Disability Access (ADA)
Request/Complaint Form Draft4 12.01.21 CB
The County of Sacramento does not discriminate on the basis
of disability in access to, or in the administration of, its programs, services,
and activities for the public, in compliance with the Americans with
Disabilities Act (ADA) and other federal and state laws and regulations.
Sacramento County has adopted procedures to ensure the prompt and equitable
resolution of disability access barriers and complaints.
Members
of the public may use this form to report a disability access barrier in a
Sacramento County Government facility or service, or to request a reasonable
accommodation or modification to participate in a Sacramento County program or
service.
PLEASE
NOTE - This process is for Sacramento County Government offices, facilities and
services only and does not address disability access barriers in private
businesses (restaurants, retail establishments, housing, etc.). Contact the CA
Department of Fair Employment and Housing (DFEH) for more information and
assistance – (800) 884-1684 (TTY 711) or visit their website at www.dfeh.ca.gov. For assistance with access barriers in
multi-family or rental housing, call the Sacramento County Renter’s Helpline,
(916) 389-7877 or online at www.rentershelpline.org
Answer the questions below as completely as
possible. If you need assistance, contact the Disability Compliance Office
(DCO) at 916 874-7642 (CA Relay 711) or email dco@saccounty.net. The DCO responds promptly to all requests, usually within one business
day.
Your Contact Information (If you do not provide contact information, we won’t be able to follow up
with you to verify issues or get additional information)
Name
Email
Address
Phone
Please
describe the access issue you encountered with Sacramento County Government
using the categories below.
Architectural
Access – Refers to Sacramento County Government buildings and
facilities, including parks and parking lots; features such as wheelchair
ramps, restrooms, doors, counter heights, etc. (Does not apply to
non-government facilities such as restaurants, retail establishments, housing,
etc.).
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Transportation
Access – Refers to sidewalks adjacent to the street, curb ramps,
bus stops, pedestrian crossings and traffic signals in unincorporated Sacramento
County. (Please note that certain requests, such as for new curb ramps and new
sidewalks may take several years in order to secure budgeting for necessary
design and construction.) Please provide specific location(s) of access barrier(s).
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Program
Access – Refers to receiving benefits from or participating in
Sacramento County programs, services and activities, and includes the right to
request Reasonable Modification to County policies, practices or procedures in
order to address an access barrier.
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Communication
Access – Refers to receiving qualified sign language
interpreters, accessible document formats, and other auxiliary aids and
services to ensure equal access to information from Sacramento County.
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Employment
Access – Refers to participating in Sacramento County job
applications, employment exams, job interviews and other hiring processes. Job
applicants may request accommodations for County employment exams using the Exam
Accommodation Request Form (link)
Current County employees should use the Reasonable
Accommodation for Employees (link) to request job accommodations, or the Discrimination
Complaint Form (link) to report allegations of disability discrimination.
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Date
of most recent issue
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Location
of most recent issue
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Sacramento
County Department or service involved, if known
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Names/Positions
of staff involved, if known
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Was there
anyone else who had the same issue, or someone else you would like us to talk
to for more information? Please provide name, involvement and contact
information.
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What
are you requesting to resolve this issue? Please be specific.
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Certification/E-signature
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Draft4 12.01.21 CB