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All inquiries concerning the City’s efforts to make its programs and services accessible to persons with disabilities should be directed to the:</p><p>Department on Disability, ADA Compliance Officer<br>Disability Access and Services Division<br>201 North Figueroa Street, Suite 100<br>Los Angeles, CA 90012</p><p>(213) 202-2764 (Voice), (213) 202-3452 TTY, and (213) 202-2715 Fax.</p><h2><strong><u>PROCEDURE RELATED TO TITLE II</u></strong></h2><p>When any person believes that the City of Los Angeles has violated Title II of the ADA by denying access to its programs, services, and activities based on a disability, a formal grievance may be filed with the Department on Disability.</p><p><span class="mark">NOTE: This grievance procedure is for reporting allegations that the City of Los Angeles government has violated Title II of the ADA. It is not for reporting complaints against private landlords, private businesses, other government agencies, or other non-City entities, and such requests will not be processed.</span></p><h3>Step 1: Complaint</h3><ul><li>The grievance should be documented on an ADA Title II Grievance Form and should contain as much information as possible concerning the alleged violation. This form must be completed by the grievant or his/her authorized representative.  The grievance should be submitted as soon as possible, but no later than sixty (60) calendar days after the alleged violation.  Constituents who choose not to use the Form, but contact DOD and state that they would like to file a Title II Grievance, shall have their relevant information written down by DOD staff. Strict confidentiality of all information provided will be maintained to the extent permitted by law. Sharing of information, including identity, will be done only as needed to resolve the grievance.</li><li>Constituents who contact DOD and raise concerns that the City may be able to resolve through its Title II grievance process will, among other options for resolution, be notified of the grievance process and asked if they would like to file a grievance. If the answer is yes, then DOD staff shall either write down all relevant information, or direct constituents to the Grievance Form and procedures. Any information written down by DOD staff in response to a constituent’s grievance shall be processed in the same manner as a completed Grievance Form.</li></ul><h3>Step 2: Investigation</h3><ul><li>DASD will review the completed ADA Title II Grievance within fifteen (15) working days of receipt. If it appears that a complete investigation and determination cannot be completed within 15 working days of receipt of the complaint, a Notice of Continuing Investigation (NCI) (Attachment C) will be mailed to the grievant within fifteen (15) working days. Staff will then discuss the issues with the grievant and the concerned department(s). If appropriate, the ADA Compliance Officer or assigned ADA Coordinator may also arrange to meet with the grievant to discuss the matter and possible resolution. Next, if the investigation leads to a determination that a Title II violation did occur or may have occurred, it will offer a proposed resolution to the grievant.  An investigation may find that no Title II violation occurred.</li><li>Auxiliary Aids or Services and other reasonable accommodations will be made available upon request. If at any time (in Step 1 or Step 2) DOD staff determine that the Complaint is not within DOD’s jurisdiction, staff will inform complainant of that determination, and provide appropriate referrals as available for the effective resolution of the complaint.</li></ul><h3>Step 3: Notice of Outcome</h3><ul><li>Within ninety (90) days of the date on which the NCI is sent, or at the conclusion of the formal resolution process (whichever comes first), the DASD Coordinator will send the grievant and the concerned department(s) a notice of outcome along with a description of the appeals process, should the grievant wish to appeal, in a format accessible to the grievant.</li></ul><h3>Step 4: Appeal of Outcome</h3><ul><li>If the City’s response does not satisfactorily resolve the matter, the grievant and/or authorized representative may appeal the notice of outcome of the ADA Compliance Officer within thirty days of receipt of the notice of outcome.</li><li>Within thirty days of receipt of the grievant’s appeal, the ADA Grievance Appeals Committee (ADAGAC) will convene a meeting to discuss the matter and its response to the appeal. In addition to the DOD’s Executive Director, the Committee will consist of a member of the City Commission on Disability and a representative from another City department. Within thirty (30) calendar days after this meeting, the Chairperson of the Committee will respond in writing and, where appropriate, in a format accessible to the grievant. If the grievant is dissatisfied with the response of the ADA Grievance Appeals Committee, he/she may contact either the U.S. Department of Justice (DOJ), or seek private counsel.</li></ul><h2><strong><u>RETALIATION</u></strong></h2><p>Individuals who exercise their rights under the ADA, or assist others in exercising their rights, are protected from retaliation. Any form of retaliation or coercion, including threats, intimidation, or interference, is prohibited if it interferes with the exercise of rights under the ADA.</p><h2><strong><u>FILE MAINTENANCE</u></strong></h2><p>The DOD will maintain all written grievances received by DOD-DASD, appeals to the ADA Grievance Appeals Committee, and responses from DOD-DASD and the ADA Grievance Appeals Committee for a period of three (3) years.</p><h2><strong><u>POSTING</u></strong></h2><p>This Grievance Procedure will be posted in prominent locations in major City facilities. Upon request, it will be made available in alternative formats by contacting the Department on Disability, Disability Access and Services, 201 N. Figueroa Street, Suite 100, Los Angeles, CA 90012. Tel.: (213) 202-2764 (Voice) or (213) 202-2755 TTY.</p><hr></div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--rich-text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-content field--type-text-long field--label-hidden field__item"><h2>ADA Title II Grievance Form</h2><p><strong>Instructions: </strong>Please fill out as much of this form as you can in black ink or type. If you need assistance, tell us and we would be happy to provide assistance with filling out this form. Sign and return (mail, fax or e-mail) to the following information listed below.</p><p><strong>Department on Disability</strong><br>Disability Access and Services ADA Compliance Officer<br>201 North Figueroa Street, Suite 100<br>Los Angeles, CA 90012<br>Phone: (213) 202-2764<br>Fax: (213) 202-2715<br>E-mail: <a href="mailto:DOD-ADA@lacity.org?subject=Form%20from%20Title%20II%20Grievance%20Policy%20and%20Procedure%20Web%20Page" target="_blank">DOD.ADA@lacity.org</a></p></div> </div> </div> </div> </div> </article> </div> </div> <div id="block-webform-2" class="settings-tray-editable block block-webform block-webform-block" data-drupal-settingstray="editable"> <div class="content"> <form class="webform-submission-form webform-submission-add-form webform-submission-ada-title-ii-grievance-form webform-submission-ada-title-ii-grievance-add-form webform-submission-ada-title-ii-grievance-node-31-form webform-submission-ada-title-ii-grievance-node-31-add-form js-webform-details-toggle webform-details-toggle antibot" data-drupal-selector="webform-submission-ada-title-ii-grievance-node-31-add-form" data-action="/procedures-forms/americans-disabilities-act-title-ii-grievance-policy-and-procedure" action="/antibot" method="post" id="webform-submission-ada-title-ii-grievance-node-31-add-form" accept-charset="UTF-8"> <noscript> <div class="antibot-no-js antibot-message antibot-message-warning">You must have JavaScript enabled to use this form.</div> </noscript> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-grievance form-item-name-grievance mb-3"> <label for="edit-name-grievance" class="js-form-required form-required">Name</label> <input data-webform-required-error="Missing name" data-drupal-selector="edit-name-grievance" type="text" id="edit-name-grievance" name="name_grievance" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-address form-item-address mb-3"> <label for="edit-address" class="js-form-required form-required">Address</label> <input data-webform-required-error="Missing address" data-drupal-selector="edit-address" type="text" id="edit-address" name="address" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-city form-item-city mb-3"> <label for="edit-city" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-city" type="text" id="edit-city" name="city" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-state form-item-state mb-3"> <label for="edit-state" class="js-form-required form-required">State</label> <input data-webform-required-error="Missing state" data-drupal-selector="edit-state" type="text" id="edit-state" name="state" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-zip-code form-item-zip-code mb-3"> <label for="edit-zip-code" class="js-form-required form-required">ZIP Code</label> <input data-webform-required-error="Missing ZIP code" data-inputmask-mask="99999[-9999]" class="js-webform-input-mask required form-control" pattern="^\d\d\d\d\d(-\d\d\d\d)?$" data-drupal-selector="edit-zip-code" type="text" id="edit-zip-code" name="zip_code" value="" size="60" maxlength="255" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-telephone-home form-item-telephone-home mb-3"> <label for="edit-telephone-home">Telephone (Home)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-telephone-home" type="text" id="edit-telephone-home" name="telephone_home" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-telephone-business form-item-telephone-business mb-3"> <label for="edit-telephone-business">Telephone (Business)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-telephone-business" type="text" id="edit-telephone-business" name="telephone_business" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-telephone-mobile form-item-telephone-mobile mb-3"> <label for="edit-telephone-mobile">Telephone (Mobile)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-telephone-mobile" type="text" id="edit-telephone-mobile" name="telephone_mobile" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-email form-item-email mb-3"> <label for="edit-email">Email Address</label> <input data-inputmask="'alias': 'email'" class="js-webform-input-mask form-control" data-drupal-selector="edit-email" aria-describedby="edit-email--description" type="text" id="edit-email" name="email" value="" size="60" maxlength="255" /> <small class="description text-muted"> <div id="edit-email--description" class="webform-element-description">E-Mail Address or Telephone Number is required.</div> </small> </div> <label class="pt-4 h4" data-drupal-selector="edit-a-label" aria-describedby="edit-a-label--description" for="edit-a-label">Person alleging grievance or complaint</label> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-name form-item-a-name mb-3"> <label for="edit-a-name">Name</label> <input data-drupal-selector="edit-a-name" type="text" id="edit-a-name" name="a_name" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-address form-item-a-address mb-3"> <label for="edit-a-address">Address</label> <input data-drupal-selector="edit-a-address" type="text" id="edit-a-address" name="a_address" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-city form-item-a-city mb-3"> <label for="edit-a-city">City</label> <input data-drupal-selector="edit-a-city" type="text" id="edit-a-city" name="a_city" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-state form-item-a-state mb-3"> <label for="edit-a-state">State</label> <input data-drupal-selector="edit-a-state" type="text" id="edit-a-state" name="a_state" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-zip-code form-item-a-zip-code mb-3"> <label for="edit-a-zip-code">ZIP Code</label> <input data-inputmask-mask="99999[-9999]" class="js-webform-input-mask form-control" pattern="^\d\d\d\d\d(-\d\d\d\d)?$" data-drupal-selector="edit-a-zip-code" type="text" id="edit-a-zip-code" name="a_zip_code" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-telephone-home form-item-a-telephone-home mb-3"> <label for="edit-a-telephone-home">Telephone (Home)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-a-telephone-home" type="text" id="edit-a-telephone-home" name="a_telephone_home" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-telephone-business form-item-a-telephone-business mb-3"> <label for="edit-a-telephone-business">Telephone (Business)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-a-telephone-business" type="text" id="edit-a-telephone-business" name="a_telephone_business" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-a-telephone-mobile form-item-a-telephone-mobile mb-3"> <label for="edit-a-telephone-mobile">Telephone (Mobile)</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-a-telephone-mobile" type="text" id="edit-a-telephone-mobile" name="a_telephone_mobile" value="" size="60" maxlength="255" /> </div> <fieldset data-drupal-selector="edit-complaint-to" class="webform-has-field-prefix checkboxes--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-checkboxes webform-type-checkboxes js-form-item form-item js-form-wrapper form-wrapper mb-3" id="edit-complaint-to--wrapper"> <legend style="display:none"> <span class="fieldset-legend"></span> </legend> <div class="fieldset-wrapper"> <span class="field-prefix"><div class="description"><h3>Complaint</h3><p>Access issues generally fall into one of three categories, please indicate which category best describes your issue.</p></div></span> <div id="edit-complaint-to" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-complaint-to-paa form-item-complaint-to-paa"> <input data-drupal-selector="edit-complaint-to-paa" aria-describedby="edit-complaint-to-paa--description" type="checkbox" id="edit-complaint-to-paa" name="complaint_to[PAA]" value="PAA" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-complaint-to-paa"> Physical/Architectural Access </label> <small class="description text-muted"> <div id="edit-complaint-to-paa--description" class="webform-element-description">Physical/Architectural Access - Is the issue related to a physical barrier? For example, a wheelchair ramp is needed, counters are too high for wheelchair users, missing braille signage, etc.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-complaint-to-pa form-item-complaint-to-pa"> <input data-drupal-selector="edit-complaint-to-pa" aria-describedby="edit-complaint-to-pa--description" type="checkbox" id="edit-complaint-to-pa" name="complaint_to[PA]" value="PA" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-complaint-to-pa"> Programmatic Access </label> <small class="description text-muted"> <div id="edit-complaint-to-pa--description" class="webform-element-description">Programmatic Access - Is the issue related to being able to participate in a program, service or activity? For example, is there a City policy, practice, and/or procedure that you allege does not provide an equally effective opportunity for persons with disabilities to participate in or benefit from the City’s programs and services.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-complaint-to-ca form-item-complaint-to-ca"> <input data-drupal-selector="edit-complaint-to-ca" aria-describedby="edit-complaint-to-ca--description" type="checkbox" id="edit-complaint-to-ca" name="complaint_to[CA]" value="CA" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-complaint-to-ca"> Communication Access </label> <small class="description text-muted"> <div id="edit-complaint-to-ca--description" class="webform-element-description">Communication Access – Is the issue related to communication? For example do you need auxiliary aids and services, a sign language interpreter, Communication Access Real-Time Translation (CART), materials in alternative formats in order to have equal access to information and communication with a City Department’s programs, services or activities.</div> </small> </div> </div> </div> </fieldset> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-bureau form-item-c-bureau mb-3"> <label for="edit-c-bureau" class="js-form-required form-required">City Department, Bureau or Service</label> <input data-webform-required-error="Missing bureau/service" data-drupal-selector="edit-c-bureau" type="text" id="edit-c-bureau" name="c_bureau" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-address form-item-c-address mb-3"> <label for="edit-c-address" class="js-form-required form-required">Address</label> <input data-webform-required-error="Missing address" data-drupal-selector="edit-c-address" type="text" id="edit-c-address" name="c_address" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-city form-item-c-city mb-3"> <label for="edit-c-city" class="js-form-required form-required">City</label> <input data-webform-required-error="Missing city" data-drupal-selector="edit-c-city" type="text" id="edit-c-city" name="c_city" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-state form-item-c-state mb-3"> <label for="edit-c-state" class="js-form-required form-required">State</label> <input data-webform-required-error="Missing state" data-drupal-selector="edit-c-state" type="text" id="edit-c-state" name="c_state" value="" size="60" maxlength="255" class="required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-zip-code form-item-c-zip-code mb-3"> <label for="edit-c-zip-code" class="js-form-required form-required">ZIP Code</label> <input data-webform-required-error="Missing ZIP code" data-inputmask-mask="99999[-9999]" class="js-webform-input-mask required form-control" pattern="^\d\d\d\d\d(-\d\d\d\d)?$" data-drupal-selector="edit-c-zip-code" type="text" id="edit-c-zip-code" name="c_zip_code" value="" size="60" maxlength="255" required="required" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-c-telephone-number form-item-c-telephone-number mb-3"> <label for="edit-c-telephone-number" class="js-form-required form-required">Telephone Number</label> <input data-webform-required-error="Missing telephone number" data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask required form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-c-telephone-number" type="text" id="edit-c-telephone-number" name="c_telephone_number" value="" size="60" maxlength="255" required="required" /> </div> <div class="js-form-item js-form-type-date form-type-date js-form-item-c-date form-item-c-date mb-3"> <label for="edit-c-date" class="js-form-required form-required">When did the alleged violation occur?</label> <input data-webform-required-error="Missing date" type="date" data-drupal-selector="edit-c-date" id="edit-c-date" name="c_date" value="" class="form-date required form-control" required="required" /> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-c-describe form-item-c-describe mb-3"> <label for="edit-c-describe" class="js-form-required form-required">Describe the alleged act(s) of discrimination, providing name(s) where possible of the individuals who allegedly violated Title II.</label> <div class="form-textarea-wrapper"> <textarea data-webform-required-error="Missing Description" data-drupal-selector="edit-c-describe" id="edit-c-describe" name="c_describe" rows="5" cols="60" class="form-textarea required form-control resize-vertical" required="required"></textarea> </div> </div> <div class="js-form-item js-form-type-select form-type-select js-form-item-f-select form-item-f-select mb-3"> <label for="edit-f-select" class="js-form-required form-required">Has this complaint been filed with the Department of Justice or any other Federal, State, or local civil rights agency or court?</label> <select class="col-4 form-select required" data-webform-required-error="Missing selection of if have filed complaint " data-drupal-selector="edit-f-select" aria-describedby="edit-f-select--description" id="edit-f-select" name="f_select" required="required"><option value="" selected="selected">- Select -</option><option value="Y">Yes</option><option value="N">No</option></select> <small class="description text-muted"> <div id="edit-f-select--description" class="webform-element-description">If yes, please complete the following information below.</div> </small> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-name form-item-f-name mb-3"> <label for="edit-f-name">Name of Agency or Court</label> <input data-drupal-selector="edit-f-name" type="text" id="edit-f-name" name="f_name" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-contact form-item-f-contact mb-3"> <label for="edit-f-contact">Contact Person</label> <input data-drupal-selector="edit-f-contact" type="text" id="edit-f-contact" name="f_contact" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-address form-item-f-address mb-3"> <label for="edit-f-address">Address</label> <input data-drupal-selector="edit-f-address" type="text" id="edit-f-address" name="f_address" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-city form-item-f-city mb-3"> <label for="edit-f-city">City</label> <input data-drupal-selector="edit-f-city" type="text" id="edit-f-city" name="f_city" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-state form-item-f-state mb-3"> <label for="edit-f-state">State</label> <input data-drupal-selector="edit-f-state" type="text" id="edit-f-state" name="f_state" value="" size="60" maxlength="255" class="form-control" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-zip-code form-item-f-zip-code mb-3"> <label for="edit-f-zip-code">ZIP Code</label> <input data-inputmask-mask="99999[-9999]" class="js-webform-input-mask form-control" pattern="^\d\d\d\d\d(-\d\d\d\d)?$" data-drupal-selector="edit-f-zip-code" type="text" id="edit-f-zip-code" name="f_zip_code" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-telephone-number form-item-f-telephone-number mb-3"> <label for="edit-f-telephone-number">Telephone Number</label> <input data-inputmask-mask="(999) 999-9999" class="js-webform-input-mask form-control" pattern="^$\d\d\d$ \d\d\d-\d\d\d\d$" data-drupal-selector="edit-f-telephone-number" type="text" id="edit-f-telephone-number" name="f_telephone_number" value="" size="60" maxlength="255" /> </div> <div class="js-form-item js-form-type-date form-type-date js-form-item-f-date form-item-f-date mb-3"> <label for="edit-f-date">Date Filed</label> <input type="date" data-drupal-selector="edit-f-date" id="edit-f-date" name="f_date" value="" class="form-date form-control" /> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-f-describe form-item-f-describe mb-3"> <label for="edit-f-describe">Additional space for description of alleged act of violation</label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-f-describe" aria-describedby="edit-f-describe--description" id="edit-f-describe" name="f_describe" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> <small class="description text-muted"> <div id="edit-f-describe--description" class="webform-element-description">Strict confidentiality of all complaint information will be maintained. Sharing of information will be done only as needed to resolve the complaint.</div> </small> </div> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-f-signature form-item-f-signature mb-3"> <label for="edit-f-signature">Signature</label> <input data-drupal-selector="edit-f-signature" aria-describedby="edit-f-signature--description" type="text" id="edit-f-signature" name="f_signature" value="" size="60" maxlength="255" class="form-control" /> <small class="description text-muted"> <div id="edit-f-signature--description" class="webform-element-description">Please sign the ADA Title II Grievance Form with your name. By signing this document, you are verifying that the content you are submitting is correct.<br> </div> </small> </div> <div class="js-form-item js-form-type-date form-type-date js-form-item-signature-date form-item-signature-date mb-3"> <label for="edit-signature-date">Signature Date</label> <input class="col-5 form-date form-control" type="date" data-drupal-selector="edit-signature-date" id="edit-signature-date" name="signature_date" value="2024-11-27" /> </div> <fieldset data-drupal-selector="edit-captcha" class="captcha captcha-type-challenge--recaptcha"> <legend class="captcha__title js-form-required form-required"> CAPTCHA </legend> <div class="captcha__element"> <input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="125226" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="mlh1UaTysyqJJucsAFbpmZc2KigO3S1-zx3wNUAOxqA" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LenPzwgAAAAAGfmXP_ANeXMw1zQtqtrGSestCl8" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> </fieldset> <div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper mb-3" id="edit-actions"><button class="webform-button--submit col-3 border-0 button button--primary js-form-submit form-submit btn btn-primary" data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Submit">Submit</button> </div> <input data-drupal-selector="edit-antibot-key" type="hidden" name="antibot_key" value="" class="form-control" /> <input data-drupal-selector="form-v12elqhxaysev-qryj73tkjwv5t9id3ledswosoagik" type="hidden" name="form_build_id" value="form-v12elQHxaySEV-QrYJ73tkJwV5t9ID3lEdSwoSOAgik" class="form-control" /> <input data-drupal-selector="edit-webform-submission-ada-title-ii-grievance-node-31-add-form" type="hidden" name="form_id" value="webform_submission_ada_title_ii_grievance_node_31_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </section> </main> </div> </div> </div> <footer class="site-footer"> <div class="container"> <div class="row site-footer__top clearfix"> <section class="col-12 col-md-6 col-lg-5 region-footer-first"> <div id="block-disability20-departmentofdisability" class="settings-tray-editable block-content-basic block block-block-content block-block-content77509a8c-aebd-4d25-b823-37e19605e115" data-drupal-settingstray="editable"> <div class="content"> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p class="mt-0"><span class="h4">Accommodation Information </span></p><p>If you are a person with a disability and require an accommodation to participate in an L.A. 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