Formal Complaint Form
This complaint process is for you (or someone on your behalf) to use when you have already tried to work through your complaint with someone else, like your STC, and you do not agree with the decision or you do not feel your complaint is fixed.
Your complaint will go to the director of the department where you receive your services. Your director, or someone else, will contact you within 5 business days letting you know they received your complaint. Your director will then research your complaint and work to fix your complaint, hopefully within 10 business days.
If you do not agree with your director on how to fix your complaint within 10 days, then your director will continue to try more ideas to fix your complaint. This may take up to an additional 30 days.
PCL's decision on how to fix your complaint will be mailed to you, your guardian or legal representative (if you have one) and your county case manager. This letter will have PCL's decision in how we can best (or most closely) fix your complaint. If someone had submitted a complaint on your behalf, we will also let them know it has been resolved.
If you do not agree with PCL's way to fix your complaint or you are still not happy with PCL's decision, we can assist you in taking your complaint to the county where your case manager works. PCL staff will continue to provide your support or make sure that support is available to you until your complaint is heard and resolved or fixed by the county.
Sign in to Google
to save your progress.
Your name if you are helping someone file this complaint:
Mailing Address (Required if you don't include an email address)
What is your complaint? Please add in if you have already talked to someone about it and also how you would like it to be solved.
Thank you for using this process
Someone will be in touch with you within a few days. If you have any questions you may contact Carrie Phillips at the PCL main office.
Never submit passwords through Google Forms.
This form was created inside of Partnerships in Community Living, Inc..