Code No. 710.1E1 

SCHOOL NUTRITION PROGRAM NOTICES OF NONDISCRIMINATION 

USDA Nondiscrimination Statement 

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 at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Compl…- 0002-508-11-28-17Fax2Mail.pdf, 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: 

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

2. fax: (833) 256-1665 or (202) 690-7442; or 

3. email: program.intake@usda.gov This institution is an equal opportunity provider

Iowa Nondiscrimination Statement 

It is the policy of this CNP provider not to discriminate on the basis of race, creed, color, sex, sexual orientation, gender identity, national origin, disability, age, or religion in its programs, activities, or employment practices as required by the Iowa Code section 216.6, 216.7, and 216.9. If you have questions or grievances related to compliance with this policy by this CNP Provider, please contact the Iowa Civil Rights Commission, Grimes State Office Building, 400 E 14th St, Des Moines, IA 50319- 1004; phone number 515-281-4121 or 800-457-4416; website: https://icrc.iowa.gov/
 

Adopted:  10/18/2022

Reviewed: 12/11/2023

Revised:    12/11/2023

Code No. 710.1E2

CHILD NUTRITION PROGRAMS CIVIL RIGHTS COMPLAINT FORM

Complaint Contact Information:
Name:
Street Address, City, State, Zip:
County: Area Code/Phone:
Email Address:
Complaint Information:
1. Specific name and location of the entity and individual delivering the service or benefit:
2. Describe the incident or action of the alleged discrimination or give an example of the situation that has a
discriminatory effect on the public, potential program participants, or current participants:
3. On what basis does the complainant feel discrimination exists (race, color, national origin, sex, age, disability,
creed, sexual orientation, religion, gender identity, political party affiliation, actual/potential
parental/family/marital status)?
4. List the names, titles, and business addresses of persons who may have knowledge of the alleged
discriminatory action:

5. List the date(s) during which the alleged discriminatory actions occurred, or if continuing, the duration of such
actions:
6. Date complaint received:
7. Person receiving complaint:
8. Action(s) taken:

USDA is the cognizant agency for the Child Nutrition Programs listed and therefore is the first contact for the six
protected classes of race, color, national origin, sex, age, and disability for complaints received within 180 days.
Civil rights complaints must be submitted to the USDA Office of Civil Rights within five calendar days of receipt
and no later than 180 days of the discriminatory act. The link for submission of a complaint is:
program.intake@usda.gov
In Iowa, protected classes also include sexual orientation, gender identity, religion or creed and complaints can be
filed up to 300 days of occurrence. The address for Iowa complaints is: Iowa Civil Rights Commission, Grimes
State Office building, 400 E. 14th St. Des Moines, IA 50319-1004; phone number 515-281-4121, 800-457-4416;
website: https://icrc.iowa.gov/.

This institution is an equal opportunity provider. 12/2021

Code No.  710.1R1

SCHOOL NUTRITION PROGRAM CIVIL RIGHTS COMPLAINTS PROCEDURE

USDA Child Nutrition Programs in Iowa
 

Procedures for Handling a Civil Rights Complaint 

1. Civil rights complaints related to the National School Lunch Program, School Breakfast Program, Afterschool Care Snack Program, Summer Food Service Program, Seamless Summer Option, or Child and Adult Care Food Program are written or verbal allegations of discrimination based on USDA protected classes of race, color, national origin, sex, age, and disability.

2. Any person claiming discrimination has a right to file a complaint within 180 days of the alleged discrimination. See below for additional Iowa Civil Rights information. A civil rights complaint based on the protected classes listed in #1 above must be forwarded to the address on the nondiscrimination statement.

3. All complaints, whether written or verbal, must be accepted by the School Food Authority (SFA)/Sponsor/Organization and forwarded to USDA at the address or link on the nondiscrimination statement within 5 calendar days of receipt. An anonymous complaint should be handled the same way as any other. Complaint forms may be developed, but their use cannot be required. If the complainant makes the allegations verbally or in a telephone conversation and is reluctant or refuses to put them in writing, the person who handles the complaint must document the description of the complaint.

4. There must be enough information to identify the agency or individual toward which the complaint is directed and indicate the possibility of a violation. Every effort should be made to obtain at least the following information:

   • Name, address and telephone number or other means of contacting the complainant;

   • The specific location and name of the organization delivering the program service or benefit;

   • The nature of the incident(s) or action(s) that led the complainant to feel there was discrimination;

   • The basis on which the complainant feels discrimination occurred (race, color, national origin, sex, age, or disability);

   • The names, titles, and addresses of people who may have knowledge of the discriminatory action(s); and

   • The date(s) when the alleged discriminatory action(s) occurred or, if continuing, the duration of such action(s).
     ​​​

5. USDA is the cognizant agency for the Child Nutrition Programs listed and therefore is the first contact for the six protected classes listed in #1 above, for complaints received within 180 days. Civil rights complaints must be submitted to the USDA Office of Civil Rights within five calendar days of receipt and no later than 180 days of the discriminatory act. The link for submission of a complaint is: program.intake@usda.gov

6. In Iowa, protected classes also include sexual orientation, gender identity, religion or creed and complaints can be filed up to 300 days of occurrence. The address for Iowa complaints is: Iowa Civil Rights Commission, Grimes State Office building, 400 E. 14th St. Des Moines, IA 50319- 1004; phone number 515-281-4121, 800-457-4416; website: https://icrc.iowa.gov/.

Bureau of Nutrition and Health, IDOE, 12/2021 
 

Legal Reference: 42 U.S.C. §§ 1751 

Iowa Code ch. 283A.

281 I.A.C. 58.

Adopted:  10/18/2022

Reviewed:

Revised: