LA-1. Language Access Complaint Form

Form Language Access Complaint Form is a form used to complain about language access barriers and to request language assistance services from the New York State Office of Children and Family Services (OCFS).

The form consists of three sections: Section 1 requires the complainant to provide their contact information and a brief description of the language access issue they are experiencing, Section 2 requires the complainant to provide a description of the language access services they are requesting, and Section 3 requires the complainant to provide a signature and date of submission.

Important fields in this form include the complainant's name, address, and contact information; a description of the language access issue they are experiencing; and a description of the language access services they are requesting. Accurate completion of the form is important in order to ensure that OCFS is able to contact the complainant and provide them with the language access services they require.

The Language Access Complaint Form should be used by individuals who are experiencing language access barriers when trying to access OCFS services. For example, a Spanish-speaking individual who is unable to communicate with OCFS staff due to a lack of language interpretation services may use this form to request language assistance services. When completing the form, the individual should provide as much detail as possible about the language access issue they are experiencing and the language access services they are requesting.

Related forms to the Language Access Complaint Form include the Language Access Complaint Form – Spanish, the Language Access Plan, and the Language Access Plan – Spanish. These forms may be used for similar purposes, however, the Language Access Complaint Form is specifically used to request language assistance services. In addition to the Language Access Complaint Form, an individual may need to provide additional documents, such as a copy of a valid identification document, in order to complete the process.