In accordance with Federal law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, disability, and reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, and American Sign Language) should contact the responsible State or local Agency that administers the program or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant's name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by mail:

U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410; or fax:

(833) 256-1665 or (202) 690-7442; or email:

Email Program Intake

This institution is an equal opportunity provider.

Conforme a la ley federal y las políticas y regulaciones de derechos civiles del Departamento de Agricultura de los Estados Unidos (USDA), esta institución tiene prohibido discriminar por motivos de raza, color, origen nacional, sexo (incluyendo identidad de género y orientación sexual), edad, discapacidad, venganza o represalia por actividades realizadas en el pasado relacionadas con los derechos civiles.

La información del programa puede estar disponible en otros idiomas además del inglés. Las personas con discapacidades que requieran medios de comunicación alternativos para obtener información sobre el programa (por ejemplo, Braille, letra agrandada, grabación de audio y lenguaje de señas americano) deben comunicarse con la agencia estatal o local responsable que administra el programa o con el TARGET Center del USDA al (202) 720-2600 (voz y TTY) o comunicarse con el USDA a través del Servicio Federal de Transmisión de Información al (800) 877-8339.

Para presentar una queja por discriminación en el programa, el reclamante debe completar un formulario AD-3027, Formulario de queja por discriminación del programa del USDA, que se puede obtener en línea, en cualquier oficina del USDA, llamando al (866) 632-9992, o escribiendo una carta dirigida al USDA. La carta debe contener el nombre, la dirección y el número de teléfono del reclamante, y una descripción escrita de la supuesta acción discriminatoria con suficiente detalle para informar al Subsecretario de Derechos Civiles (ASCR, por sus siglas en inglés) sobre la naturaleza y la fecha de la presunta violación de los derechos civiles. La carta o el formulario AD-3027 completado debe enviarse al USDA por medio de

correo postal:

U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410; ó fax:

(833) 256-1665 0 (202) 690-7442; 0

correo electrónico:

Email Program Intake

Esta institución ofrece igualdad de oportunidades.

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

MAIL

U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410

FAX

(833) 256-1665 or (202) 690-7442

EMAIL

Email Program Intake

This institution is an equal opportunity provider.
05/05/2022


NOTE: USDA does not require that the SFA include this statement on menus.
NOTE: The SFA is permitted to include the last sentence of this NDS in situations of limited space. "This institution is an equal opportunity provider" only with pre-approval from the State Agency.
NOTE: Spacing may not be altered. Font size may not be smaller than the smallest font on any document.

The sponsor (Director of Food Services) is responsible to inform the complainant that any person or representative alleging discrimination based on a prohibited basis has the right to file a complaint and must also provide and necessary information to the complainant in or to file the complaint.

The sponsor (Director of Food Services) receives a Civil Rights complaint from the complainant (i.e. parent).

a) The sponsor (Director of Food Services) must inform complainant of Federal Civil Rights rules and regulations that have been established for protected classes. (A protected class is any person or group of people who are protected from discrimination based on):

1. Race
2. Color
3. National Origin
4. Age
5. Sex
6. Disability

b) The sponsor (Director of Food Services) must provide complainant the necessary information to file a complaint, which is:

Mailing address of the USDA:

U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410

USDA’s Contact Information: 
Telephone: (866) 632-9992 or (202) 260-1026
Local or Federal relay: (800) 877-8339 
Spanish Relay: (800) 845-6136 
Fax: (833) 256-1665 or (202) 690-7442 
Email Program Intake

Electronic link to file a civil rights complaint

(How to File a Program Discrimination Complaint):
https://www.usda.gov/oascr/complaint-resolution 

Note: If the sponsor (Director of Food Services) is unsure if the complaint falls under a protected class, the sponsor (Director of Food Services) should provide complainant the federal complaint information.

c) After providing the complainant with the information on how to file a Civil Rights complaint directly at the Federal level, the sponsor (Director of Food Services) may attempt to resolve the complaint if it is a matter that can be resolved quickly. Resolving complaints in real-time at the lowest possible level is encouraged.  *Note: This is not an investigation as neither the sponsor (Director of Food Services) nor the State agency has the authority to conduct complaint investigations. This is simply trying to resolve the situation if it was potentially caused by a miscommunication.

If the complainant refuses to discuss the matter any further with the sponsor (Director of Food Services) or if the matter cannot be resolved quickly, then the sponsor (Director of Food Services) should:

1. Reiterate the complaint filing procedures in 1)b)

2. Document the complaint and actions taken (i.e. referral to Federal complaint procedures) in a Civil Rights complaint log that is separate from any other complaint log. Note: A separate Civil Rights complaint log is necessary due to confidentiality and privacy laws. See complaint log requirements in d) below.), and

3. Notify the State agency of the discussion. *Note: it is important for the sponsor to notify the State agency because regular communication between the sponsor and State agency is key to operating the program successfully.)
If the complainant is willing to try to resolve the issue with the sponsor and a satisfactory resolution is achieved, then the sponsor should still remind the complainant (using the information in 1)b)) of his/her right to file at the Federal level if necessary. *Note: Complainants retain the right to file at the Federal level even if a resolution seems to have been reached at the sponsor level. The sponsor needs to document the complaint and actions taken (i.e. how resolution was achieved) in a log that is separate from any other complaint log, and notify the State agency of the resolution.

d) Regardless if the complainant wishes to file at the Federal level, the sponsor (Director of Food Services)  should document as much information as possible in their Civil Rights complaint log including, but not limited to, the following:

Date Complaint Received
Complainant’s Name
Complainant’s Address
Complainant’s Telephone Number
Complainant’s Email Address
Allegation of Discrimination/Issue (i.e. FNS program involved, protected class(es) involved, etc.)
Date of Alleged Discriminatory Action

1. The sponsor (Director of Food Services) must forward the information, within 5 days of receipt of complaint from complainant, to the State agency (process depicted below):

State Agency Civil Rights Coordinator -  State Agency Director* -  FNS Regional Office Civil
Rights Contact -  FNS Headquarters Civil Rights Office -  Complainant

2. *State Agency level must forward complaint information, within 5 days of receipt of complaint from sponsor (Director of Food Services), to the FNS regional office.

3. FNS team conducts complaint review and investigation, which includes contact with the
complainant, State agency, sponsor, etc.

2) Additional Information:

a) Complainants must file within 180 days of the alleged action
b) Confidentiality is extremely important
c) USDA complaint form:
English version: http://www.ocio.usda.gov/sites/default/files/docs/2012/Complain_combined_6_8_12.pdf
Spanish version: http://www.ocio.usda.gov/sites/default/files/docs/2012/Spanish_Form_508_Compliant_6_8_1 2_0.pdf  

d) Email the State Agency Civil Rights Coordinator for all Civil Rights complaints, including disability related complaints: 

• Child and Adult Care Food Program: Email State Agency Civil Rights Coordinator

  • National School Lunch Program: Email State Agency Civil Rights Coordinator 

  • Summer Food Service Program: Email State Agency Civil Rights Coordinator

If you are unable to view the complaint form in the window below, please click here to download.