Compliance Monitoring Form

(Formerly Equal Opportunity/Section 504 Monitoring Form)

Grantee:  	

Grant Number:  	

Prepared by:  	

Date Prepared:  	

		Comments	
Compliance  Requirements	

1.	
Have the documents for Section 504 been received by compliance and in the file?

Have the documents for Equal Opportunity Employment been received by compliance and in the file?

Have the documents for Procurement been received by compliance?	Yes	No	 	

2.	
Does the grantee have a written affirmative action plan and/or Equal Employment Opportunity Policy in their files?

Does the grantee have an Equal Employment and
Procurement Plan in their files?	Yes	No	Date of Adoption:	

3.	
Are all jobs advertised as “Equal Employment Opportunity”?  What documentation demonstrates this?	
Yes	
No		

4.	
Are Equal Employment Opportunity posters displayed?  Please describe where the posters are located.	Yes	No		

5.	Is there a local system of self-monitoring for affirmative action/equal opportunity goals? How is this done?	Yes	No	Who does the monitoring?	

6.	
Have any complaints of discrimination on CDBG employment been filed against the grantee by either employees and/or applicants for employment? If so, what is the status?	
Yes	
No	If yes, describe:	
Title VI - Limited English Proficient (LEP) and Language Access Plan (LAP)	

7.	
Have the documents for the Language Access Plan been received by Compliance and are in the file?
		
Yes	
No	Date of Adoption:

Date of Expiration:	

8.	
Does the grantee have the received Language Access Plan and Letter from Compliance in their files?

Does the grantee show comprehensive and organized recordkeeping of their due diligence in their LEP records?	Yes	No		

9.	

Title VI Coordinator’s Contact Information:	
Name: Title:
Phone Number:

Email Address:	

10.	

Please list all languages specified in the LAP:		

11.	
Are LEP posters and brochures available for the public to view and obtain?	Yes	No		

12.	
All published material has minimum required
Spanish translation included?	
Yes	
No		

13.	
Have provisions for publics hearings at all stages of program been made for LEP residents?	
Yes	
No		

14.	
Does the grantee have a Complaint Procedure in place?	Yes	No		

15.	

Have there been any complaints to date?	
Yes	
No	If yes, please explain:	
Section 3 – Local Economic Benefit for Low and Very Low Income persons Plan	

16.	
Have the documents for Section 3 been received by compliance?	
Yes	
No		

17.	

Does the grantee have the received Section 3 and
Letter from Compliance in their files?

Does the grantee show comprehensive and organized recordkeeping of their due diligence in their Section 3 records?	
Yes	
No		

18.	

Section 3 Coordinator’s Contact Information:	
Name: Title:
Phone Number: Email Address:	

19.	

Does the grantee have a Section 3 database with residents and businesses registered?	
Yes	
No		

20.	
Does the grantee have written procedures about how Section 3 residents are to be notified about employment and training opportunities generated by the grantee or its contractors as a result of the expenditure of covered financial assistance?	
Yes	
No		
		
N/A		

21.	
Does the grantee have written procedures about how Section 3 business concerns are to be notified about contracting (or subcontracting) opportunities generated by the grantee or its contractors involving covered financial assistance?	
Yes	
No		
		
N/A		

22.	
Does the grantee have written procedures about how covered contractors and sub-recipients are to be monitored for compliance with the requirements of Section 3?	Yes	No		
		
N/A		

23.	
Does the grantee have written procedures about what steps are taken to facilitate meeting the minimum numerical goals for employment and contracting opportunities?	Yes	No		
		
N/A		

24.	
Did the grantee advertise all Section 3 plan required information, including a list of jobs utilized during the project?	
Yes	
No	If yes, how was the information
advertised? Date?	

25.	
Does the Section 3 clause found at 24 CFR
135.38 include all contracts executed under the
CDBG program?	
Yes	
No		

26.	
Can the grantee provide evidence of the submission of a Section 3 Report to REDD (Form HUD- 60002)?	
Yes	
No		

27.	
Does the grantee’s records include documentation of the actions taken to comply with the Section 3 regulations (results of actions taken, any impediments encountered during implementation, etc)?	
Yes	
No		
Access to Program	

28.	
Are public hearings held in facilities that are accessible to handicapped persons?	
Yes	
No	Building Name where they are held?	

29.	
Has the program participant adopted and implemented procedures to ensure that interested persons (including those with impaired vision or hearing) can obtain information concerning the existence and location of accessible services, activities and facilities?	
Yes	
No		

30.	
Does the grantee maintain data showing the extent to which beneficiaries of the program with disabilities are being reviewed?	Yes	No		
		N/A		

31.	

If community development advisory groups exist, are persons from protected classes represented?

Indicate type of group, total number and the number and type of protected class members:	
Yes	
No		
		
White Males		White
Females		
		
Minority
Males		
Minority
Females		

32.	
Are facilities funded in whole or in part with CDBG
funds accessible to the handicapped?	
Yes	
No		
Contracts	

33.	
Does the grantee encourage historically underutilized businesses to submit bids/proposals for CDBG contracts?	
Yes	
No	Newspaper name and Date of
Publication:	

34.	
Do the preconstruction conference minutes indicate discussion of equal opportunity requirement contained in contract?	
Yes	
No		

35.	

Does grantee maintain records on all contracts that are sufficient to complete the APR?  (Information on type of contract, contractor ID number, contractor name, address, and zip code, contract amount, and whether contractor is small, minority, female or Section 3)	
Yes	
No		
Beneficiary Information	

36.	
Does the grantee maintain information on protected class status for each person receiving CDBG assistance?	Yes	No		

37.	
Is there indication of discrimination in the implementation of any activity?	
Yes	
No	If yes, describe:	
Workforce Data	

38.	
Insert Workforce Data for Grantee below:	
	Total Employees	CDBG Funded	
	Male		
Male		
	Female		
Female		
	Total Minority	CDBG Funded	
	Male		
Male		
	Female		
Female		

_________________________________________	           _______________________
Grantee Representative				                    Date

_________________________________________    _____________________
Grant Management Representative			        Date