Eligibility Intake Checklist - DeKalb County GA

Transcription

Eligibility Intake ChecklistName:Phone Number:Email:Requested ItemsInternalInternalInternalA copy of this checklistRegistration: Georgia Work Ready Online Participant Portal Registration Page – ault.aspx.Registration: WSD Online Application Confirmation/Thank You Page or Welcome Back PageConfirmation www.worksourcedekalb.orgResumeComplaints & Grievances FormEmployment Consent AgreementGeorgia Driver’s License or Georgia Identification Card (I-94 card if applicable)Social Security Card of everyone in householdProof of DeKalb County Residency (Lease/ Utility/ Mortgage Statement)Veterans Determination FormOnly Males born after January 1, 1960: Selective Service Verification www.sss.govProof of Military Status (DD214)Adult: Proof of Gross Combined Family Income for past six months and Composition Form(Pay Stubs/Wage Inquiry)Dislocated Worker: Proof of Gross Combined Income for past six months/ Separation Letter/Severance Letter/UI Determination Letter/Wage Inquiry)Participant AffidavitProof of Job Readiness Workshop AttendanceITA Enrollment AgreementProgram Ready Letter (ACCEPTANCE LETTER FROM ELIGIBLE TRAINING PROVIDER)https://www.workreadyga.orgFinancial Aid Verification (if applicable—all colleges) www.fafsa.ed.govTraining Interest QuestionnairePrint out of 3 Job Ads in Industry (Detailed job ads from the Internet in the desired field of training)Print Results from O’NET Interest Profiler www.mynextmove.org/explore/ipTABE ResultsIndividual Employment Plan(IEP)Supportive Service FormRevised July 11, 20181WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals withdisabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

Language Assistance/Babel NoticeIMPORTANT! This document contains important information about your rights, responsibilities and/or benefits. It is critical that you understandthe information in this document, and we will provide the information in your preferred language at no cost to you. Call WorkSource DeKalb at(404) 687-3400/www.worksourcedekalb.org for assistance in the translation and understanding of the information in this document.Spanish: ¡IMPORTANTE! Este documento contiene información importante sobre sus derechos, responsabilidades y/o beneficios. Es importanteque usted entienda la información en este documento. Nosotros le podemos ofrecer la información en el idioma de su preferencia sin costo algunopara usted. Llame al WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org para pedir asistencia en traducir y entender lainformación en este documento.Chinese – Traditional: �。請致電 WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org �。Vietnamese: LƯU Ý QUAN TRỌNG! Tài liệu này chứa thông tin quan trọng về quyền hạn, trách nhiệm và/hoặc quyền lợi của quý vị. Việc hiểu rõthông tin trong tài liệu này là rất quan trọng, và chúng tôi sẽ cung cấp miễn phí cho quý vị thông tin này bằng ngôn ngữ mà quý vị ưadùng. Hãy gọi WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org để được hỗ trợ về việc thông dịc h và hiểu thông tintrong tài liệunày.Tagalog: MAHALAGA! Naglalaman ang dokumentong ito ng mahalagang impormasyon tungkol sa iyong mga karapatan, responsibilidad at/obenepisyo. Napakahalaga na nauunawaan mo ang impormasyong nakapaloob sa dokumentong ito, at ibibigay namin nang libre ang impormasyonsa pinili mong wika. Tumawag sa WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org upang humingi ng tulong sa pagsasalingwika at pag-unawa sa impormasyong nasa dokumentong ito.French : IMPORTANT! Le présent document contient des informations importantes sur vos droits, vos responsabilités et/ou vos avantages. Il estessentiel que vous compreniez les informations figurant dans ce document, et nous vous fournirons gratuitement les informations dans la languede votre choix. Appelez au WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org pour obtenir de l'aide pour la traduction et lacompréhension des informations contenues dans le présent document.Haitian Creole: ENPÒTAN! Dokiman sa a gen enfòmasyon enpòtan ladan konsènan dwa, responsablite ak/oswa avantaj ou yo. Li ap vrèmanenpòtan pou ou konprann enfòmasyon yo ki nan dokiman sa a, epi n ap ba ou enfòmasyon sa yo nan lang ou prefere a gratis. Rele WorkSourceDeKalb at (404) 687-3400/www.worksourcedekalb.org pou jwenn asistans pou tradui ak pou konprann enfòmasyon ki nan dokiman sa a.Portuguese: IMPORTANTE! Este documento contém informações importantes sobre os seus direitos, responsabilidades e/ou benefícios. Éessencial que compreenda as informações constantes neste documento, as quais disponibilizaremos, gratuitamente, na língua à sua escolha.Contacte o número WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org para solicitar ajuda para traduzir e compreender asinformações contidas neste documento.Arabic وﺳﻨﻮﻓﺮ اﳌﻌﻠﻮﻣﺎ ت ﻚﺘﻐﻠﺑ اﳌﻔﻀﻠﺔ دون ، ﻦﻣ اﻷھﻤﯿﺔ مبﻜﺎ ن ﻢﮭﻓ اﳌﻌﻠﻮﻣﺎ ت اﻟﻮاردة ﻲﻓ ھﺬا اﳌﺴﺘﻨﺪ . أو ﻓﻮا ﺋﺪك / ﻢﮭﻣ! ﯾﺤﺘﻮي ھﺬا اﳌﺴﺘﻨﺪ ﻰﻠﻋ ﻣﻌﻠ ﻮ ﻣﺎ ت ﺔﻤﮭﻣ ﺣﻮل ﻚﻗﻮﻘﺣ وﻣﺴ ﺆوﻟﯿﺎﺗﻚ و ﻟﻠﺤﺼﻮل ﻋﲆ ﻣﺴﺎﻋﺪة ﰲ ﺗﺮﺟﻤﺔ اﳌﻌ ﻠﻮﻣﺎ ت اﻟﻮاردة ﰲ ھﺬا WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.org اﺗﺼﻞ ﻋﻠ ﻰ . ﺗﺤﻤﻠﻚ أي ﺗﻜﻠﻔﺔ اﳌﺴﺘﻨﺪ وﻓﮭ ﻤﮭﺎ . اﻟﺮﻗﻢ Russian: ВАЖНО! В настоящем документе содержится важная информация о ваших правах, обязанностях и/илипреимуществах. Крайне важно, чтобы вы поняли информацию, содержащуюся в данном документе, а мы бесплатно предоставим вамэту информацию на выбранном вами языке. Позвоните по телефону WorkSource DeKalb at (404) 687-3400/www.worksourcedekalb.orgдля получения помощи в переводе и понимании информации, содержащейся в данном документе. Korean중요! 본 문서는 귀하의 권리, 책임 및/또는 이익에 관한 중요한 정보를 포함하고 있습니다. 귀하가 본 문서에 있는 정보를 이해하는것은 대단히 중요하며, 귀하가 원하는 언어로 정보를 제공받으실 수 있습니다.WorkSource DeKalb at (404) 6873400/www.worksourcedekalb.org 로 전화하여 본 문서에 있는 정보의 번역 및 이해를 위해 도움받으시길 바랍니다. .Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with2disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

2018 Income Guidelines for WIOA Low Income LevelThe income levels shown in the table below will apply to WIOA eligibility and reporting in federal program years 20172018, or until another update occurs.Six-Month Income Guidelines for WIOA: Low Income Level Figures Effective June 01, 2018Family SizeMetropolitan AreasMetro - 200% LLSIL1 6,070 12,1402 8,230 16,4603 10,581 21,1624 13,063 26,1265 15,418 30,8366 18,032 36,0647 20,646 41,2928 23,260 46,520For each over 8 Add: 2,614 2,614Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with3disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

Individual Training Account (ITA) Completion GuideThe ITA Training Guide is designed to assist with the completion of the Individual Training Application (ITA). Prior tosubmitting your ITA application, you must attend a mandatory WIOA Training Information Session which is held weekly onTuesdays 10am. Once your paperwork is complete, you will need to schedule an appointment with your assigned CareerConsultant in order to submit your application.Residency: You must be a DeKalb County resident or must have been laid off from an employer in DeKalb County.Eligibility Documents:p Proof of identification (Georgia Driver’s License or Georgia Identification Card)Proof of work eligibility (Social Security Card, Green Card, US Passport)Proof of Residence (Utility bill, Lease, Voter Registration Card, if living with a DeKalb Resident statement from thatperson and utility bill in their name)Family Income Verification/Proof of income for the past six months can be any of the following:Most recent check stubs, social security benefits, TANF, food stamps, letter from a person providing support (if noincome).p Dislocated Workers/Displaced Homemakers Determination: Unemployment Insurance Examiner’s Letter orSeparation Notice for Dislocated Workers (Dislocated Workers qualify if there was an involuntary layoff orcompany closure or notice of layoff due to no fault of the customer). Displaced homemakers, bring copies of layoffof spouse.p Copy all requested documents prior to coming to the WIOA Training Information Session (Social Security Card,Driver’s License or Georgia ID, Alien Card or Passport, food stamp letters, EBT cards, Lease, check stubs,Unemployment Determination Letter, Separation Notice, etc.)Selective Service: for all males born after January 1, 1960, you must be registered. Visit www.sss.gov to print acopy of your verification or you may bring a copy of your DD214. (If you are not registered you will need to callthe number listed on the website. You cannot submit your file without an exemption letter if you have notregistered).Training Requirements:p Must be program ready – WIOA will not pay for any developmental or prerequisite courses. All course workmust be in the major of study.Funding is available upon eligibility, 1st year of training, up to 5000, and the 2nd year up to 3000. You are onlyeligible for one approved training program and funds do not roll over. You must meet all eligibilityrequirements to be considered for funding.WIOA does not support career changes. You are encouraged to build on your existing skills. In cases whereyour occupational experience is listed in one of the areas declining industries or occupations, or a career changeis required for health reasons, your transferrable skills will be assessed to assist you in selecting a trainingoption.p WIOA does not generally pay for Bachelor or master’s degrees – Exceptions may be reviewed individually, andapproval will be on a case-by-case basis (if less than two years are left for completion).Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with4disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

ppppAreas of training that will not be approved are: Commissioned Based programs, CNA only (must take CNA/PCTcombo program), Paralegal has stipulations of experience, education and pre-hire letters and any industry that isnot deemed in demand may not be considered.Truck Drivers – Should not have any DUI’s or felonies within the last 7-years. Misdemeanors will be discussed onan individual basis. Must provide a copy of his/her 7yr MVRApproved school information –Visit https://www.workreadyga.org. Click on “Training Providers and Schools”or Training and Education Programs”. Search by your school name or program choice. Contact the school to getthe cost and duration of training.Attendance Verification Form: You must attend at least one (1) workshops from the Georgia Department ofLabor, of your choice, and have the instructor sign the verification form.Financial Aid Verification (www.fafsa.ed.gov) – Only for Technical Schools, College, Universities and schoolsthat accept Financial AidProgram Ready Letter – Only for Colleges, Universities, and Technical SchoolsIf there is a break in training and you decide to finish at a later time, you will be required to reapply for trainingfunds. Training funds are on a first-come, first-serve basis.Copy of Resume is necessary (Be sure to include email address)** Please do not attend classes or pay in advance for any training that you expect to be paid by WIOAfunding until your training plan is completed, signed and approved. **Program Assessments:p TABE Results –TABE test results are required to match school requirements. Your assigned Career Counselor willschedule this test for you. You can only retest one time – all other results will be discarded. To study for theMath portion of your test you can visit www.math.com.Print 3 job ads of employment you will qualify for after training. Do you have the requested years ofexperience? Do you have the education? Must be fulltime jobs and located in Georgia. Do not attach singlenewspaper cut outs. Print off detailed job ads from the INTERNET.Interest Profiler - Steps to Completing the O*NET Interest Profiler1.2.3.4.5.6.7.8.Type in website address www.mynextmove.org/explore/ipClick on the “next” button 4 times.Complete the 60 assessment questions.Once you have completed answering questions click the “next” button.Click the “print” button.At the top of the page type in your name.Click print again.Once your O*NET Interest Profiler results is through printing close icon (DO NOT STOP HERE) Clickcontinue to complete the entire profiler survey.9. Print your Job Zones Report.10. Print your Career List Report11. Completion 3 printouts 1. O*Net Interest Profiler 2. Job Zones 3. Career ListRevised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with5disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

Program Registrations:Georgia Work Ready Online Participant Portal:a.b.c.d.e.f.g.h.i.j.Go to the internet and put in the following web address: ick on “Not Registered”Click on “Individual” under Option 2.Create a “Username and Password”.Enter all requested information. All items marked with a red *, must be entered.At the bottom of the page click “Next”After filling in the Name, Address, and Phone information, click “Next”You will then be asked to select your “Preferred Method of Communication”. Please select “Email”.Complete the next pages of your registration and at the end click “Finish”Please print the page that comes to your email after you complete your registration and place it in your packet.Online Application Confirmation/Thank You Page or Welcome Back Pagea. Register as a WorkSource DeKalb customer. Go to the internet and put in the following web address:www.worksourcedekalb.orgb. Click “Job Seeker Services”c. Click “Online Customer Registration”d. Click “Submit Application Here” and complete application – You will need to upload an electronic resume tocomplete the process.e. Click “Submit”f. Print the “Confirmation/Thank You” page & include the page in your applicationg. If you are already registered, login and then log back out. Print the page that thanks you for being a registereduser and insert in your package.** Please do not attend classes or pay in advance for any training that you expect to be paid by WIOA funding until yourtraining plan is completed, signed and approved. **Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with6disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

WorkSource DeKalbWorkforce Innovation and Opportunity ActGrievance/Complaint Procedures and Equal OpportunityPolicyEQUAL OPPORTUNITY COMPLAINT POLICYWorkSource DeKalb adheres to the following United States Law: “Equal Opportunity Is the Law”.It is against the law for this recipient of Federal financial assistance to discriminate on the following bases: Against anyindividual in the United States, on the basis of race, color, religion, sex (including pregnancy, childbirth, and related medicalconditions, sex stereotyping, transgender status, and gender identity), national origin (including limited Englishproficiency), age, disability, or political affiliation or belief, or, against any beneficiary of, applicant to, or participant inprograms financially assisted under Title I of the Workforce Innovation and Opportunity Act, on the basis of the individual'scitizenship status or participation in any WIOA Title I-financially assisted program or activity.The recipient (WorkSource DeKalb) must not discriminate in any of the following areas:§§§Deciding who will be admitted, or have access, to any WIOA Title I-financially assisted program or activity;Providing opportunities in, or treating any person with regard to, such a program or activity; orMaking employment decisions in the administration of, or in connection with, such a program or activity.Recipients of federal financial assistance must take reasonable steps to ensure that communications with individuals withdisabilities are as effective as communications with others. This means that, upon request and at no cost to the individual,recipients are required to provide appropriate auxiliary aids and services to qualified individuals with disabilities.COMPLAINTS OF DISCRIMINATION: What to Do If You Believe You Have Experienced DiscriminationIf you think that you have been subjected to discrimination under a WIOA Title I-financially assisted program or activity,you may file a complaint within 180 days from the date of the alleged violation with either:§LOCAL: The recipient's Equal Opportunity Officer: Michelle Jones, Workforce Manager/EO Officer, WorkSourceDeKalb, 774 Jordan Lane, Building #4, Decatur, GA 30033, Phone: 404-687-3400, Email:jmjones@dekalbcountyga.gov. Use the attached complaint form or download from www.worksourcedekalb.org,or§STATE: David Dietrichs, Deputy Counsel, The Georgia Department of Economic Development, WorkforceDivision, 75 Fifth Street NW, Atlanta, GA 30308, Phone: 404-679-1370, Email: DDietrichs@tcsg.edu§FEDERAL: The Director, Civil Rights Center (CRC), U.S. Department of Labor, 200 Constitution Avenue NW, RoomN-4123, Washington, DC 20210 or electronically as directed on the CRC Web site at www.dol.gov/crc.Furthermore, a complainant may file directly with the Director, Civil Rights Center at the address listed above. Orat the website: orc-complaints.htm.Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with7disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

§If you file your complaint with the recipient, you must wait either until the recipient issues a written notice of FinalAction, or until 90 days have passed (whichever is sooner), before filing with the Civil Rights Center.§If the recipient does not give you a written Notice of Final Action within 90 days of the day on which you filed yourcomplaint, you may file a complaint with CRC before receiving that Notice. However, you must file your CRCcomplaint within 30 days of the 90-day deadline (in other words, within 120 days after the day on which you filedyour complaint with the recipient).§If the recipient does give you a written Notice of Final Action on your complaint, but you are dissatisfied with thedecision or resolution, you may file a complaint with CRC. You must file your CRC complaint within 30 days of thedate on which you received the Notice of Final Action.Definition: A complaint is an allegation of discrimination on the grounds a person, or any specific class of individuals, hasbeen or is being discriminated against on the basis of race, color, religion, sex (including pregnancy, childbirth, and relatedmedical conditions, transgender status, and gender identity), national origin (including limited English proficiency), age,disability, political affiliation or belief, citizenship status, or participation in any WIOA Title I-financially assisted program oractivity as prohibited by WIOA or part 29 CFR 38.69. An allegation of retaliation, intimidation or reprisal for taking actionor participating in any action to secure rights protected under WIOA will be processed as a complaint.Who May File: Any person requesting aid, benefits, services or training through the WorkSource DeKalb; eligible applicantsand/or registrants; participants; employees, applicants for employment; service providers, eligible training providers (asdefined in the Workforce Innovation and Opportunity Act), and staff with the workforce system that believes he/she hasbeen or is being subjected to discrimination prohibited under the Nondiscrimination and Equal Opportunity Provisions 29CFR Part 38 and Section 188 of the Workforce Innovation and Opportunity Act (WIOA).WorkSource DeKalb is prohibited from discriminating against a person, or any specific class of individuals, on the basis ofrace, color, religion, sex (including pregnancy, childbirth, and related medical conditions, transgender status, and genderidentity), national origin (including limited English proficiency), age, disability, political affiliation or belief, citizenshipstatus, or participation in any WIOA Title I-financially assisted program or activity as prohibited by WIOA or part 29 CFR38.69 in admission or access to, opportunity or treatment in, or employment in the administration of or in connection with,any WIOA funded program or activity. If you think that you have been subjected to discrimination under a WIOA fundedprogram or activity, you may file a complaint within 180 days from the date of the alleged violation.Complaint Processing ProcedureAn initial written notice to the complainant will be provided within fifteen (15) days of receipt of the complaint. The noticewill include the following information pursuant to part 29 CFR 38.72:§ Acknowledgement of complaint received including date received; notice that the complainant has the right to berepresented in the complaint process; notice of rights contained in §38.35; and notice that the complainant hasthe right to request and receive, at no cost, auxiliary aids and services, language assistance services, and that thisnotice will be translated into the non-English languages as required in §§38.4(h) and (i), 38.34, and 38.36.§ A written statement of issue(s) which includes a list of the issues raised in the complaint; for each issue, astatement of whether or not the issue is accepted for investigation or rejected and the reasons for each rejectionafter performing a period of fact-finding.§ Notice that the complainant may resolve the issue Alternative Dispute Resolution (ADR) any time after thecomplaint has been filed, but before a Notice of Final Action has been issued.Revised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with8disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

§If the complaint does not fall within the Workforce Innovation and Opportunity Act jurisdiction for processingcomplaints alleging discrimination under Section 188 or Equal Opportunity and Nondiscrimination provisions at29 CFR Part 38.74, the complainant will be notified in writing within five (5) business days of making such§determination. The notification shall include the basis of the determination as well as a statement of thecomplainant’s right to file with the Civil Rights Center (CRC) within thirty (30) days of the determination.§Upon determination that the complaint has merit and is within the Workforce Innovation and Opportunity Actjurisdiction and period of fact-finding or investigation of the circumstances underlying the complaint.Complaint Processing Time FrameA complaint will be processed, and Notice of Final Action issued within ninety (90) days of receipt of the complaint pursuantto 29 CFR 38.72. Complainant may elect to file his or her equal opportunity complaint with the Georgia Department ofEconomic Development, Workforce Division (GDEcD). GDEcD’s address and information is as follows: Attention: DeputyCounsel David Dietrichs, 75 Fifth Street, NW, Suite 845, Atlanta, Georgia 30308, (404) 962-4005,wdcompliance@georgia.org; use form at: WFD-Grievance-Form110915.pdf.If WorkSource DeKalb has not provided complainant with a written decision within ninety (90) days of the filing of thecompliant, complainant need not wait for a decision to be issued. Complainant may file a complaint with GDEcD or CRCwithin thirty (30) days of the expiration of the 90-day period. If complainant is dissatisfied with WorkSource DeKalb’sresolution of his or her equal opportunity complaint, complainant may file a complaint with GDEcD. Such complaint mustbe filed within thirty (30) days of the date you received notice of WorkSource DeKalb’s proposed resolution.ORComplaints may be initially filed or appealed to the Director, Civil Rights Center (CRC) U.S. Department of Labor, 200Constitution Avenue, N.W. Room N-4123, Washington, DC 20210 or electronically as directed on the CRC website atwww.dol.gov/crc within thirty (30) days of complainant’s receipt of either WorkSource DeKalb Notice of Final Action orGDEcD Notice of Final Action. In other words, within one hundred eighty (180) days Complainant may file his or her appeal.Resolution Process:Alternative Dispute Resolution: Complainant must be given a choice as to the manner in which they have their complaintresolved. After an investigation is conducted by the Equal Opportunity Officer, ADR may be chosen by the complainant toresolve the issues, as long as a Notice of Final Action has not been issued. Mediation is recommended ADR and will beconducted by an impartial mediator. Complainant must notify the Equal Opportunity Officer prior to receiving the Noticeof Final Action if ADR is selected to resolve the dispute. WorkSource DeKalb will provide an impartial mediator and willprovide interested parties information regarding the arrangements (date, time, and location).Time Frame: The period for attempting to resolve the complaint through mediation will be thirty (30) days from the datethe complainant chooses mediation; but must be performed within ninety (90) days of the initial filing date.Successful Mediation: Upon completion of successful mediation, the complainant and respondent will both sign aconciliation agreement attesting that the complaint has been resolved. A copy of the conciliation agreement will beRevised July 11, 2018WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with9disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% fundedby the U.S. Department of Labor and is a proud partner of the American Job Center Network.

provided to Georgia Department of Economic Development, Workforce Division within ten (10) days of the date theconciliation agreement was signed.Unsuccessful Mediation: In the event mediation was not successful, WorkSource DeKalb shall proceed with issuing a Noticeof Final Action within the ninety (90) day limit.Complainant Responsibility: The complainant may amend the complaint at any point prior to the beginning of mediationor the issuance of the Notice of Final Action. The complainant may withdraw the complaint at any time by writtennotification.Breach of Agreement: Any party to any agreement reached under ADR may file a complaint in the event the agreement isbreached with David Dietrichs, Deputy Counsel, Georgia Department of Economic Development(GDEcD), Workforce Division, 75 Fifth Street, NW, Suite 845, Atlanta, Georgia 30308 or Director, Civil Rights Center (CRC)U.S. Department of Labor, 200 Constitution Avenue, N.W. Room N-4123, Washington, DC 20210.The non-breaching party may file a complaint within thirty (30) days of the date that party learns of the alleged breach (29CFR 38.72).GENERAL, NON-DISCRIMINATORY COMPLAINTSDefinition: General Complaint – A Complaint involving a general, non-discriminatory WIOA violation. A grievance is acomplaint about customer service, working conditions, wages, work assignment, etc., arising in connection with WIOA TitleI funded programs operated by WIOA recipients including service providers, eligible training providers, one-stop partnersand other contractors. A grievance is a more formalized complaint.Any person applying for or receiving services through the Workforce Innovation and Opportunity Act Title I (WIOA) paid forby WorkSource DeKalb will be treated fairly. WorkSource DeKalb will make every effort to resolve all general, nondiscriminatory complaints informally between those involved before a grievance is filed. Grievances may be filed inaccordance with the written procedures established by WorkSource DeKalb. If you believe a violation of Title I of WorkforceInnovation and Opportunity Act or regulations of the program has occurred, you have the right to file a grievance.Filing A General Grievance/Complaint (violations of the act or regulations not alleging discrimination)Who May File: Any person, including WIOA program participants, applicants, staff, employers, board members or any otherinterested parties who believes they have received unfair treatment in a W

WorkSource DeKalb is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals with disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 (TTY) for assistance. WorkSource DeKalb is 100% funded by the U.S. Department of Labor and is a proud partner of the American Job Center Network.