Title VI Program & Complaint Form

Download the City of Elk Grove's Title VI and Limited English Proficiency Plan

The City of Elk Grove is committed to ensuring that no person is excluded from participation in or denied the benefits of its services on the basis of race, color or national origin, as provided by Title VI of the Civil Rights Act of 1964, as amended. Title VI complaints must be filed within 180 days of the alleged discrimination.

The following information is necessary to assist us in processing your complaint. If you require any assistance in completing this form, please contact the Title VI Coordinator.

The completed form must be returned to:

Title VI Coordinator
Mike Costa
8401 Laguna Palms Way
Elk Grove, CA 95758
Phone: (916) 687-3030
Email: mcosta@elkgrovecity.org

Procedures for Investigating Complaints

The Transit System Manager will investigate the complaint and make a determination. Formal investigation of the complaint will be confidential and will include, but is not limited to, details of the specific incident, frequency and dates of occurrences, and names of any witnesses. The complainant will be notified of the resolution.

Appeals Process

If the complainant is not satisfied with the resolution, an appeal process is available.  An appeal request for review of a determination of unlawful denial of access or accommodation to public transportation must be filed, in writing, within sixty (60) calendar days of the incident.  The written appeal must include the customer’s name, address, and telephone number. A statement of reason(s) why the complainant believes the denial of the complaint was inappropriate is recommended.

The City Manager will set a mutually agreed-upon time and place for the review process with the complainant and/or his/her representatives within thirty (30) days of the request. The complainant may submit documents or other information to be included with the record and considered in the review process. A record of the review will be kept, as determined by the City Manager. Anyone needing special accommodations may contact the City at (916) 683-7111 for assistance.

Title VI Complaint Form
Title VI Complaint Form
Person(s) discriminated against (if someone other than complainant):
  • If so, list agency/agencies and contact information below:

The City will make every effort to address your concern within a reasonable period of time. You will be contacted by the Title VI Coordinator within ten (10) business days. If your concern pertains to an agency other than the City of Elk Grove, we will forward this form to the responsible agency.

All written complaints and responses will be retained by the City of Elk Grove for at least three years.

If the response by the Title VI Coordinator or designee does not satisfactorily resolve the concern, the complainant may appeal the decision within sixty (60) calendar days after receipt of the response to the City Manager or designee.

By clicking on "Submit" below, I affirm that I have read the above charge and that it is true to the best of my knowledge, information, and belief.

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Translation Service

If you need translation services for languages other than English, please call 916.687.3009 for assistance.

Spanish: Si necesita servicios de traducción para otro lenguaje, aparte de Ingles, Por favor llamar al 916.687.3009 para asistencia.

Vietnamese: Nếu bạn cần dịch vụ thông  dịch cho các ngôn ngữ khác ngoài tiếng Anh, xin vui lòng gọi 916.687.3009 để được trợ giúp.

Tagalog: Kung nangangailangan po ng tulong o interpretasyon sa ibang wika liban sa inglés, tumawag lang po sa 916.687.3009.

Chinese: 若你需要中文翻譯服務,請來電 916.687.3009 接受協助

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