notice of non-discrimination - roze room
TRANSCRIPT
Notice of Non-Discrimination
Roze Room Hospice complies with applicable Federal civil rights laws and does not discriminate
on the basis of race, color, national origin, age, disability, or sex. Roze Room Hospice does not
exclude people or treat them differently because of race, color, national origin, age, disability, or
sex.
Roze Room Hospice:
Provides free aids and services to people with disabilities to communicate effectively
with us, such as qualified sign language interpreters and written information in other formats
(large print, audio, accessible electronic formats, other formats)
Provides free language services to people whose primary language is not English, such as
qualified interpreters and information written in other languages
If you need these services, contact our Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335,
Telephone: 323-938-1155, Fax: 818-462-5854.
If you believe that Roze Room Hospice has failed to provide these services or discriminated in
another way on the basis of race, color, national origin, age, disability, or sex, you can file a
grievance with our Roze Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman
Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.,
[email protected]. You can file a grievance in person or by mail, fax, or email. If you
need help filing a grievance, our Civil Rights Coordinator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human
Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint
Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S.
Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH
Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are
available at http://www.hhs.gov/ocr/office/file/index.html.
discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Roze Room
Hospice no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color,
nacionalidad, edad, discapacidad o sexo.
Roze Room Hospice:
• Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que
se comuniquen de manera eficaz con nosotros, como los siguientes:
Intérpretes de lenguaje de señas capacitados.
Información escrita en otros formatos (letra grande, audio, formatos
electrónicos accesibles, otros formatos).
• Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el
inglés, como los siguientes:
Información escrita en otros idiomas.
Si necesita recibir estos servicios, comuníquese con Civil Rights Coordinator at Roze
Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda,
CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.
Si considera que Roze Room Hospice no le proporcionó estos servicios o lo discriminó
de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo,
puede presentar un reclamo a la siguiente persona: Civil Rights Coordinator – Roze Room
Hospice, 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax:
818-462-5854, [email protected]. Puede presentar el reclamo en persona o por correo
postal, fax o correo electrónico. Si necesita ayuda para hacerlo, Civil Rights Coordinator está a
su disposición para brindársela.
También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights
(Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de
Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil
Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por
correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:
U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F,
HHH Building, Washington, D.C. 2020; 1-800-368-1019, 800-537-7697 (TDD); Puede obtener
los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html.
Roze Room Hospice
•
Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335,
Telephone: 323-938-1155, Fax: 818-462-5854
Civil Rights Coordinator – Roze Room Hospice
18107 Sherman Way, Suite 100, Reseda, CA 91335 323-938-1155
818-462-5854 [email protected]
Civil Rights Coordinator-
Roze Room Hospice
U.S. Department of Health and Human Services
Office for Civil Rights Office for Civil Rights Complaint Portal
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH
Building, Washington, D.C.20201, 1-800-368-1019800-537-7697 (TDD)
http://www.hhs.gov/ocr/office/file/index.html
Roze Room Hospice tuân th lut dân quyn hin hành ca Liên bang và không phân bit i x
da trên chng tc, màu da, ngun gc quc gia, tui, khuyt tt, hoc gii tính. Roze Room Hospice
không loi tr mi ngi hoc i x vi h khác bit vì chng tc, màu da, ngun gc quc gia, tui,
khuyt tt, hoc gii tính.
Roze Room Hospice:
• Cung cp dch v h tr min phí cho nhng ngi khuyt tt giao tip vi chúng tôi có hiu
qu, nh:
Thông dch viên ngôn ng ký hiu nng lc
Thông tin bng vn bn các nh dng khác (ch in ln, âm thanh, nh dng in t
có th tip cn, các nh dng khác)
• Cung cp min phí các dch v ngôn ng cho nhng ngi có ngôn ng chính không phi là
ting Anh, nh:
Thông tin c trình bày bng ngôn ng khác
Nu bn cn nhng dch v này, hãy liên h Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854.
Nu bn tin rng Roze Room Hospice không cung cp nhng dch v này hoc phân bit i x
theo cách khác da trên chng tc, màu da, ngun gc quc gia, tui, khuyt tt, hoc gii tính, bn có
th np n khiu ni vi: Roze Room Hospice, Attention: Civil Rights Coordinator at 18107
Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.,
[email protected]]. Bn có th trc tip np n khiu ni hoc gi qua ng bu in,
chuyn fax, hoc email. Nu bn cn tr giúp np n khiu ni, Civil Rights Coordinator of Roze Room
Hospice sn sàng giúp bn.
Bn cng có th np n khiu ni v dân quyn lên U.S. Department of Health and Human
Services (B Y T và Dch V Nhân Sinh Hoa K), Office for Civil Rights (Vn Phòng Dân Quyn) bng
hình thc in t qua Office for Civil Rights Complaint Portal, có trên trang
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoc qua ng bu in hoc bng in thoi ti:
U.S. Department of Health and Human Services; 200 Independence Avenue, SW; Room 509F, HHH
Building; Washington, D.C. 20201 ; 1-800-368-1019, 800-537-7697 (TDD)
Các mu khiu ni có trên trang http://www.hhs.gov/ocr/office/file/index.html.
sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
Ang Roze Room Hospice ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil
sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
Ang Roze Room Hospice ay:
• Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay
silang makipag-ugnayan sa amin, gaya ng:
Mga kwalipikadong interpreter ng sign language
Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-
access na electronic na format, iba pang mga format)
• Nagbibigay ng mga libreng serbisyo sa wika sa mga taong hindi Ingles ang pangunahing wika,
gaya ng:
Impormasyong nakasulat sa iba pang mga wika
Kung kailangan mo ang mga serbisyong ito, makipag-ugnayan kay Civil Rights Coordinator at
Roze Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA
91335, Telephone: 323-938-1155, Fax: 818-462-5854.
Kung naniniwala kang hindi naibigay ng Roze Room Hospice ang mga serbisyong ito o
nandiskrimina ito sa ibang paraan batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian,
maaari kang maghain ng karaingan sa: Civil Rights Coordinator – Roze Room Hospice, 18107
Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854,
[email protected] Maaari kang maghain ng karaingan nang personal o sa pamamagitan ng
koreo, fax o email. Kung kailangan mo ng tulong sa paghahain ng karaingan, narito si Civil Rights
Coordinator – Roze Room Hospice upang tulungan ka.
Maaari ka ring maghain ng reklamo sa mga karapatang sibil sa U.S. Department of Health and
Human Services (Kagawaran ng Mga Serbisyong Pangkalusugan at Pantao ng U.S.), Office for Civil
Rights (Tanggapan para sa Mga Karapatang Sibil), sa electronic na paraan sa Office for Civil Rights
Complaint Portal, na makikita sa https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o sa pamamagitan ng
koreo o telepono sa: U.S. Department of Health and Human Services; 200 Independence Avenue, SW
Room 509F, HHH Building; Washington, D.C. 20201; 1-800-368-1019, 800-537-7697 (TDD)
Ang mga form ng reklamo ay makukuha sa http://www.hhs.gov/ocr/office/file/index.html.
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Roze Room Hospice ua raws cov kev cailij choj yuam siv ntawm Tsom Fwv Nrub Nrab Teb
Chaw hais txog pej xeem cov cai (Federal civil rights laws) thiab tsis ciav-cais leejtwg vim nws hom
neeg, nqaij tawv, lub tebchaws tuaj, hnub nyoog, kev tsis taus, los yog poj niam txiv. Roze Room
Hospice tsis cais cov neeg los yog coj ntxawv rau lawv vim haiv neeg, xim tawv nqaij, tuaj teb chaws
twg, hnub nyoog, kev tsis taus, los yog poj niam txiv.
Roze Room Hospice:
• Pab nyiaj thiab muab kev pab rau cov neeg txuas lus tsis taus zoo nrog peb, xws li:
Cov neeg txhais lus piav uas tsim nyog
Tej ntaub ntawv ua lwm hom (tu ntawv loj, suab lus, tej hom siv tau hauv electronic, lwm lwm
hom)
• Muab kev pab dawb txog lus hais rau cov neeg uas tsis hais lus Akiv, xws li: Cov neeg txhais lus tsim nyog
Tej ntaub ntawv ua lwm hom lus
Yog koj xavtau cov kev pab no, thov hu rau Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854
Yog koj ntseeg hais tias Roze Room Hospice tsis muab tau cov kev pab no los yog tau coj lwm
hom kev ciav-cais saib raws haiv neeg, xim tawv nqaij, teb chaw tuaj, hnub nyoog, xiam oob qhab, los
poj niam lossis txiv neej, koj tuaj yeem xa ib daim ntawv tsis txaus siab nrog Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854., [email protected].. Koj xa daim ntawv tsis txaus siab kiag
tus kheej, raws kev xa ntawv, fev los yog email tuaj tau. Yog koj xav tau kev pab sau daim ntawv tsis
txaus siab, Roze Room Hospice Civil Rights Coordinator pab tau koj.
Koj kuj muaj peev xwm ua tau ib daim ntawv tsis txaus siab rau cov cai pej xeem mus rau Mekas
Department of Health and Human Services (Thawj Fab Pab Kev Noj Qab Haus Huv thiab Pab Tib Neeg),
Office for Civil Rights (Chaw Ua Hauj Lwm txog Pej Xeem Cov Cai), tshuab hluav taws xob los ntawm
Office for Civil Rights Complaint Portal, nyob rau hauv https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, los
yog xa ntawv lossis hu xovtooj ntawm: U.S. Department of Health and Human Services; 200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201 1-800-868-1019, 800-537-7697 (TDD); Cov qauv ntawv tsis txaus siab muaj rau ntawm http://www.hhs.gov/ocr/office/file/index.html.
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HHH Building; Washington, D.C. 20201; 1-800-868-1019, 800-537-7697 (TDD)
http://www.hhs.gov/ocr/office/file/index.html.
Roze Room Hospice complies with applicable Federal civil rights laws and does not discriminate
on the basis of race, color, national origin, age, disability, or sex. Roze Room Hospice does not
exclude people or treat them differently because of race, color, national origin, age, disability, or
sex.
Roze Room Hospice:
Provides free aids and services to people with disabilities to communicate effectively
with us, such as qualified sign language interpreters and written information in other formats
(large print, audio, accessible electronic formats, other formats)
Provides free language services to people whose primary language is not English, such as
qualified interpreters and information written in other languages
If you need these services, contact our Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335,
Telephone: 323-938-1155, Fax: 818-462-5854.
If you believe that Roze Room Hospice has failed to provide these services or discriminated in
another way on the basis of race, color, national origin, age, disability, or sex, you can file a
grievance with our Roze Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman
Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.,
[email protected]. You can file a grievance in person or by mail, fax, or email. If you
need help filing a grievance, our Civil Rights Coordinator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human
Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint
Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S.
Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH
Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are
available at http://www.hhs.gov/ocr/office/file/index.html.
discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Roze Room
Hospice no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color,
nacionalidad, edad, discapacidad o sexo.
Roze Room Hospice:
• Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que
se comuniquen de manera eficaz con nosotros, como los siguientes:
Intérpretes de lenguaje de señas capacitados.
Información escrita en otros formatos (letra grande, audio, formatos
electrónicos accesibles, otros formatos).
• Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el
inglés, como los siguientes:
Información escrita en otros idiomas.
Si necesita recibir estos servicios, comuníquese con Civil Rights Coordinator at Roze
Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda,
CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.
Si considera que Roze Room Hospice no le proporcionó estos servicios o lo discriminó
de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo,
puede presentar un reclamo a la siguiente persona: Civil Rights Coordinator – Roze Room
Hospice, 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax:
818-462-5854, [email protected]. Puede presentar el reclamo en persona o por correo
postal, fax o correo electrónico. Si necesita ayuda para hacerlo, Civil Rights Coordinator está a
su disposición para brindársela.
También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights
(Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de
Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil
Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por
correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:
U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F,
HHH Building, Washington, D.C. 2020; 1-800-368-1019, 800-537-7697 (TDD); Puede obtener
los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html.
Roze Room Hospice
•
Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335,
Telephone: 323-938-1155, Fax: 818-462-5854
Civil Rights Coordinator – Roze Room Hospice
18107 Sherman Way, Suite 100, Reseda, CA 91335 323-938-1155
818-462-5854 [email protected]
Civil Rights Coordinator-
Roze Room Hospice
U.S. Department of Health and Human Services
Office for Civil Rights Office for Civil Rights Complaint Portal
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH
Building, Washington, D.C.20201, 1-800-368-1019800-537-7697 (TDD)
http://www.hhs.gov/ocr/office/file/index.html
Roze Room Hospice tuân th lut dân quyn hin hành ca Liên bang và không phân bit i x
da trên chng tc, màu da, ngun gc quc gia, tui, khuyt tt, hoc gii tính. Roze Room Hospice
không loi tr mi ngi hoc i x vi h khác bit vì chng tc, màu da, ngun gc quc gia, tui,
khuyt tt, hoc gii tính.
Roze Room Hospice:
• Cung cp dch v h tr min phí cho nhng ngi khuyt tt giao tip vi chúng tôi có hiu
qu, nh:
Thông dch viên ngôn ng ký hiu nng lc
Thông tin bng vn bn các nh dng khác (ch in ln, âm thanh, nh dng in t
có th tip cn, các nh dng khác)
• Cung cp min phí các dch v ngôn ng cho nhng ngi có ngôn ng chính không phi là
ting Anh, nh:
Thông tin c trình bày bng ngôn ng khác
Nu bn cn nhng dch v này, hãy liên h Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854.
Nu bn tin rng Roze Room Hospice không cung cp nhng dch v này hoc phân bit i x
theo cách khác da trên chng tc, màu da, ngun gc quc gia, tui, khuyt tt, hoc gii tính, bn có
th np n khiu ni vi: Roze Room Hospice, Attention: Civil Rights Coordinator at 18107
Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854.,
[email protected]]. Bn có th trc tip np n khiu ni hoc gi qua ng bu in,
chuyn fax, hoc email. Nu bn cn tr giúp np n khiu ni, Civil Rights Coordinator of Roze Room
Hospice sn sàng giúp bn.
Bn cng có th np n khiu ni v dân quyn lên U.S. Department of Health and Human
Services (B Y T và Dch V Nhân Sinh Hoa K), Office for Civil Rights (Vn Phòng Dân Quyn) bng
hình thc in t qua Office for Civil Rights Complaint Portal, có trên trang
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoc qua ng bu in hoc bng in thoi ti:
U.S. Department of Health and Human Services; 200 Independence Avenue, SW; Room 509F, HHH
Building; Washington, D.C. 20201 ; 1-800-368-1019, 800-537-7697 (TDD)
Các mu khiu ni có trên trang http://www.hhs.gov/ocr/office/file/index.html.
sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
Ang Roze Room Hospice ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil
sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
Ang Roze Room Hospice ay:
• Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay
silang makipag-ugnayan sa amin, gaya ng:
Mga kwalipikadong interpreter ng sign language
Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-
access na electronic na format, iba pang mga format)
• Nagbibigay ng mga libreng serbisyo sa wika sa mga taong hindi Ingles ang pangunahing wika,
gaya ng:
Impormasyong nakasulat sa iba pang mga wika
Kung kailangan mo ang mga serbisyong ito, makipag-ugnayan kay Civil Rights Coordinator at
Roze Room Hospice, Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA
91335, Telephone: 323-938-1155, Fax: 818-462-5854.
Kung naniniwala kang hindi naibigay ng Roze Room Hospice ang mga serbisyong ito o
nandiskrimina ito sa ibang paraan batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian,
maaari kang maghain ng karaingan sa: Civil Rights Coordinator – Roze Room Hospice, 18107
Sherman Way, Suite 100, Reseda, CA 91335, Telephone: 323-938-1155, Fax: 818-462-5854,
[email protected] Maaari kang maghain ng karaingan nang personal o sa pamamagitan ng
koreo, fax o email. Kung kailangan mo ng tulong sa paghahain ng karaingan, narito si Civil Rights
Coordinator – Roze Room Hospice upang tulungan ka.
Maaari ka ring maghain ng reklamo sa mga karapatang sibil sa U.S. Department of Health and
Human Services (Kagawaran ng Mga Serbisyong Pangkalusugan at Pantao ng U.S.), Office for Civil
Rights (Tanggapan para sa Mga Karapatang Sibil), sa electronic na paraan sa Office for Civil Rights
Complaint Portal, na makikita sa https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o sa pamamagitan ng
koreo o telepono sa: U.S. Department of Health and Human Services; 200 Independence Avenue, SW
Room 509F, HHH Building; Washington, D.C. 20201; 1-800-368-1019, 800-537-7697 (TDD)
Ang mga form ng reklamo ay makukuha sa http://www.hhs.gov/ocr/office/file/index.html.
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Roze Room Hospice ua raws cov kev cailij choj yuam siv ntawm Tsom Fwv Nrub Nrab Teb
Chaw hais txog pej xeem cov cai (Federal civil rights laws) thiab tsis ciav-cais leejtwg vim nws hom
neeg, nqaij tawv, lub tebchaws tuaj, hnub nyoog, kev tsis taus, los yog poj niam txiv. Roze Room
Hospice tsis cais cov neeg los yog coj ntxawv rau lawv vim haiv neeg, xim tawv nqaij, tuaj teb chaws
twg, hnub nyoog, kev tsis taus, los yog poj niam txiv.
Roze Room Hospice:
• Pab nyiaj thiab muab kev pab rau cov neeg txuas lus tsis taus zoo nrog peb, xws li:
Cov neeg txhais lus piav uas tsim nyog
Tej ntaub ntawv ua lwm hom (tu ntawv loj, suab lus, tej hom siv tau hauv electronic, lwm lwm
hom)
• Muab kev pab dawb txog lus hais rau cov neeg uas tsis hais lus Akiv, xws li: Cov neeg txhais lus tsim nyog
Tej ntaub ntawv ua lwm hom lus
Yog koj xavtau cov kev pab no, thov hu rau Civil Rights Coordinator at Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854
Yog koj ntseeg hais tias Roze Room Hospice tsis muab tau cov kev pab no los yog tau coj lwm
hom kev ciav-cais saib raws haiv neeg, xim tawv nqaij, teb chaw tuaj, hnub nyoog, xiam oob qhab, los
poj niam lossis txiv neej, koj tuaj yeem xa ib daim ntawv tsis txaus siab nrog Roze Room Hospice,
Attention: Civil Rights Coordinator at 18107 Sherman Way, Suite 100, Reseda, CA 91335, Telephone:
323-938-1155, Fax: 818-462-5854., [email protected].. Koj xa daim ntawv tsis txaus siab kiag
tus kheej, raws kev xa ntawv, fev los yog email tuaj tau. Yog koj xav tau kev pab sau daim ntawv tsis
txaus siab, Roze Room Hospice Civil Rights Coordinator pab tau koj.
Koj kuj muaj peev xwm ua tau ib daim ntawv tsis txaus siab rau cov cai pej xeem mus rau Mekas
Department of Health and Human Services (Thawj Fab Pab Kev Noj Qab Haus Huv thiab Pab Tib Neeg),
Office for Civil Rights (Chaw Ua Hauj Lwm txog Pej Xeem Cov Cai), tshuab hluav taws xob los ntawm
Office for Civil Rights Complaint Portal, nyob rau hauv https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, los
yog xa ntawv lossis hu xovtooj ntawm: U.S. Department of Health and Human Services; 200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201 1-800-868-1019, 800-537-7697 (TDD); Cov qauv ntawv tsis txaus siab muaj rau ntawm http://www.hhs.gov/ocr/office/file/index.html.
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