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Civil Rights Complaint Procedure & Form

Child Nutrition Services




1. Complaints of discrimination must be filed within 180 days of the alleged discrimination.

2. Complaints of discrimination should be given to Child Nutrition Services director, Mike Klemetson.  He can be reached at 360-289-3888 or The Director will forward the complaint to:

                        U.S. Department of Agriculture

                        Office of the Assistant Secretary for Civil Rights

                        1400 Independence Avenue, SW

                        Washington, D.C. 20250-9410

3. Complaints of discrimination may be written or verbal. Use of a form is not required for a person filing a complaint. If a person is unwilling, unable, or not inclined to put the complaint in writing, the person taking the complaint shall do so.

4. Complaints of discrimination should contain as much as possible of the following information:

a. Name, address, e-mail address, and telephone number or other means of contacting the complainant.

b. The specific location and name of the entity providing the benefits.

c. A description of a specific action that caused the complainant to believe that discrimination was a factor.

d. Basis on which the complainant feels that discrimination occurred (race, color, national origin, sex, age, disability, or reprisal or retaliation for prior civil rights activity).

e. Name and titles, if known, and addresses of persons who may have knowledge of the discriminatory action.

f. The date(s) the alleged discriminatory actions occurred or the duration of such action.


Print the Civil Rights Complaint Form here.


Si necesita esta información en otro idioma, llame al 360-289-2447.