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DPSS ePolicy

The purpose of this document is to release the PA 607, Complaint of Discriminatory Treatment, to staff. Additionally, this document includes definitions for retaliation and discrimination complaints, instructions for DPSS staff to make available the GEN 1179, Complaint of Discrimination in non-DPSS threshold languages, and DPSS Civil Rights Section email address and fax number for customers to submit complaints.

CIVIL RIGHTS

PA 607, Complaint of Discriminatory Treatment

Release Date
06/08/2023

Section Heading

Purpose

To revise an existing policy and/or form(s).


What changed?

  1. Added an instructions page to the PA 607, Complaint of Discriminatory Treatment (Revised March 2023) form and included information on all options to submit a complaint.
  2. The instructions page explains that a PA 607 may be used to file a retaliation complaint.
  3. Added definitions of retaliation and discrimination complaint to this release.
  4. Added instructions for DPSS staff to make available the California Department of Social Services form GEN 1179 (Revised May 2018), Complaint of Discrimination, in non-DPSS threshold languages.
  5. Added the DPSS Civil Rights Section email address and fax number to the PA 607 form.

Policy

According to the California Department of Social Services (CDSS) Division 21-101 and 21-109, DPSS customers are protected against discrimination in the delivery of program benefits.  Discrimination towards any customer is prohibited.  Customers are protected under the laws listed in the Background section.  Staff must not discriminate against any person because of:

  • National Origin (Includes Language)
  • Color
  • Race
  • Ancestry
  • Ethnic Group Identification
  • Age
  • Sex
  • Gender Expression
  • Gender Identity
  • Sexual Orientation
  • Marital Status
  • Domestic Partnership
  • Medical Condition
  • Genetic Information
  • Religion
  • Political Affiliation
  • Disability
  • Citizenship
  • Immigration Status
  • Any applicable basis

Staff must ensure all customers have equal access and meaningful opportunity to participate in all DPSS programs and services.

Retaliation

Retaliation is prohibited under CDSS Division 21.  A retaliation complaint must identify harm such as intimidation, threat, or discrimination against a protected activity (e.g., filing a complaint or assisting/participating in an investigation or hearing).  There must be a nexus/connection between the harm and protected activity.  DPSS must handle retaliation complaints the same way as a discrimination complaint, in that if the elements are met, the complaint must be investigated.

The PA 607 is used by customers to file a complaint of discriminatory treatment and to request that an investigation be conducted.  Customers must either grant or deny their consent for the Civil Rights Section to release their identity or other personal information to investigate their complaint.

If the customer says that they feel that they have been discriminated against, or their civil rights were violated, staff must assist them with filing their complaint.  Staff must provide the customer with a PA 607 and instructions page which explains they may submit a written complaint by mail, fax, or email directly to the Civil Rights Section.  They may also submit a verbal complaint by calling the Civil Rights Complaint Hotline (see Definitions).

Impact

CalWORKs, CalFresh, CAPI, GAIN, Medi-cal, District Operations, General Relief, IHSS, and START


Available Through

Forms Library and WLAMS


Languages

English, Spanish, Armenian, Cambodian, Chinese, Farsi, Korean, Russian, Tagalog, Vietnamese

Note: When a form is needed in a language for which we do not have a translation (including the GEN 1179), provide the customer the English version, along with the GEN 1365, Notice of Language Services.


Ordering Instructions

Order supplies from WLAMS via a PA 16, Supply Requisition.  An initial supply of the revised PA 607 and GEN 1179, Complaint of Discrimination forms will be distributed in all threshold languages to all DPSS offices.  Additional supplies must be requested by each DPSS office through WLAMS.


Current Inventory

Should be recycled per procedures contained in the DPSS Operations Handbook, Section 23-600.


Background

The purpose of CDSS Division 21 is to effectuate the provisions of the following laws: Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; Title II of the Americans with Disabilities Act of 1990; the Age Discrimination Act of 1975, as amended; the Food Stamp Act of 1977, as amended; and California Civil Code, Section 51 et seq., as amended; California Government Code, Section 11135 et seq., as amended; and California Government Code, Section 4450; and other applicable federal and state laws and their implementing regulations to ensure that the administration of public assistance and social services programs are nondiscriminatory, and that no person shall, because of national origin, color, race, ancestry, ethnic group identification, age, sex, gender expression, gender identity, sexual orientation, marital status, domestic partnership, medical condition, genetic information, religion, political affiliation, disability, citizenship, immigration status, any other applicable basis, or retaliation be  excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal or state financial assistance.  Administrative methods/procedures which have the effect of subjecting individuals to discrimination or defeating the objectives of these regulations are prohibited.  Additionally, CDSS Division 21-203.5 addresses how DPSS employees and contracted staff should handle retaliation complaints in the same way as discrimination complaints, in that if the elements are met, the complaint must be investigated.


Definitions

Civil Rights Liaison (CRL)

A manager at the level of Human Services Administrator I, or higher, responsible for ensuring implementation of Civil Rights policy at their respective offices and providing information to customers requesting to file civil rights complaints, among other duties. 


Civil Rights Compliance Unit (CRCU) Manager

A manager who oversees the Civil Rights Section Investigators (CRIs), the disposition of Civil Rights complaints and monitors the performance of investigations. The CRCU Manager receives and assigns  discrimination complaints to the CRIs.


Civil Rights Investigator (CRI)

CRIs are Program Assistants in the Civil Rights Section who review discrimination complaints and conduct investigations. CRIs will receive, process, and investigate PA 607 forms and other discrimination complaints. 


Civil Rights Complaint Hotline

The Civil Rights Complaint Hotline is available to the Department of Public Social Services (DPSS) customers to file a Civil Rights complaint.  The CRIs answer calls received via the Civil Rights Complaint Hotline at (562) 908-8501.


Civil Rights Complaint Submission

Completed PA 607s may be dropped off at any DPSS office or sent directly to the Civil Rights Section by:

  • Mail to:

Civil Rights Section

12860 Crossroads Parkway South

City of Industry, CA 91746

  • Email to: DPSSCivilRights@dpss.lacounty.gov
  • Fax to: (562) 692-2240

Civil Rights Coordinator (CRC)

Required by CDSS Division 21-201.1, the CRC is a designated DPSS manager responsible for ensuring the Department’s compliance with state and federal non-discrimination laws.  The CRC reviews all completed investigation reports and approves reports within the CRC’s approval authority or forwards to the appropriate state and/or federal agency for approval.


Discrimination Complaint

A complaint against a DPSS employee or staff from a contracted agency who has allegedly violated one or more of the protected classes (see list above).


GEN 1179

Complaint of Discrimination form developed by CDSS. This form is available in the DPSS Forms Library in Arabic, English, Hindi, Hmong, Japanese, Lao, Mien, Portuguese, Punjabi, Thai, and Ukrainian. 


Retaliation

Any form of intimidation, threat, coercion, or discrimination against any individual for engaging in a protected activity, such as filing a complaint, testifying, or participating in any manner in any investigation,  proceeding, or hearing. This is not the same as a discrimination complaint, however, it is prohibited under CDSS Division 21.


Requirements

  1. Anytime a customer requests to file a Civil Rights complaint, staff must inform the customer of all options available to submit a complaint, including submitting a PA 607, or other written format by mail, email, or fax, and provide them with the Civil Rights Complaint Hotline information, where the complaint can be taken over the phone with an interpreter, if needed.
  2. If a PA 607 is not available in the customer's preferred language, staff must provide the customer with a GEN 1179, if available in their preferred language.
  3. If neither the PA 607 not the GEN 1179 is available in the customer's preferred language, then provide the English version of the PA 607, along with the GEN 1365.
  4. District and contracted offices must display the PA 607 in all DPSS threshold languages and the GEN 1179 in non-DPSS threshold languages.

Verification Docs

N/A


Attachments

PA 607, Complaint of Discriminatory Treatment Form

Page one of PA 607.
Page two of PA 607.

GEN 1179, Complaint of Discrimination

GEN 1179

Index

Glossary

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APP
Pre Apprenticeship Certificate Program
AU
Administratively Unemployable
CLA
Clinical Assessment Appointment
CLE
Clinical Engagement
CORE
Career, Opportunities, Resources and Employment
CSS
Department Of Community And Senior Services
CSSD
Child Support Services Department
DMH
Department Of Mental Health
EJS
Early Job Search
ELAAJCC
East Los Angeles America’s Job Center Of California
ES-EW
Employment Special Eligibility Worker
HiSEC
High School Equivalency Certificate
HiSET
High School Equivalency Test
JOC
Job Order Coordinator
JRT
Job Readiness Training
JSPC
Job Skills Preparation Class
LACOE
Los Angeles County Office of Education
LADOT
Los Angeles Department of Transportation
LOD
Line Operations Development
NSA
Need Special Assistance
PCC
Pasadena City College
REP
Rapid Employment Promotion
SIP
Self-Initiated Program
SOA
Security Officer Assessment
SOT
Security Officer Training
SSVF
Supportive Services for Veteran Families
TAP
Transit Access Pass
VA
Department of Veteran Affairs
VL
Veteran Liaison
WIOA
Workforce Innovation & Opportunity Act

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