Emery Unified School District

 

 

Community Relations                                                                                            E(2) 1312.4(a)

 

WILLIAMS UNIFORM COMPLAINT PROCEDURES

 

COMPLAINT FORM:  WILLIAMS UNIFORM COMPLAINT PROCEDURE

 

Complaints may be filed anonymously.  However, if you wish to receive a response to your complaint, you must provide the contact information below

 

Response requested?    Yes      No

 

Name:                                                                                                                              

 

Address:                                                                                                                          

 

Phone Number    Day:                                           Evening:                                             

 

 

Location of the problem that is the subject of this complaint:

 

School:                                                                                                                                    

Course or Grade and teacher name:                                                                                      

Room number or name of room:                                                                                      

Date problem was observed:                                                                                                

 

Only the following issues may be the subject of this complaint process.  If you wish to complain about an issue not specified below, please use the appropriate district complaint procedure.

 

Specific issue(s) of the complaint. Please check all that apply:

 

1.      Textbooks and instructional materials:

     A student does not have standards-aligned textbooks or instructional materials or state-or district-adopted textbooks or other required instructional materials to use in class.

     A student does not have access to instructional materials to use at home or after school.

     Textbooks or instructional materials are in poor or unusable condition, have missing pages, or are unreadable due to damage.

     A student was provided photocopied sheet from only a portion of a textbook or instructional materials to address a shortage of textbooks or instructional materials.

 

 

2.  Teacher vacancy or misassignment:

     A semester begins and a teacher vacancy exists, as defined in Education Code 35186 and AR 1312.4.

     A teacher lacking credentials or training to teach English learners is assigned to teach a class with more than 20% English learners in the class.

     A teacher is assigned to teach a class for which the teacher lacks subject matter competency.

 

3.   Facility conditions:

     A condition exists that poses an emergency or urgent threat to the health or safety of students or staff as defined in AR 1312.4.

Please describe the issue of your complaint in detail. You may attach additional pages if necessary to fully describe the situation: ____________________________________________________________________________________________________________________________________________________________

Please file this complaint with the person specified below at one of the following locations:

 

Principal

Anna Yates Elementary School

1070 41st Street

Emeryville, CA 94608

 

Principal

Emery Secondary School

1100 47th Street

Emeryville, CA 94608

 

Superintendent

Emery Unified School District

4727 San Pablo Avenue

Emeryville, CA 94608

Please provide a signature below. If you wish to remain anonymous, a signature is not required. However, all complaints, even anonymous ones, should be dated.

 

______________________________            _______________________

(signature)                                                        (date)