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West Virginia WIC Policy & Procedure 1.08 1.08 Civil Rights Effective Date: 7/19/22 1. A Civil Rights File maintained at the Local Agency will contain the following documents: a. FNS Instruction 113-1, dated 11/08/2005; b. Grassroots Organization Directory; and c. Local Agency 504 Evaluation (see Attachment #1 1.08). 2. A copy of each complaint and decision received will be maintained on file for at least three (3) years plus the current year. C. Public Notification and Outreach 1. Nondiscrimination Statement: The following nondiscrimination statement must be included, in full, on all materials regarding the WIC Program that are produced for public information, public education, or public distribution. 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-Complaint-Form-0508- 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. a. When space prohibits use of the lengthy statement, the following statement may be used, in print size no smaller than the text: 2 of 8