

County Investigations.

Management Directive, 17-02 (Rev. 05/10/2021) Page 4 of 14

An eligible employee may not be entitled to reimbursement from the County under the

following circumstances:

 If he/she does not properly file the Claim for Damage to Personal Vehicle, within

10 business days from the date of the damage and submit the additional required

documents within thirty (30) business days from the date of the damage with his

or her Regional Administrator/Office Head/Division Chief;

 When the amount of damage is $5.00 or less;

 When damage occurs while the employee is commuting to and from work, or

during the employee’s lunch hour;

 While the employee is off-duty; or

 If the purpose of the trip is to undergo medical examination or treatment, to

participate in a civil service examination, or to pursue employee relations matters

on the employee’s behalf.

An eligible employee who, in conjunction with a claim filed under this directive, performs

any of the following acts shall be in violation of this directive:

 States as a fact, that which is not true if the employee/driver knew or should have

known based upon supporting documentation, it was untrue;

 States as a fact, that which is not true if the employee has no reasonable ground

to believe it is true; or

 Conceals any facts that he/she knows or believes to be material in conjunction

with any claim he/she files.

Any employee suspected of violating the directive shall be referred for investigation. Any

employee in violation of the directive shall be referred for disciplinary action.

Back to Policy

Third Party Liability Costs

If a mileage permittee is involved in an accident where there is personal injury or

damage to property (other than the permittee’s own vehicle), the County will assume the

resulting liability costs, with the exception of liability resulting from permittee fraud,

corruption, or actual malice, or for certain other exceptions required by County Code

Section 5.32.

The County contracts with a private firm, Carl Warren and Company (Carl Warren), to

handle auto and other liability claims filed against the County. To ensure Carl Warren

has the necessary information, all persons who drive on County business must be given

the following documents when they are first certified to drive on County business. In

addition, pursuant to the provisions of the Fringe Benefits MOUs, all current mileage

permittees must also be given these documents on an annual basis, even if they have

been given such documents previously. Current permittees are to be given these forms

as soon as possible to comply with these MOU provisions:

 County Third-Party Auto-Liability Protection: Information and Instructions for

Permittee Drivers, Attachment B:

Management Directive, 17-02 (Rev. 05/10/2021) Page 5 of 14

A one-page instruction sheet that should be kept in the permittee’s vehicle. This

sheet describes the County’s third-party auto liability coverage and provides

instructions for the permittee to follow in the event of an accident.

 Los Angeles County Evidence of Financial Responsibility, Attachment C:

Must be kept in the permittee’s vehicle. This document, rather than the

permittee’s notice of insurance issued by their private insurance, is to be shown

to other parties in case of an accident. In addition, if the permittee’s private

insurance company requires proof that the County has assumed liability for the

permittee while driving on County business, this document can be used as the

needed documentation.

 Certification of Receipt of Mileage Reimbursement Program Information,

Attachment D:

A form that departments use to document that the permittee has received

information concerning the County’s Mileage Reimbursement Program, and the

permittee’s responsibilities in the event of a loss or accident. This form should be

kept in the permittee’s personnel file.

 County of Los Angeles Report of Vehicle Collision of Incident, Attachment E:

The vehicle accident report form. This form must be completed within 3 business

days after an accident and submitted to the permittee’s supervisor.

Annually, the Regional Administrator/Office Head/Division Chief will notify each mileage

permittee that the County will provide third party liability protection to such employees

who use their personal vehicle to conduct County business. Regional

Administrator/Office Head/Division Chief are responsible for providing the

aforementioned forms as soon as possible to the employees assigned and or re-

assigned to his or her office.

Back to Policy

Providing Proof of Personal Auto Liability Insurance and

Driver’s License Information

The Auditor-Controller’s fiscal manual has been revised to no longer require

departments to have a mileage permittee provide proof of automobile insurance on an

annual or other routine basis. However, should the permittee’s vehicle be involved in an

accident or file a claim for reimbursement for damage for the permittee’s vehicle, the

permittee must provide the County with the name of the permittee’s private insurance

company and policy information.

When requesting reimbursement by filling out the Claim for Damage to Personal

Vehicle, a mileage permittee acknowledges that they are obligated to reimburse the

County one hundred percent of any other payments received from another source for

the same damages. If the reimbursement from another source is greater than the

County reimbursement amount, the permittee must reimburse only the County

reimbursement amount. Back to Policy

Management Directive, 17-02 (Rev. 05/10/2021) Page 6 of 14

PROCEDURE

An Employee/Driver is Involved in an Auto Accident

Employee Responsibilities

1. Exchange insurance information with the other party or parties showing the

County of Los Angeles: Evidence of Financial Responsibility form that has been

provided to you by the County. Do not admit fault or liability, nor discuss the

circumstances of the accident with anyone other than an investigating officer.

2. If the permittee is transporting a DCFS client (parent/guardian/child/non-minor

dependents), and is in a vehicle accident, the employee shall immediately report

the accident to their supervisor/manager and contact the necessary Law

Enforcement agency and document those efforts. Police Report is required if

accident/incident involved hit and run, theft, vandalism, injury, death.

3. The employee shall also seek medical attention for DCFS clients, especially

minor child(ren), regardless of whether or not there is apparent/visible injury.

The accident, follow up appointments and efforts of seeking medical attention

must be documented in CWS/CMS within 72 hours of the vehicle accident.

4. Employee is to consult with management as to who the designated staff member

assigned to the office is, to properly discard and replace the child car seat once

they have been involved in an accident in order to ensure a continued high level

of crash protection for child passengers.

5. Within 24 hours of the accident, and only if your accident involved a third party,

contact Carl Warren and Company, the County’s claim administrator, at (818)

247-2206 to inform them of the incident. In addition, have your supervisor

contact Carl Warren and Company to verify that you are an eligible permittee

driving in the course and scope of your County employment, only if your accident

involved a third party.

6. Within 3 business days of the accident, fill out the County of Los Angeles Report

of Vehicle Collision or Incident and submit the completed form to your supervisor.

7. Within 10 days, all permittee drivers involved in a vehicle accident are

responsible for completing and filing the State SR-1

https://www.dmv.ca.gov/portal/file/report-of-traffic-accident-occurring-in-

california-sr-1-pdf/ form for any accident involving damages of $750.00 or over,

and/or any injury to any party involved. Failure to file this form could affect the

permittee’s driver’s license or registration renewal. Neither the County nor Carl

Warren and Company can file the form on behalf of the permittee.

Management Directive, 17-02 (Rev. 05/10/2021) Page 7 of 14

 If the employee is not able to conduct the mentioned tasks as stated

above, the supervisor is to take on the responsibilities as noted under

Step #2 in the Supervisor’s Responsibilities section below.

Supervisor Responsibilities

1. Contact Carl Warren and Company to verify that the employee is an eligible

permittee driving in the course and scope of County employment, only if the

accident involved a third party.

2. Assist in contacting appropriate parties (i.e. client’s parents/caregivers, follow up

with client’s medical providers, and Law Enforcements), inputting contacts,

ensuring that the car seats are discarded and replaced appropriately. In addition,

assist with completing DCFS 1688-1, DCFS Worker and Report to the Juvenile

Court of Death, Injury or Illness to notify Children’s Court and attorneys of any

injuries if applicable and if the employee is unable to complete the tasks.

3. Review the County of Los Angeles Report of Vehicle Collision or Incident form,

and supporting documentation for completeness and accuracy. If not complete or

accurate, return to employee for corrective action.

4. Inspect the employee’s vehicle within the next business day or as soon as

possible and complete the DCFS Vehicle Accident/Incident Preliminary Checklist

form. If the vehicle is reported inoperable, view the photos submitted by the

employee and complete the DCFS Vehicle Accident/Incident Preliminary

Checklist form.

5. Forward the complete County of Los Angeles Report of Vehicle Collision or

Incident form with the supporting documents and photos, and the DCFS Vehicle

Accident/Incident Preliminary Checklist form to the Regional Administrator/Office

Head/Division Chief.

Regional Administrator/Office Head/Division Chief Responsibilities

1. Review and forward the duly signed electronic copy of County of Los Angeles

Report of Vehicle Collision or Incident with photos and the DCFS Vehicle

Accident/Incident Preliminary Checklist forms to the OHSM In-Box at

healt@dcfs.lacounty.gov within 30 business days.

2. Provide the employee copies of the duly signed County of Los Angeles Report of

Vehicle Collision or Incident and the DCFS Vehicle Accident/Incident Preliminary

Checklist forms. The employee is required to submit copies of these forms if he

or she files a Claim for Damage to Personal Vehicle.

Management Directive, 17-02 (Rev. 05/10/2021) Page 8 of 14

3. File a copy of the County of Los Angeles Report of Vehicle Collision or Incident

with photos and the DCFS Vehicle Accident/Incident Preliminary Checklist forms

in the employee’s personnel file.

Office of Health and Safety Management (OHSM) Responsibilities

1. The OHSM shall receive completed County of Los Angeles Report of Vehicle

Collision or Incident with photos and the DCFS Vehicle Accident/Incident

Preliminary Checklist forms, maintain a copy for recordkeeping purposes, and

forward the originals to County’s Claims Administrator for processing. If the

County driver is injured, the OHSM shall also attach a copy of the County of Los

Angeles Report of Vehicle Collision or Incident form to the Employer’s Report of

Occupation Injury or Illness form and forward to the contracted Third Party

Administrator for Workers’ Compensation purposes.

Back to Procedure

Filing for a Vehicle Damage Claim

Employee Responsibilities

1. To obtain reimbursement for damage to his or her vehicle, a mileage permittee

must fill out and submit the Claim for Damage to Personal Vehicle, to the

Regional Administrator/Office Head/Division Chief or the designated Supervisor

within ten (10) business days from the date of the damage as required by the

County Code. The mileage permittee must attach two (2) estimates from

licensed auto repair facilities with the details and cost to repair the vehicle.

Copies of the signed County of Los Angeles Report of Vehicle Collision or

Incident, the DCFS Vehicle Accident/Incident Preliminary Checklist forms and the

Field Itinerary (if applicable) must be attached to the claim form.

In addition to the forms required by the County Code, the mileage permittee must

also submit the following to the Regional Administrator/Office Head/Division

Chief within thirty (30) business days from the date of the damage:

 Copy of approved E-Caps Timesheet (REQUIRED);

 Copy Vehicle Registration (REQUIRED);

 Copy of driver’s license (REQUIRED);

 Proof of insurance (REQUIRED);

 Colored photos of the vehicle’s front and back with license plate, driver

and passenger sides and the damage (REQUIRED); and

 Police Report (REQUIRED if accident/incident involved hit and run, theft,

vandalism, injury, death).

Management Directive, 17-02 (Rev. 05/10/2021) Page 9 of 14

The mileage permittee may check with the State of California Department of

Consumer Affairs, Bureau of Automotive Repair whether an auto repair facility is

licensed.

If the cost to repair the damage exceeds the fair market value of the vehicle,

reimbursement will be made at Kelley Blue Book fair market value minus the

salvage value of the car. In this case, the mileage permittee will be requested to

submit another estimate, which indicates the vehicle’s salvage value, year and

make of the vehicle, odometer and Vehicle Identification Number.

If the vehicle is inoperable and towed to a licensed repair facility, the claimant

may submit an appraisal of damages from his/her insurance company in lieu of a

second estimate.

If the mileage permittee filed a claim with his/her personal insurance carrier, the

County will reimburse the insurance deductible only. Employees must provide

verification that the deductible was applied.

Rental Expense Reimbursement

Employee must provide sufficient documentation (bill, invoice, receipts, etc.) for

the costs of rental car coverage. Rental reimbursement is not to exceed $40.00

per day and will cover each day the employee is without his or her vehicle but not

to exceed thirty (30) consecutive days. Additional documentation may be

required for clarification.

Towing Expense Reimbursement

Employee must provide sufficient documentation (bill, invoice, receipts, etc.) for

towing cost if needed. Reimbursement for towing charges claim is not to exceed

50 miles in towing. Additional documentation may be required for clarification.

Storage Expense Reimbursement

Employee must provide sufficient documentation (bill, invoice, receipts, etc.) for

storage cost if needed. Reimbursement for storage cost claims is not to exceed

$10.00 per day and is not to exceed thirty (30) consecutive days. Additional

documentation may be required for clarification.

Failure to properly file the claim with the required forms and submit the documents in

the proper time will result in the denial of the claim.

If the Director of the Department of Children and Family Services or his/her designee

finds that the mileage permittee is not entitled to reimbursement, he/she shall notify the

mileage permittee in writing. In accordance with Section 5.85.080 of Chapter 5.85 of the

Management Directive, 17-02 (Rev. 05/10/2021) Page 10 of 14

County Code, the denial of the claim by the Department Head or his/her designee shall

be final and not subject to review.

If during repairs supplemental damages are discovered, the County will reimburse

based on the supplemental damage estimate. Reimbursement for supplemental

damage is available only if the repairs are completed at the repair facility that provided

the original estimate for which a permittee is compensated.

If a mileage permittee is entitled to reimbursement under section 5.85.060 of County

Code Chapter 5.85, the amount of the reimbursement shall be calculated by subtracting

$5.00 and the amount that he/she has received from insurance or any other sources

other than the County from the lower of two estimates of the cost to repair from licensed

auto repair business, provided said lower estimate does not exceed the current fair

market value of such vehicle. If the lower estimate of the cost of repairs exceeds the

current fair market value of the vehicle, the amount of the reimbursement shall be

calculated by subtracting $5.00 and the salvage value of the vehicle from the current fair

market value.”

Supervisor Responsibilities

Determine whether the incident occurred in the course and scope of employment by

reviewing the information including but not limited to the date, time, location and the

purpose of the trip on the DCFS 632B, Field Itinerary form and reconcile with other

documents submitted by the employee. Recommend whether to accept or reject the

claim. Complete Section B of the Claim for Damage to Personal Vehicle and submit it

with attachments to the Regional Administrator/Office Head/Division Chief no later than

the next business day of receipt from employee.

Regional Administrator/Office Head/Division Chief Responsibilities

Confer with the supervisor to ensure accuracy of the claim information and complete

Section C of the Claim for Damage to Personal Vehicle. Forward the claim with the

supporting forms and documents to the OHSM In-Box at: heal[email protected]acounty.gov.

The Regional Administrator/Office Head/Division Chief shall ensure that the claim

packet is forwarded to OHSM no later than five (5) business days from the date the

claim and required documents are received. The Regional Administrator/Office

Head/Division Chief shall ensure that the original claim and the documents are filed in

the employee’s office personnel folder and must not be returned to the employee, or

designate the employee to submit his or her own claim on behalf of the Regional

Administrator/Office Head/Division Chief.

Management Directive, 17-02 (Rev. 05/10/2021) Page 11 of 14

Office of Health and Safety Management (OHSM) Responsibilities

Verify the information submitted with the claim and investigate as deemed appropriate.

1. If the employee was involved in an accident and filed a Claim for Vehicle

Damage Reimbursement, check whether the employee submitted a complete

County of Los Angeles Report of Collision or Incident form within three (3) days

from the date of the accident. Untimely reporting for vehicle damage

reimbursement shall result in denial of a permittee’s claim.

2. Check whether the employee has been certified as a Mileage Permittee covering

the time of the incident.

3. Check whether the permittee has provided proof of ownership for the damaged

vehicle.

 The permittee must be using his/her privately owned vehicle to be

compensated for any damages that occur to the vehicle while in the

course and scope of County business.

 Vehicles include the following: automobiles, pick-up trucks, or vans.

Excluded from consideration are motorcycles, recreational vehicles, off-

road vehicles and marine vehicles.

4. Check whether the permittee provided a copy of the current vehicle registration

and proof of vehicle liability insurance.

5. Check whether the permittee was working on the day of the incident and whether

the permittee was utilizing his/her personal vehicle while on County business

(includes parked at field location or headquarters).

 In order to benefit from the Program, the permittee must be on duty and

driving in the course and scope of County business.

 Excluded are trips to undergo a medical examination or treatment, to

participate in a Civil Service examination, or to pursue employee relations

matters on the employee’s behalf.

6. Check whether the permittee’s vehicle was damaged in his/her assigned

headquarters. Verify the employee’s status as a mileage permittee.

 The Program will pay for damages sustained in the permittee’s

headquarters parking location. This does not apply to occasional drivers.

If the permittee is parked at another location and the vehicle is damaged

during this time, the permittee must be in course and scope of County

business.

7. Check whether the permittee has a current driver’s license.

 If the permittee does not have a current driver’s license, report the

discovery to the supervisor so that action can be taken to re-evaluate the

employee’s mileage permittee status.

Management Directive, 17-02 (Rev. 05/10/2021) Page 12 of 14

8. Check whether the Claim for Damage to Personal Vehicle report is completed.

 Untimely claims shall be denied for reimbursement.

9. Check whether two separate itemized estimates were completed by a licensed

repair facility. Evaluate whether the estimates are similar in itemization of work

to be repaired. If there is a significant difference, clarification may be requested

to explain the disparity in costs. Request for a salvage value estimate, if the

expenses exceed the fair market value of the vehicle.

a. If the lower estimate of the cost of repairs exceeds the current fair market

value of the vehicle, request the employee to provide a salvage value of

the car.

 To determine whether an auto repair facility is licensed, contact the State

of California Department of Consumer Affairs, Bureau of Automotive

Repair.

 If during repairs supplemental damages are discovered, the County will

reimburse based on the supplemental damage estimate. Coverage for

supplemental damage is available only if the repairs are completed at the

repair facility that provided the original estimate for which a permittee is

compensated.

10. Check whether rental, towing and/or storage fees have been verified with

sufficient documentation (invoices, receipts, etc.).

11. Check whether photos of the damaged vehicle were provided by the permittee.

12. Photos should validate the permittee’s claim for the specified damages. Check

to reconcile the damage seen in the photo against the documentation provided

by the permittee to ensure that the estimated cost is validated by all the evidence

provided including photos.

13. Check whether a copy of the police report was attached to the claim. There may

be occasions when a report was not filed. If a report is on file, review the

information and reconcile with the other documentation including the County of

Los Angeles Report of Vehicle Collision or Incident form to ensure both are

consistent with the permittee’s claim.

 Police reports are customarily filed when there is an injury to any party, or

when the damage is caused by hit and run or vandalism.

14. Recommend approval or denial of the claim.

a. If denied, return the claim with a written explanation of the denial. If the

Director of the Department of Children and Family Services or his/her

designee finds that the mileage permittee is not entitled to reimbursement,

he/she shall notify the mileage permittee in writing. Pursuant to Section

5.85.080 of Chapter 5.85 of the County Code, the denial of the claim by the

Department Head or his/her designee shall be final and not subject to

review.

Management Directive, 17-02 (Rev. 05/10/2021) Page 13 of 14

b. If approved, calculate reimbursement pursuant to section 5.85.060 of

Chapter 5.85 of the County Code which states:

“When an Eligible Employee is entitled to reimbursement

under this chapter, the amount of the reimbursement

shall be calculated by subtracting $5.00 and the amount

that he/she has received from insurance or any other

sources other than the County from the lower of two

estimates of the cost to repair from licensed auto repair

business, provided said lower estimate does not exceed

the current fair market value of such vehicle. If the lower

estimate of the cost of repairs exceeds the current fair

market value of the vehicle, the amount of the

reimbursement shall be calculated by subtracting $5.00

and the salvage value of the vehicle from the current fair

market value.” Back to Procedure

APPROVALS

Supervisor Approval

 County of Los Angeles Report of Vehicle Collision or Incident

 Claim for Damage to Personal Vehicle

Regional Administrator/Office Head/Division Chief Approval

 County of Los Angeles Report of Vehicle Collision or Incident

 Claim for Damage to Personal Vehicle

Office of Health and Safety Management (OHSM)

 County of Los Angeles Report of Vehicle Collision or Incident

 Claim for Damage to Personal Vehicle

Back to Approvals

HELPFUL LINKS

Attachments

Attachment A, Claim for Damage to Personal Vehicle

Attachment B, County Third-Party Auto-Liability Protection: Information and Instructions

for Permittee Drivers

Attachment C, Los Angeles County Evidence of Financial Responsibility

Management Directive, 17-02 (Rev. 05/10/2021) Page 14 of 14

Attachment D, Certification of Receipt of Mileage Reimbursement Program Information

Attachment E, County of Los Angeles Report of Vehicle Collision or Incident

Attachment F, DCFS Vehicle Accident/Incident Preliminary Checklist

Forms

LA Kids

DCFS 1688-1, DCFS Worker and Report to the Juvenile Court of Death, Injury or Illness

References

L.A. County (LAC) Code Chapter 5.85, Section 5.32: Addresses when the County will

or will not assume liability costs, County Code Section 5.32

LAC Code Chapter 5.85, Section 5.85.060: Provides instruction for calculating

reimbursement.

Back to Helpful Links