Grievance Form and Policy

Resident/Family Grievance Procedure/Form

GRIEVANCE PROCEDURE

  1. Upon admission, Second Chances will provide resident, resident’s parent or legal representative, a guardian, or a concerned person in the resident’s life a form where concerns can be addressed.
  2. Complaints, suggestions or expressed concerns are immediately submitted to the Program Director.
  3. A written response will be provided by the Program Director within 5 working days.
  4. If the complaint is still not resolved, it will be brought to the attention of the client’s case manager/caseworker from the referring agency.
  5. If the complaint is suggestive of abuse, it will be reported to MCHS.
  6. The person who reports a grievance will not be subject to adverse action by Second Chances as a result of filing the grievance;
  7. Appropriate disciplinary action will be taken against any perpetrators of abuse
  8. If a grievance is filed, Second Chances will document the grievance along with the investigation findings and resulting action taken by Second Chances. All information will be kept on file for two licensing periods.

 Resident/Family Grievance Form

 

__________________________ Name of person filling out form

__________________________ Resident name

__________________________ Date

Concern:

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Outcome:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Submit the following form to

Staff Person or Program Director

Or

________________________Placing Agency

ALL GRIEVANCES WILL BE ADDRESSED WITHIN 5 DAYS OF RECEIPT