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Form RD 400-8
(Rev. 06-10)
Position 5
DATE OF REVIEW
STATE
COMPLIANCE REVIEW
COUNTY
(Nondiscrimination by Recipients
of Financial Assistance through
U. S. Department of Agriculture)
SOURCE OF FUNDS
Direct
1
FORM APPROVED
OMB No. 0575-0018
OMB No. 0570-0062
Exp. Date: MM/DD/YY
CASE NUMBER
DATE LOAN OR GRANT CLOSED
Insured
Water and Waste Disposal Loan or Grant
Grazing Association
EO Cooperative
Community Facilities
RMAP
TYPE OF ASSISTANCE
Housing Preservation Grant
RBEG
RBOG
B&I Loans
RRH and LH Organization
Intermediary Re-lending Program
Rural Housing Site Loans
Cooperative Service
Other
NAME OF BORROWER ORGANIZATION OR ASSOCIATION
ADDRESS OF BORROWER
I. STATISTICAL INFORMATION
(For the purpose of this report, the term ''PARTICIPANTS'' will be used to describe ''USER,'' "MEMBERS," OCCUPANTS,"
''SITE PURCHASER'' OR Potential Users for pre-loan closing compliance reviews, as applicable.)
A(l).
POPULATION
ETHNICITY
No.
%
PARTICIPANTS
THIS REVIEW
No.
%
LAST REVIEW
No.
%
Hispanic or Latino
Not Hispanic or
Latino
TOTAL
100%
MALE
FEMALE
According to the paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0575-0018 and 0570-0062. The
time required to complete this information collection is estimated to average 8 hours per response, including the time for reviewing instruction, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this
collection of information is voluntary. However, in order to obtain or retain a benefit, the information in this form is required under 7 CFR 1901 Civil
Rights Compliance Requirements, Section 6022 of the Food, Conservation, and Energy Act of 2008 (2008 Farm Bill).
Rural Development has no plans to publish information collected under the provisions of this program. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Rural
Development Innovation Center, Regulations Management Division at ICRMTRequests@usda.gov
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A(2).
POPULATION
RACE
No.
PARTICIPANTS
THIS REVIEW
LAST REVIEW
%
No.
%
No.
%
American Indian/
Alaskan Native
Asian
Black or African
American
Native Hawaiian
or Other Pacific
Islander
White
100%
TOTAL
100%
100%
Male
Female
A (3).
EMPLOYEES
ETHNICITY
No.
%
MALE
No.
%
BOARD OF
DIRECTORS
FEMALE
No.
%
ETHNICITY
Hispanic or
Latino
Hispanic or
Latino
Not Hispanic or
Latino
Not Hispanic or
Latino
TOTAL
TOTAL
No.
%
MALE
No.
FEMALE
%
No.
%
3
A (3). cont.
EMPLOYEES
RACE
No.
%
FEMALE
MALE
No.
BOARD OF
DIRECTORS
%
No.
%
RACE
No.
American Indian/
Alaskan Native
American Indian/
Alaskan Native
Asian
Asian
Black or African
American
Black or African
American
Native Hawaiian
or Other Pacific
Islander
Native Hawaiian
or Other Pacific
Islander
White
White
TOTAL
TOTAL
%
MALE
No.
%
FEMALE
No.
II. APPLICATION INFORMATION (Project, Facility, Complex or Lender)
Number of
Applications Received
B(1).
This Review
ETHNICITY
Hispanic or Latino
Not Hispanic or
Latino
TOTAL
Male
TOTAL
Female
No.
%
Last Review
No.
%
Number of
Applications Approved
No.
%
No. of
Number of
Applications Rejected Applications Withdrawn
No.
%
No.
%
%
B (1.) cont.
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Number of
Applications Received
This Review
RACE
No.
%
Number of
Last Review Applications Approved
No.
%
No.
%
Number of
Number of
Applications Rejected Applications Withdrawn
No.
%
No.
%
American Indian/
Alaskan Native
Asian
Black or African
American
Native Hawaiian
or Other Pacific
Islander
White
TOTAL
Male
TOTAL
Female
A. Are racial and gender of the participants and the number of employees in proportion to the population percentages?
...............................................................................................................................................................
B. Number of participants as of last review:
YES
NO
Date of last review:
C. Are all interested individuals permitted to file an application (written or otherwise) for participation?
YES
NO
If ''NO'' explain why not:
D. Does or will recipient of financial assistance maintain adequate records on the receipt and disposition of applications, including a
NO
list of applicants wishing to become participants?....................................................................................... YES
If ''NO'' what action is being taken to establish adequate records:
If ''YES'' number of applicants wishing to become participants on list ...............................................................
Number on list from minority group ...................................................................................................................
The list of the applicants will include ethnicity, race, and gender of potential applicants.
E. Number of applications received from prospective participants since last review: Total ..................................
If zero skip to III.
From minority group applicants ...............................................................................................................
F. Number of applications which have been withdrawn since last review:
Number of applications which have been rejected since last review:
Total .........
Total .........
From minority group applicants ...........................................................................................................................
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G. Number of applications now pending on which no action has been taken:
Total .............
From minority group applicants. ..........................................................................................................................
III. LOCATION OF THE FACILITY
A. Does the location of the facility or complex have the effect of denying access to any person on the basis of race, color, national
NO
origin, age, sex, or disability?
................ YES
B. Describe the racial makeup of the area surrounding the facility (if area is not the same as population).
IV. USE OF SERVICES AND FACILITIES
A. Are all participants required to pay the same fees, assessments, and charges per unit for the use of the facilities?.......
YES
NO
YES
NO
If ''NO'', explain:
B. Explain how charges for services, i.e., rent, connection, and user fees are assessed.
C. Is the use of the services or the facilities restricted in any manner because of race, color, or national origin?..............
If ''YES'', explain:
D. Is there evidence that individuals, in a protected class, are provided different services, charged different or higher rate amounts
NO
than others? .............................................................................................................................................
YES
If ''YES'', explain:
E. List the methods used by the recipient to inform the community of the availability of services or benefits of the facility.
(newspaper, radio, tv, etc.).
F. Do these methods reach the minority group population equally with the rest of the community?...............................
YES
NO
YES
NO
G. Are appropriate Equal Opportunity posters conspicuously displayed? (And Justice For All and the Fair Housing poster)
........................................................................................................................................................................
H. Do written materials, i.e., ads, pamphlets, brochures, handbooks and manuals, have a nondiscrimination statement, Fair Housing,
and/or accessibility logo or Equal Opportunity statement? ................................................................................
NO
YES
I. Describe the efforts of the recipient to attract minorities, females, and persons with disabilities to serve on the advisory board,
board of directors, or similar boards.
J. Indicate whether the facility is being properly maintained and whether services are provided on a timely basis.
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K. Describe any restrictions that may exist on the use of the facility, i.e., no playgrounds for children; restrictions on use by
minorities, segregated or prohibited by age or disability of tenant or other participants.
L. If participation is restricted by age of beneficiary, please indicate any Federal statute, or state or local ordinance which may permit
such restrictions.
M. How does this facility compare-with other similar facilities in the area serving low income beneficiaries which are privately or
federally financed by other agencies.
Answer N for RRH and LH only:
N. Does the organization's Operating Rules provide for standard reasons for eviction? ................................................
YES
NO
YES
NO
YES
NO
If ''YES,'' specify:
Are these reasons stipulated in the Lease Agreements? ..........................................................................................
If not, how are they made known to participants?
V. ACCESSIBILITY REQUIREMENTS (DISABILITY)
(For All Programs Funded By Rural Development)
A. Does the facility or project have an accessible route through common use areas?
B. Has a self-evaluation for Section 504 of the Rehabilitation Act been conducted and a transition plan developed for all structural
barriers?
................ YES NO
C. Does this facility or project have a Telecommunication Device for the Deaf (TDD) or participate in a relay service?
....................................
YES
NO
.........
YES
NO
If not, is this part of the self-evaluation and transition plan?
D. Describe reasonable accommodations made by the recipient for making the program accessible to individuals with disabilities.
VI. ACCESSIBILITY REQUIREMENTS FOR RURAL RENTAL HOUSING
A. Does the complex meet the 5% accessibility requirement of 504 of the Rehabilitation Act of 1973 for facilities built after June
1982?
........................ YES NO
B. Are the units occupied by persons with disabilities in need of the special design features?
....................................
YES
C. If not, indicate what outreach has been conducted utilizing appropriate organizations and advertising to reach the individuals in
need of such units.
NO
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VII. ACCESSIBILITY REQUIREMENTS FOR COMMUNITY FACILITIES
(Health Care Facilities)
A. List methods used by health care providers to communicate with the hearing impaired in the emergency room.
B. List methods used to communicate waivers and consent to treatment requirements to persons with disabilities, including those with
impaired sensory or speaking skills.
C. Are there restrictions in delivery of services for the treatment of alcohol, drug addiction or other related illnesses?
............
YES
NO
A. Does the facility have an approved Affirmative Fair Housing Marketing Plan?
...........
YES
NO
B. Is there a copy of the most recently approved plan being used and conspicuously posted?
...........
YES
NO
C. Is management meeting the objectives of the plan?
...........
YES
NO
A. Is there evidence that individuals in a protected class are required to meet different employment selection criteria than nonminorities?
YES
.............
NO
(Aids, Hepatitis)
VIII. COMPLEXES AND FACILITIES THAT PROVIDE HOUSING
(Nursing Homes, Retirement Group, Rural Rental)
If not, is there an updated plan in place?
IX. PROGRAMS THAT CREATE EMPLOYMENT
B. Is there evidence that individuals of a protected class are being terminated in a disproportionate rate than non-minority employees?
........................................................
YES
NO
C. Do recipients that employ fifteen or more persons have a designated person to coordinate its efforts to comply with Section 504 of
the Rehabilitation Act of 1973?
NO
YES
............
D. Has the recipient provided reasonable accommodations to the known physical or mental impairment of employees with
disabilities?
......................... YES
NO
X. CONTACTS WITH INDIVIDUALS AFFILIATED WITH THE FACILITY OR COMPLEX
A. List contacts made with a diverse selection of tenants, users, patients, employees, and others affiliated with the facility or complex.
List by name, race, sex, and disability (if provided).
B. Summarize comments made by the person(s) contacted.
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XI. COMMUNITY CONTACTS
A. List contacts made with community leaders and organizations representing minorities, females, families with children, and
individuals with disabilities. Include the date and the method of contact.
B. Summarize comments made by person(s) contacted.
XII. PAST ASSISTANCE FROM RD OR OTHER FEDERAL AGENCY
A. List past loans or other federal financial assistance from other agencies.
B. Does the recipient have a pending application with RD or another Federal agency?
..................
YES
NO
..................
YES
NO
XIII. CIVIL RIGHTS COMPLIANCE HISTORY
Provide a history of the following:
A. Compliance Review. Has this recipient had a finding of non-compliance by RD or
another federal agency?
B. Discrimination Complaints. Has a complaint of prohibited discrimination been filed against this recipient in the past three (3)
years?
.................. YES
NO
C. Law Suit. Has a law suit based on prohibited discrimination been filed against this recipient in the past three (3) years? If so,
describe and attach copies of the law suit.
.................. YES
NO
D. Did the recipient take appropriate corrective or remedial action to achieve compliance with civil laws or to resolve any
discrimination complaint cases or law suits?
.................. YES
NO
E. Identify the resources and or contacts used in verifying the recipient's past civil rights compliance history.
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XIV. CONCLUSIONS
A. Did your review of the records maintained by the association or organization disclose any evidence of discrimination on the
grounds of race, color, national origin, sex, age, or disability in the services or use of the facility? .......................... YES
If ''YES,'' describe in detail such discrimination:
NO
B. Did your contacts with community leaders, including minority leaders, disclose any evidence of discrimination as to race, color,
national origin, sex, age, or disability in the services or use of the facility? ............................................................ YES NO
C. Did your observation of this borrower's operations or proposed operations indicate any discrimination on the grounds of race,
color, national origin, sex, age, or disability in the services or use of the facility? ................................................... YES
If ''YES,'' describe in detail such discrimination:
D. Comments for other observations or conclusions:
Based upon my observation of this borrower's operation or proposed operation and the attitude of the Governing Body and
Is
Is Not complying with the requirements under Title VI of the
Officials it is my opinion that the Recipient
Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, Age Discrimination Act of 1975, and Title IX of the
Education Amendments Act of 1972.
COMPLIANCE REVIEW OFFICER
DATE
XV. RECIPIENT IS IN NON-COMPLIANCE (Complete only if there is a finding of non-compliance)
A. Sent recipient notice of non-compliance on this date
.
B. Date of compliance meeting
.
C. Target date for recipient to voluntarily comply
.
D. Recipient has complied with all requirements and made all
necessary corrective action by this date
.
E. Describe all meetings with recipient to achieve compliance.
F. Recipient has refused to voluntarily comply by this date
G. Comments:
.
NO
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |