Civil Rights Complaint Procedure and Form

Civil Rights Complaint Procedure

United States Department of Agriculture (USDA)/Food and Nutrition Service (FNS) Instruction 113-1(dated 11/8/05) delineates the civil rights requirements for participants in Child Nutrition Programs.

Accepting a Complaint

Civil rights complaints are directed to: Amy Maclosky, Director, Office of Food and Nutrition Services, 2110 Washington Blvd, Arlington, VA 22204, Office: 703.228.2621, amy.maclosky@apsva.us Complaints can be received verbally, in writing or anonymously and within 90 days of the alleged discriminatory action. (Complaint Form).

Transcribing a Complaint

Complaints will be processed within 90 days. The following information will be collected (verbally, inwriting or anonymously): name, address, and telephone number of the complainant, the nature of the incident or action that led the complainant to feel discrimination was a factor, the basis on which the complainant believes discrimination exists, the names, telephone numbers, titles, and business or personal addresses of persons who may have knowledge of the alleged discriminatory action, and the date(s) during which the alleged discriminatory action occurred.

Forwarding a Complaint

Complaints will be forwarded to: VDOE Office of School Nutrition Programs, PO BOX 2120 Richmond, VA 23218-2120

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at(800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: https://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights1400 Independence Avenue, SW Washington, D.C. 20250-9410;
Fax: (202) 690-7442; or
Email: program.intake@usda.gov.

This institution is an equal opportunity provider.