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USDA
Position 5
FORM APPROVED
Form RD 400-8
OMB No. 0575-0018
(Rev. 8-00)
DATE OF REVIEW
STATE
COMPLIANCE REVIEW
COUNTY
(Nondiscrimination by Recipients
of Financial Assistance through
U. S. Department of Agriculture)
SOURCE OF FUNDS
Direct
CASE NUMBER
DATE LOAN OR GRANT CLOSED
Insured
TYPE OF ASSISTANCE
Housing Preservation Grant
Water and Waste Disposal Loan or Grant
RBEG
RBOG
Grazing Association
EO Cooperative
Community Facilities
B&I Loans
RRH and LH Organization
Intermediary Relending 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
LAST REVIEW
No.
%
No.
%
Hispanic or Latino
0%
0%
0%
Not Hispanic or
Latino
0%
0%
0%
0%
0%
TOTAL
100%
MALE
0%
0%
0%
FEMALE
0%
0%
0%
According to the paperwork Reduction Act of 1995, no persons are 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. 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.
2
A(2).
POPULATION
PARTICIPANTS
THIS REVIEW
RACE
No.
%
American Indian/
Alaskan Native
No.
%
LAST REVIEW
No.
%
0%
0%
0%
0%
0%
0%
Black or African
American
0%
0%
0%
Native Hawaiian
0%
0%
0%
White
0%
0%
0%
Asian
TOTAL
100%
100%
100%
Male
0%
0%
0%
Female
0%
0%
0%
A (3).
BOARD OF
DIRECTORS
EMPLOYEES
MALE
ETHNICITY
No.
%
No.
FEMALE
%
No.
MALE
%
ETHNICITY
No.
%
No.
FEMALE
%
No.
%
Hispanic or
Latino
0%
0%
0%
Hispanic or
Latino
0%
0%
0%
Not Hispanic
or Latino
0%
0%
0%
Not Hispanic
or Latino
0%
0%
0%
TOTAL
0%
0%
0%
TOTAL
0%
0%
0%
3
A (3). cont.
BOARD OF
DIRECTORS
EMPLOYEES
MALE
RACE
No.
%
No.
FEMALE
%
No.
MALE
%
RACE
American
Indian/Alaskan
Native
0%
0%
0%
Asian
0%
0%
0%
Black or
African
American
0%
0%
No.
%
American
Indian/Alaskan
Native
Asian
Black or
African
American
0%
No.
FEMALE
%
%
No.
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Native
Hawaiian
0%
0%
0%
Native
Hawaiian
White
0%
0%
0%
White
0%
0%
0%
TOTAL
0%
0%
0%
TOTAL
0%
0%
0%
II. APPLICATION INFORMATION (Project, Facility, Complex or Lender)
B(1).
Number of
Application Received
This Review
Last Review
ETHNICITY
No.
%
No.
Number of
Applications Approved
%
No.
%
Number of
Applications Rejected
No.
%
Hispanic or
Latino
0%
0%
Not Hispanic or
Latino
0%
0%
TOTAL
0%
0%
0%
0%
Male
0%
0%
0%
0%
Female
0%
0%
0%
0%
Family
0%
0%
0%
0%
TOTAL
0%
0%
0%
0%
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Number of
B (1.)
Number of
Application Received
This Review
RACE
No
Last Review
%
Applications Approved
%
No.
No.
%
Number of
Applications Rejected
%
No.
American Indian/
Alaskan Native
0%
0%
Asian
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Male
0%
0%
0%
0%
Female
0%
0%
0%
0%
Family
0%
0%
0%
0%
Black or African
American
Native Hawaiian
White
TOTAL
TOTAL
0%
0%
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
YES
NO
Date of last review:
C. Are all interested individuals permitted to file an application (written or otherwise) for participation?
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
YES
list of applicants wishing to become participants?
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
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 or rejected since last review:
From minority group applicants
Total
5
G. Number of applications now pending on which no action has been taken:
From minority group applicants..
Total
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
origin, age, sex, or disability?
YES
NO
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
YES NO
than others?
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,
Yes
NO
and/or accessibility logo or Equal Opportunity statement?
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.
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.
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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?
If ''YES,'' specify:
Are these reasons stipulated in the Lease Agreements?
YES
NO
YES
NO
YES
NO
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?
If not, is this part of the self-evaluation and transition plan?
YES
NO
YES
NO
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
YES
1982?
NO
YES
NO
B. Are the units occupied by persons with disabilities in need of the special design features?
C. If not, indicate what outreach has been conducted utilizing appropriate organizations and advertising to reach the individuals in
need of such units.
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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?
(Aids, Hepatitis)
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
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
A. Is there evidence that individuals in a protected class are required to meet different employment selection criteria than nonminorities?
YES
NO
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
NO
the Rehabilitation Act of 1973?
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)
YES
years?
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,
YES
describe and attach copies of the law suit.
NO
D. Did the recipient take appropriate corrective or remedial action to achieve compliance with civil laws or to resolve any
YES
discrimination complaint cases or law suits?
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 Not complying with the requirements under Title VI of the
Officials it is my opinion that the Recipient
Is
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 | 2007-09-20 |
| File Created | 2007-09-19 |