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DPSS ePolicy

The purpose of this document is to release the revised PA 2457, Civil Rights Information Notice, to staff. Revisions include additional basis of discrimination categories and revised County, State, and Federal contact information.

Civil Rights, PA 2457, Civil Rights Information Notice, 12-27-2024

NAVIGATION

CIVIL RIGHTS

PA 2457, Civil Rights Information Notice

Release Date
10/24/2024

Section Heading

Purpose

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

What changed?

The following revisions were made to the PA 2457, Civil Rights Information Notice:

  1. Updated contact information for requesting a State Hearing.
  2. Updated contact information for Federal Agencies. 

Policy

The PA 2457 is an informational brochure that explains to Department of Public Social Services (DPSS) customers their civil rights and provides information on how to file a civil rights complaint.  The reverse side of the form provides instructions for filing a State Hearing via the DPSS Appeals and State Hearing (ASH) Section. 

Impact

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

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, provide the customer with the English version, along with the GEN 1365, Notice of Language Services and verbally translate the form in the customer’s preferred language using a free telephone language interpreter or by certified bilingual staff without undue delay.

Ordering Instructions

Order supplies from WLAMS via a PA 16, Supply Requisition.  An initial supply of the revised PA 2457 form 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 PA 2457 includes the complaint and appeal information provided in the PUB 13, Your Rights Under California Public Benefits Programs brochure.  Additionally, the PA 2457 includes ASH and Civil Rights Section contact information.   The California Department of Social Services released ACL 23-98, Changes to Civil Rights Appeal Language, to provide updated discrimination complaint appeals rights information.

Definitions

N/A

Requirements

The PA 2457 must be provided to all customers in the appropriate language at intake and renewal.  In addition, the PA 2457 must be displayed in all public facing DPSS and contract agency reception areas in all DPSS threshold languages. 

Verification Docs

N/A

Attachments

N/A

Index

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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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