It is the policy of Hillsides to treat all clients with fairness and professionalism and to strive for excellence in providing services to clients. Hillsides policy provides clients and their families or legal guardians with the opportunity to express a problem or grievance related to the quality of services. If you feel you have been treated unfairly, unprofessionally or feel that your rights have been breached, the following procedure should be used. Hillsides grievance procedure is designed to provide a means for those applying for Hillsides' services and clients receiving services to bring a grievance to the attention of Hillsides and to reach a speedy resolution. Hillsides has a strict policy prohibiting retaliation in any form against anyone who files a grievance. A grievance is defined as any situation or condition that a client thinks is unfair, unjust or inequitable. In addition, if a client merely states they want to file a grievance, a grievance should be completed. Under this Client Grievance Procedure, you should submit a grievance in the following sequence: If you have a grievance, the concern can be discussed with a Hillsides staff. If you decide to speak to a Hillsides staff and an agreement cannot be reached, you should proceed to the next step of this grievance procedure. You can also file a grievance without any discussion and proceed to the next step. Grievance forms can be found at the following: 1. The lobby of any Hillsides site. 2. On the computers assigned for client use. Please see desktop for grievance icon 3. You can request the form from any Hillsides staff. 4. Call (323) 254-2274, ext. 12231 to request a form. 5. On our website at www.Hillsides.org. Click "Grievance Form" on home page If the matter has not been resolved to your satisfaction, you may choose to discuss your concerns with any supervisor. Once notified in writing, Hillsides will initiate an investigation within two business days and provide an acknowledgment to you within 7 business days. Hillsides will report the outcome of the complaint investigation to you within 14 business days after the complaint is received. If it has not been possible to gather the necessary information that would lead to a resolution by 14 days, you will be notified and given a new date, up to 30 days, by which a resolution or determination will be made. If for any reason you are unsatisfied with the results, you may contact Hillsides Chief Executive Officer to further discuss the matter. The CEO will conduct a review of the matter and will respond to you in writing within 10 business days. The CEO's decision and recommendations will be final. REPORTING AND PROCEDURE FORM This form is to be completed if you wish to make or file a grievance or complaint. You may also ask someone else who is acting with your knowledge and consent to write or express the grievance. You may file this report anonymously, without your name, however it may make it more difficult for Hillsides to address the matter. Date of Report * Year Year2013201420152016201720182019202020212022202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Client Name: (Last, First) * Client Address * Client Phone * Program or Location * Grievance Statement When did the event or incident happen? Specific Date(s) * Time(s) if known List the name or names of all persons involved in the event or incident * State the event or incident that prompted this complaint or grievance (Include all relevant details that will help in following up on this issue) * CAPTCHAClick on the box below to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.
