CA PA 607 - County of Los Angeles 2011 free printable template
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County of Los Angeles Department of Public Social Services COMPLAINT OF DISCRIMINATORY TREATMENT TO: DEPARTMENT OF PUBLIC SOCIAL SERVICES CIVIL RIGHTS SECTION 12860 CROSSROADS PARKWAY SOUTH CITY OF
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How to fill out CA PA 607 - County of Los
How to fill out a complaint of discriminatory treatment:
01
Begin by clearly stating your name, contact information, and the date at the top of the complaint form.
02
Describe the incident of discriminatory treatment in detail, including dates, times, and locations. Be specific about what discriminatory actions or behaviors occurred.
03
Provide names of the individuals involved in the discriminatory treatment if known. If you are unsure of their names, provide as much identifying information as possible.
04
Explain how the discriminatory treatment personally affected you, your well-being, and any negative consequences you may have experienced as a result.
05
If applicable, mention any actions you took at the time of the incident, such as reporting it to a supervisor or seeking support from colleagues.
06
Include any evidence you have to support your complaint, such as emails, messages, photographs, or witness statements. Make sure to reference and attach these documents to your complaint.
07
Clearly state the type of discrimination you believe you experienced, such as discrimination based on race, gender, religion, disability, or any other protected characteristic.
08
Describe the impact the discriminatory treatment had on your ability to perform your job or participate fully in the workplace.
09
Outline any previous attempts to resolve the issue or attempts to address the discriminatory treatment informally. Include dates and outcomes.
10
Specify what actions you would like to see taken to address the discriminatory treatment, such as disciplinary action against those involved, workplace policy changes, or sensitivity training.
11
Sign and date the complaint form, and make copies for your own records.
Who needs a complaint of discriminatory treatment?
01
Employees who have experienced discriminatory treatment in the workplace.
02
Job applicants who believe they were discriminated against during the hiring process.
03
Clients or customers who have faced discriminatory treatment from employees or staff members.
04
Students who have experienced discriminatory treatment in educational institutions.
05
Any individual who believes they have been subjected to discriminatory treatment in housing, public services, or other areas protected by anti-discrimination laws.
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What is complaint of discriminatory treatment?
A complaint of discriminatory treatment is a formal accusation or allegation made against an individual, organization, or institution for treating someone unfairly or differently based on certain protected characteristics.
Who is required to file complaint of discriminatory treatment?
Anyone who believes they have been subjected to discriminatory treatment based on their protected characteristics, such as race, gender, age, disability, or religion, is required to file a complaint of discriminatory treatment.
How to fill out complaint of discriminatory treatment?
To fill out a complaint of discriminatory treatment, individuals typically need to provide their personal information, details of the incident of discrimination, and any supporting evidence or witnesses.
What is the purpose of complaint of discriminatory treatment?
The purpose of a complaint of discriminatory treatment is to bring attention to and address instances of unfair treatment based on protected characteristics, in order to seek resolution and prevent future incidents of discrimination.
What information must be reported on complaint of discriminatory treatment?
Information such as the date and location of the incident, the individuals involved, any witnesses, a description of the discriminatory behavior, and any supporting documentation should be reported on a complaint of discriminatory treatment.
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