+---------+---+-------+----------+-------------+-----+-----------------+
| **EEOC  |   | **    |          |             |     |                 |
| FORM\   |   | *U.S. |          |             |     |                 |
| 7       |   | Equal |          |             |     |                 |
| 15-01** |   | Emplo |          |             |     |                 |
|         |   | yment |          |             |     |                 |
| **PART  |   | O     |          |             |     |                 |
| A - D** |   | pport |          |             |     |                 |
|         |   | unity |          |             |     |                 |
|         |   | Com   |          |             |     |                 |
|         |   | missi |          |             |     |                 |
|         |   | on*** |          |             |     |                 |
|         |   |       |          |             |     |                 |
|         |   | **FE  |          |             |     |                 |
|         |   | DERAL |          |             |     |                 |
|         |   | A     |          |             |     |                 |
|         |   | GENCY |          |             |     |                 |
|         |   | ANN   |          |             |     |                 |
|         |   | UAL** |          |             |     |                 |
|         |   |       |          |             |     |                 |
|         |   | **EEO |          |             |     |                 |
|         |   | PR    |          |             |     |                 |
|         |   | OGRAM |          |             |     |                 |
|         |   | S     |          |             |     |                 |
|         |   | TATUS |          |             |     |                 |
|         |   | REP   |          |             |     |                 |
|         |   | ORT** |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
| **For   |   |       |          |             |     |                 |
| period  |   |       |          |             |     |                 |
| c       |   |       |          |             |     |                 |
| overing |   |       |          |             |     |                 |
| October |   |       |          |             |     |                 |
| 1,\_\   |   |       |          |             |     |                 |
| _\_\_\_ |   |       |          |             |     |                 |
| , to    |   |       |          |             |     |                 |
| Se      |   |       |          |             |     |                 |
| ptember |   |       |          |             |     |                 |
| 30      |   |       |          |             |     |                 |
| ,\_\_\_ |   |       |          |             |     |                 |
| \_\_.** |   |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
| **PART  | * |       |          | **1.**      |     |                 |
| A**     | * |       |          |             |     |                 |
|         | 1 |       |          |             |     |                 |
| Depa    | . |       |          |             |     |                 |
| rtment\ | A |       |          |             |     |                 |
| or      | g |       |          |             |     |                 |
| Agency\ | e |       |          |             |     |                 |
| Ident   | n |       |          |             |     |                 |
| ifying\ | c |       |          |             |     |                 |
| Info    | y |       |          |             |     |                 |
| rmation | * |       |          |             |     |                 |
|         | * |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
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+---------+---+-------+----------+-------------+-----+-----------------+
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       |          | **2.**      |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       |          | **3.**      |     |                 |
|         | * |       |          |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       | **5.**   | **4.**      | **5 |                 |
|         | * |       | FIPS     |             | .** |                 |
|         | 4 |       | code(s)  |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
| **PART  | * |       |          |             |     | **1.**          |
| B**     | * |       |          |             |     |                 |
|         | 1 |       |          |             |     |                 |
| Total\  | . |       |          |             |     |                 |
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| loyment | * |       |          |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       |          |             |     | **2.**          |
|         | * |       |          |             |     |                 |
|         | 2 |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | * |       |          |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       |          |             |     | **3.**          |
|         | * |       |          |             |     |                 |
|         | 3 |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | * |       |          |             |     | **4.**          |
|         | * |       |          |             |     |                 |
|         | 4 |       |          |             |     |                 |
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|         | ] |       |          |             |     |                 |
|         | * |       |          |             |     |                 |
|         | * |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
| **PART  | 1 |       |          | **1.**      |     |                 |
| C**     | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
| Agency\ | H |       |          |             |     |                 |
| Offic   | e |       |          |             |     |                 |
| ial(s)\ | a |       |          |             |     |                 |
| Respo   | d |       |          |             |     |                 |
| nsible\ | o |       |          |             |     |                 |
| For     | f |       |          |             |     |                 |
| Ove     | A |       |          |             |     |                 |
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| of EEO\ | e |       |          |             |     |                 |
| Pro     | n |       |          |             |     |                 |
| gram(s) | c |       |          |             |     |                 |
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|         | \ |       |          |             |     |                 |
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+---------+---+-------+----------+-------------+-----+-----------------+
|         | 2 |       |          | **2.**      |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | A |       |          |             |     |                 |
|         | g |       |          |             |     |                 |
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|         | e |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         | 3 |       |          | **3.**      |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | P |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
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|         | D |       |          |             |     |                 |
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|         | / |       |          |             |     |                 |
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|         | \ |       |          |             |     |                 |
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|         | c |       |          |             |     |                 |
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|         | a |       |          |             |     |                 |
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|         | d |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         | 4 |       |          | **4.**      |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | T |       |          |             |     |                 |
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|         | V |       |          |             |     |                 |
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|         | r |       |          |             |     |                 |
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|         | a |       |          |             |     |                 |
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|         | \ |       |          |             |     |                 |
|         | P |       |          |             |     |                 |
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|         | a |       |          |             |     |                 |
|         | l |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         | 5 |       |          | **5.**      |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | S |       |          |             |     |                 |
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|         | 5 |       |          |             |     |                 |
|         | 0 |       |          |             |     |                 |
|         | 1 |       |          |             |     |                 |
|         | A |       |          |             |     |                 |
|         | f |       |          |             |     |                 |
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|         | i |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
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|         | A |       |          |             |     |                 |
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|         | t |       |          |             |     |                 |
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|         | o |       |          |             |     |                 |
|         | n |       |          |             |     |                 |
|         | \ |       |          |             |     |                 |
|         | P |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
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|         | g |       |          |             |     |                 |
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|         | a |       |          |             |     |                 |
|         | m |       |          |             |     |                 |
|         | O |       |          |             |     |                 |
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|         | a |       |          |             |     |                 |
|         | l |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         | 6 |       |          | **6.**      |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | C |       |          |             |     |                 |
|         | o |       |          |             |     |                 |
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|         | p |       |          |             |     |                 |
|         | l |       |          |             |     |                 |
|         | a |       |          |             |     |                 |
|         | i |       |          |             |     |                 |
|         | n |       |          |             |     |                 |
|         | t |       |          |             |     |                 |
|         | P |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
|         | o |       |          |             |     |                 |
|         | c |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
|         | s |       |          |             |     |                 |
|         | s |       |          |             |     |                 |
|         | i |       |          |             |     |                 |
|         | n |       |          |             |     |                 |
|         | g |       |          |             |     |                 |
|         | P |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
|         | o |       |          |             |     |                 |
|         | g |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
|         | a |       |          |             |     |                 |
|         | m |       |          |             |     |                 |
|         | \ |       |          |             |     |                 |
|         | M |       |          |             |     |                 |
|         | a |       |          |             |     |                 |
|         | n |       |          |             |     |                 |
|         | a |       |          |             |     |                 |
|         | g |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         | 7 |       |          |             |     |                 |
|         | \ |       |          |             |     |                 |
|         | . |       |          |             |     |                 |
|         | O |       |          |             |     |                 |
|         | t |       |          |             |     |                 |
|         | h |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
|         | r |       |          |             |     |                 |
|         | R |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
|         | s |       |          |             |     |                 |
|         | p |       |          |             |     |                 |
|         | o |       |          |             |     |                 |
|         | n |       |          |             |     |                 |
|         | s |       |          |             |     |                 |
|         | i |       |          |             |     |                 |
|         | b |       |          |             |     |                 |
|         | l |       |          |             |     |                 |
|         | e |       |          |             |     |                 |
|         | E |       |          |             |     |                 |
|         | E |       |          |             |     |                 |
|         | O |       |          |             |     |                 |
|         | S |       |          |             |     |                 |
|         | t |       |          |             |     |                 |
|         | a |       |          |             |     |                 |
|         | f |       |          |             |     |                 |
|         | f |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         |   |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+
|         |   |       |          |             |     |                 |
+---------+---+-------+----------+-------------+-----+-----------------+

+-----------+----------------+---------------------------+-----+-----+
| **EEOC    | ***U.S. Equal  |                           |     |     |
| FORM\     | Employment     |                           |     |     |
| 715-01**  | Opportunity    |                           |     |     |
|           | Commission***  |                           |     |     |
| **PART    |                |                           |     |     |
| A - D**   | **FEDERAL      |                           |     |     |
|           | AGENCY         |                           |     |     |
|           | ANNUAL**       |                           |     |     |
|           |                |                           |     |     |
|           | **EEO PROGRAM  |                           |     |     |
|           | STATUS         |                           |     |     |
|           | REPORT**       |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
| **PART    |                | **Subordinate Component   | **C |     |
| D**       |                | and Location              | PDF |     |
|           |                | (City/State)**            | and |     |
| List of   |                |                           | F   |     |
| Su        |                |                           | IPS |     |
| bordinate |                |                           | c   |     |
| C         |                |                           | ode |     |
| omponents |                |                           | s** |     |
| Covered   |                |                           |     |     |
| in This   |                |                           |     |     |
| Report    |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+
|           |                |                           |     |     |
+-----------+----------------+---------------------------+-----+-----+

+---------------------------+---+---------------------------------------+
| EEOC FORMS and Documents  |   |                                       |
| Included With This Report |   |                                       |
+---------------------------+---+---------------------------------------+
| \*Executive Summary       |   | \*Optional Annual Self-Assessment     |
| \[FORM 715-01 PART E\],   |   | Checklist Against Essential Elements  |
| that includes:            |   | \[FORM 715-01PART G\]                 |
+---------------------------+---+---------------------------------------+
| Brief paragraph           |   | \*EEO Plan To Attain the Essential    |
| describing the agency\'s  |   | Elements of a Model EEO Program       |
| mission and               |   | \[FORM 715-01PART H\] for each        |
| mission-related functions |   | programmatic essential element        |
|                           |   | requiring improvement                 |
+---------------------------+---+---------------------------------------+
| Summary of results of     |   | \*EEO Plan To Eliminate Identified    |
| agency\'s annual          |   | Barrier\                              |
| self-assessment against   |   | \[FORM 715-01 PART I\] for each       |
| MD-715 \"Essential        |   | identified barrier                    |
| Elements\"                |   |                                       |
+---------------------------+---+---------------------------------------+
| Summary of Analysis of    |   | \*Special Program Plan for the        |
| Work Force Profiles       |   | Recruitment, Hiring, and Advancement  |
| including net change      |   | of Individuals With Targeted          |
| analysis and comparison   |   | Disabilities for agencies with 1,000  |
| to RCLF                   |   | or more employees \[FORM 715-01 PART  |
|                           |   | J\]                                   |
+---------------------------+---+---------------------------------------+
| Summary of EEO Plan       |   | \*Copy of Workforce Data Tables as    |
| objectives planned to     |   | necessary to support Executive        |
| eliminate identified      |   | Summary and/or EEO Plans              |
| barriers or correct       |   |                                       |
| program deficiencies      |   |                                       |
+---------------------------+---+---------------------------------------+
| Summary of EEO Plan       |   | \*Copy of data from 462 Report as     |
| action items implemented  |   | necessary to support action items     |
| or accomplished           |   | related to Complaint Processing       |
|                           |   | Program deficiencies, ADR             |
|                           |   | effectiveness, or other compliance    |
|                           |   | issues                                |
+---------------------------+---+---------------------------------------+
| \*Statement of            |   | \*Copy of Facility Accessability      |
| Establishment of          |   | Survey results as necessary to        |
| Continuing Equal          |   | support EEO Action Plan for building  |
| Employment Opportunity    |   | renovation projects                   |
| Programs\                 |   |                                       |
| \[FORM 715-01 PART F\]    |   |                                       |
+---------------------------+---+---------------------------------------+
| \*Copies of relevant EEO  |   | \*Organizational Chart                |
| Policy Statement(s)       |   |                                       |
| and/or excerpts from      |   |                                       |
| revisions made to EEO     |   |                                       |
| Policy Statements         |   |                                       |
+---------------------------+---+---------------------------------------+

+-----------+---------------+-----+-----------------------------------+
| **EEOC    | ***U.S. Equal |     |                                   |
| FORM\     | Employment    |     |                                   |
| 715-01**  | Opportunity   |     |                                   |
|           | Commission*** |     |                                   |
| **PART    |               |     |                                   |
| E**       | **FEDERAL     |     |                                   |
|           | AGENCY        |     |                                   |
|           | ANNUAL**      |     |                                   |
|           |               |     |                                   |
|           | **EEO PROGRAM |     |                                   |
|           | STATUS        |     |                                   |
|           | REPORT**      |     |                                   |
+-----------+---------------+-----+-----------------------------------+
| \[Insert  |               | **  |                                   |
| Name of   |               | For |                                   |
| Agency or |               | per |                                   |
| Reporting |               | iod |                                   |
| Co        |               | co  |                                   |
| mponent\] |               | ver |                                   |
|           |               | ing |                                   |
|           |               | O   |                                   |
|           |               | cto |                                   |
|           |               | ber |                                   |
|           |               | 1,\ |                                   |
|           |               | _\_ |                                   |
|           |               | \_\ |                                   |
|           |               | _\_ |                                   |
|           |               | ,   |                                   |
|           |               | to  |                                   |
|           |               | Sep |                                   |
|           |               | tem |                                   |
|           |               | ber |                                   |
|           |               | 3   |                                   |
|           |               | 0,\ |                                   |
|           |               | _\_ |                                   |
|           |               | \_\ |                                   |
|           |               | _\_ |                                   |
|           |               | .** |                                   |
+-----------+---------------+-----+-----------------------------------+
| ##        |               |     |                                   |
|  EXECUTIV |               |     |                                   |
| E SUMMARY |               |     |                                   |
+-----------+---------------+-----+-----------------------------------+
|           |               |     |                                   |
+-----------+---------------+-----+-----------------------------------+
| Executive |               |     | Page 1                            |
| Summary   |               |     |                                   |
+-----------+---------------+-----+-----------------------------------+

  ---------------------------- -------------------- -----------------------------------
  \[Insert Name of Agency or   **FY\_\_\_\_\_\_**   
  Reporting Component\]                             

                                                    

  Executive Summary                                 Page 2
  ---------------------------- -------------------- -----------------------------------

+-----------+----------------------------------------------------------+
| **EEOC    | ***U.S. Equal Employment Opportunity Commission***       |
| FORM\     |                                                          |
| 715-01**  | **FEDERAL AGENCY ANNUAL**                                |
|           |                                                          |
| **PART    | **EEO PROGRAM STATUS REPORT**                            |
| F**       |                                                          |
+-----------+----------------------------------------------------------+

+-------------+---------+------+---+--------------------+---+----------------+
| **CE        |         |      |   |                    |   |                |
| RTIFICATION |         |      |   |                    |   |                |
| of          |         |      |   |                    |   |                |
| ES          |         |      |   |                    |   |                |
| TABLISHMENT |         |      |   |                    |   |                |
| of          |         |      |   |                    |   |                |
| CONTINUING\ |         |      |   |                    |   |                |
| EQUAL       |         |      |   |                    |   |                |
| EMPLOYMENT  |         |      |   |                    |   |                |
| OPPORTUNITY |         |      |   |                    |   |                |
| PROGRAMS**  |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
|             |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
| I,          |         |      |   |                    |   | am the         |
+-------------+---------+------+---+--------------------+---+----------------+
|             | (Insert |      | ( |                    |   |                |
|             | name    |      | I |                    |   |                |
|             | above)  |      | n |                    |   |                |
|             |         |      | s |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | r |                    |   |                |
|             |         |      | t |                    |   |                |
|             |         |      | o |                    |   |                |
|             |         |      | f |                    |   |                |
|             |         |      | f |                    |   |                |
|             |         |      | i |                    |   |                |
|             |         |      | c |                    |   |                |
|             |         |      | i |                    |   |                |
|             |         |      | a |                    |   |                |
|             |         |      | l |                    |   |                |
|             |         |      | \ |                    |   |                |
|             |         |      | t |                    |   |                |
|             |         |      | i |                    |   |                |
|             |         |      | t |                    |   |                |
|             |         |      | l |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | / |                    |   |                |
|             |         |      | s |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | r |                    |   |                |
|             |         |      | i |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | s |                    |   |                |
|             |         |      | / |                    |   |                |
|             |         |      | g |                    |   |                |
|             |         |      | r |                    |   |                |
|             |         |      | a |                    |   |                |
|             |         |      | d |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | a |                    |   |                |
|             |         |      | b |                    |   |                |
|             |         |      | o |                    |   |                |
|             |         |      | v |                    |   |                |
|             |         |      | e |                    |   |                |
|             |         |      | ) |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
| Principal   |         |      |   |                    |   |                |
| EEO         |         |      |   |                    |   |                |
| Direct      |         |      |   |                    |   |                |
| or/Official |         |      |   |                    |   |                |
| for         |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
|             |         | (In  |   |                    |   |                |
|             |         | sert |   |                    |   |                |
|             |         | Agen |   |                    |   |                |
|             |         | cy/C |   |                    |   |                |
|             |         | ompo |   |                    |   |                |
|             |         | nent |   |                    |   |                |
|             |         | Name |   |                    |   |                |
|             |         | ab   |   |                    |   |                |
|             |         | ove) |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
| The agency  |         |      |   |                    |   |                |
| has         |         |      |   |                    |   |                |
| conducted   |         |      |   |                    |   |                |
| an annual   |         |      |   |                    |   |                |
| self        |         |      |   |                    |   |                |
| -assessment |         |      |   |                    |   |                |
| of Section  |         |      |   |                    |   |                |
| 717 and     |         |      |   |                    |   |                |
| Section 501 |         |      |   |                    |   |                |
| programs    |         |      |   |                    |   |                |
| against the |         |      |   |                    |   |                |
| essential   |         |      |   |                    |   |                |
| elements as |         |      |   |                    |   |                |
| prescribed  |         |      |   |                    |   |                |
| by EEO      |         |      |   |                    |   |                |
| MD-715. If  |         |      |   |                    |   |                |
| an          |         |      |   |                    |   |                |
| essential   |         |      |   |                    |   |                |
| element was |         |      |   |                    |   |                |
| not fully   |         |      |   |                    |   |                |
| compliant   |         |      |   |                    |   |                |
| with the    |         |      |   |                    |   |                |
| standards   |         |      |   |                    |   |                |
| of EEO      |         |      |   |                    |   |                |
| MD-715, a   |         |      |   |                    |   |                |
| further     |         |      |   |                    |   |                |
| evaluation  |         |      |   |                    |   |                |
| was         |         |      |   |                    |   |                |
| conducted   |         |      |   |                    |   |                |
| and, as     |         |      |   |                    |   |                |
| a           |         |      |   |                    |   |                |
| ppropriate, |         |      |   |                    |   |                |
| EEO Plans   |         |      |   |                    |   |                |
| for         |         |      |   |                    |   |                |
| Attaining   |         |      |   |                    |   |                |
| the         |         |      |   |                    |   |                |
| Essential   |         |      |   |                    |   |                |
| Elements of |         |      |   |                    |   |                |
| a Model EEO |         |      |   |                    |   |                |
| Program,    |         |      |   |                    |   |                |
| are         |         |      |   |                    |   |                |
| included    |         |      |   |                    |   |                |
| with this   |         |      |   |                    |   |                |
| Federal     |         |      |   |                    |   |                |
| Agency      |         |      |   |                    |   |                |
| Annual EEO  |         |      |   |                    |   |                |
| Program     |         |      |   |                    |   |                |
| Status      |         |      |   |                    |   |                |
| Report.     |         |      |   |                    |   |                |
|             |         |      |   |                    |   |                |
| The agency  |         |      |   |                    |   |                |
| has also    |         |      |   |                    |   |                |
| analyzed    |         |      |   |                    |   |                |
| its work    |         |      |   |                    |   |                |
| force       |         |      |   |                    |   |                |
| profiles    |         |      |   |                    |   |                |
| and         |         |      |   |                    |   |                |
| conducted   |         |      |   |                    |   |                |
| barrier     |         |      |   |                    |   |                |
| analyses    |         |      |   |                    |   |                |
| aimed at    |         |      |   |                    |   |                |
| detecting   |         |      |   |                    |   |                |
| whether any |         |      |   |                    |   |                |
| management  |         |      |   |                    |   |                |
| or          |         |      |   |                    |   |                |
| personnel   |         |      |   |                    |   |                |
| policy,     |         |      |   |                    |   |                |
| procedure   |         |      |   |                    |   |                |
| or practice |         |      |   |                    |   |                |
| is          |         |      |   |                    |   |                |
| operating   |         |      |   |                    |   |                |
| to          |         |      |   |                    |   |                |
| d           |         |      |   |                    |   |                |
| isadvantage |         |      |   |                    |   |                |
| any group   |         |      |   |                    |   |                |
| based on    |         |      |   |                    |   |                |
| race,       |         |      |   |                    |   |                |
| national    |         |      |   |                    |   |                |
| origin,     |         |      |   |                    |   |                |
| gender or   |         |      |   |                    |   |                |
| disability. |         |      |   |                    |   |                |
| EEO Plans   |         |      |   |                    |   |                |
| to          |         |      |   |                    |   |                |
| Eliminate   |         |      |   |                    |   |                |
| Identified  |         |      |   |                    |   |                |
| Barriers,   |         |      |   |                    |   |                |
| as          |         |      |   |                    |   |                |
| a           |         |      |   |                    |   |                |
| ppropriate, |         |      |   |                    |   |                |
| are         |         |      |   |                    |   |                |
| included    |         |      |   |                    |   |                |
| with this   |         |      |   |                    |   |                |
| Federal     |         |      |   |                    |   |                |
| Agency      |         |      |   |                    |   |                |
| Annual EEO  |         |      |   |                    |   |                |
| Program     |         |      |   |                    |   |                |
| Status      |         |      |   |                    |   |                |
| Report.     |         |      |   |                    |   |                |
|             |         |      |   |                    |   |                |
| I certify   |         |      |   |                    |   |                |
| that proper |         |      |   |                    |   |                |
| do          |         |      |   |                    |   |                |
| cumentation |         |      |   |                    |   |                |
| of this     |         |      |   |                    |   |                |
| assessment  |         |      |   |                    |   |                |
| is in place |         |      |   |                    |   |                |
| and is      |         |      |   |                    |   |                |
| being       |         |      |   |                    |   |                |
| maintained  |         |      |   |                    |   |                |
| for EEOC    |         |      |   |                    |   |                |
| review upon |         |      |   |                    |   |                |
| request.    |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
|             |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
| Signature   |         |      |   |                    | D |                |
| of          |         |      |   |                    | a |                |
| Principal   |         |      |   |                    | t |                |
| EEO         |         |      |   |                    | e |                |
| Directo     |         |      |   |                    |   |                |
| r/Official\ |         |      |   |                    |   |                |
| Certifies   |         |      |   |                    |   |                |
| that this   |         |      |   |                    |   |                |
| Federal     |         |      |   |                    |   |                |
| Agency      |         |      |   |                    |   |                |
| Annual EEO  |         |      |   |                    |   |                |
| Program     |         |      |   |                    |   |                |
| Status      |         |      |   |                    |   |                |
| Report is   |         |      |   |                    |   |                |
| in          |         |      |   |                    |   |                |
| compliance  |         |      |   |                    |   |                |
| with EEO    |         |      |   |                    |   |                |
| MD-715.     |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
|             |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+
| Signature   |         |      |   |                    | D |                |
| of Agency   |         |      |   |                    | a |                |
| Head or     |         |      |   |                    | t |                |
| Agency Head |         |      |   |                    | e |                |
| Designee    |         |      |   |                    |   |                |
+-------------+---------+------+---+--------------------+---+----------------+

+-----------+----------------------------------------------------------+
| **EEOC    | ***U.S. Equal Employment Opportunity Commission***       |
| FORM\     |                                                          |
| 715-01**  | **FEDERAL AGENCY ANNUAL**                                |
|           |                                                          |
| **PART    | **EEO PROGRAM STATUS REPORT**                            |
| G**       |                                                          |
+-----------+----------------------------------------------------------+
| **        |                                                          |
| Essential |                                                          |
| Element   |                                                          |
| A:        |                                                          |
| [Dem      |                                                          |
| onstrated |                                                          |
| C         |                                                          |
| ommitment |                                                          |
| From      |                                                          |
| Agency    |                                                          |
| Leader    |                                                          |
| ship]{.sm |                                                          |
| allcaps}\ |                                                          |
| Requires  |                                                          |
| the       |                                                          |
| agency    |                                                          |
| head to   |                                                          |
| issue     |                                                          |
| written   |                                                          |
| policy    |                                                          |
| s         |                                                          |
| tatements |                                                          |
| ensuring  |                                                          |
| a         |                                                          |
| workplace |                                                          |
| free of   |                                                          |
| discr     |                                                          |
| iminatory |                                                          |
| h         |                                                          |
| arassment |                                                          |
| and a     |                                                          |
| c         |                                                          |
| ommitment |                                                          |
| to equal  |                                                          |
| e         |                                                          |
| mployment |                                                          |
| oppor     |                                                          |
| tunity.** |                                                          |
+-----------+----------------------------------------------------------+

  ----------------------------------------------------- ----------------------------------- ----------- -------- --------------
  ![](media/image1.png){width="0.3541666666666667in"    **EEO policy statements are         **Measure            **For all
  height="0.16666666666666666in"}**Compliance           up-to-date.**                       has been             unmet
  Indicator**                                                                               met**                measures,
                                                                                                                 provide a
                                                                                                                 brief
                                                                                                                 explanation in
                                                                                                                 the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an EEOC
                                                                                                                 FORM 715-01
                                                                                                                 PART H to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

  The Agency Head was installed on \_\_\_\_\_\_\_. The                                                            
  EEO policy statement was issued on \_\_\_\_\_\_\_\_.\                                                          
  Was the EEO policy Statement issued within 6 - 9                                                               
  months of the installation of the Agency Head?\                                                                
  If no, provide an explanation.                                                                                 

  During the current Agency Head\'s tenure, has the EEO                                                           
  policy Statement been re-issued annually?\                                                                     
  If no, provide an explanation.                                                                                 

  Are new employees provided a copy of the EEO policy                                                             
  statement during orientation?                                                                                  

  When an employee is promoted into the supervisory                                                               
  ranks, is s/he provided a copy of the EEO policy                                                               
  statement?                                                                                                     

  ![](media/image1.png){width="0.3541666666666667in"    **EEO policy statements have been   **Measure            **For all
  height="0.16666666666666666in"}**Compliance           communicated to all employees.**    has been             unmet
  Indicator**                                                                               met**                measures,
                                                                                                                 provide a
                                                                                                                 brief
                                                                                                                 explanation in
                                                                                                                 the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an EEOC
                                                                                                                 FORM 715-01
                                                                                                                 PART H to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

  Have the heads of subordinate reporting components                                                              
  communicated support of all agency EEO policies                                                                
  through the ranks?                                                                                             

  Has the agency made written materials available to                                                              
  all employees and applicants, informing them of the                                                            
  variety of EEO programs and administrative and                                                                 
  judicial remedial procedures available to them?                                                                

  Has the agency prominently posted such written                                                                  
  materials in all personnel offices, EEO offices, and                                                           
  on the agency\'s internal website? **\[see 29 CFR                                                              
  §1614.102(b)(5)\]**                                                                                            
  ----------------------------------------------------- ----------------------------------- ----------- -------- --------------

  ----------------------------------------------------- ----------------------------------- ----------- -------- --------------
  ![](media/image1.png){width="0.3541666666666667in"    **Agency EEO policy is vigorously   **Measure            **For all
  height="0.16666666666666666in"}**Compliance           enforced by agency management.**    has been             unmet
  Indicator**                                                                               met**                measures,
                                                                                                                 provide a
                                                                                                                 brief
                                                                                                                 explanation in
                                                                                                                 the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an EEOC
                                                                                                                 FORM 715-01
                                                                                                                 PART H to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

  Are managers and supervisors evaluated on their                                                                 
  commitment to agency EEO policies and principles,                                                              
  including their efforts to:                                                                                    

  resolve problems/disagreements and other conflicts in                                                           
  their respective work environments as they arise?                                                              

  address concerns, whether perceived or real, raised                                                             
  by employees and following-up with appropriate action                                                          
  to correct or eliminate tension in the workplace?                                                              

  support the agency\'s EEO program through allocation                                                            
  of mission personnel to participate in community                                                               
  out-reach and recruitment programs with private                                                                
  employers, public schools and universities?                                                                    

  ensure full cooperation of employees under his/her                                                              
  supervision with EEO office officials such as EEO                                                              
  Counselors, EEO Investigators, etc.?                                                                           

  ensure a workplace that is free from all forms of                                                               
  discrimination, harassment and retaliation?                                                                    

  ensure that subordinate supervisors have effective                                                              
  managerial, communication and interpersonal skills in                                                          
  order to supervise most effectively in a workplace                                                             
  with diverse employees and avoid disputes arising                                                              
  from ineffective communications ?                                                                              

  ensure the provision of requested religious                                                                     
  accommodations when such accommodations do not cause                                                           
  an undue hardship?                                                                                             

  ensure the provision of requested disability                                                                    
  accommodations to qualified individuals with                                                                   
  disabilities when such accommodations do not cause an                                                          
  undue hardship?                                                                                                

  Have all employees been informed about what behaviors                                                           
  are inappropriate in the workplace and that this                                                               
  behavior may result in disciplinary actions?                                                                   

  Describe what means were utilized by the agency to so                                                          
  inform its workforce about the penalties for                                                                   
  unacceptable behavior.                                                                                         

  Have the procedures for reasonable accommodation for                                                            
  individuals with disabilities been made readily                                                                
  available/accessible to all employees by                                                                       
  disseminating such procedures during orientation of                                                            
  new employees and by making such procedures available                                                          
  on the World Wide Web or Internet?                                                                             

  Have managers and supervisor been trained on their                                                              
  responsibilities under the procedures for reasonable                                                           
  accommodation?                                                                                                 
  ----------------------------------------------------- ----------------------------------- ----------- -------- --------------

  ----------------------------------------------------- -------------- ---------------------------------- ----------- -------- -------------
  **Essential Element B: [Integration of EEO into the                                                                          
  Agency\'s Strategic Mission]{.smallcaps}\                                                                                    
  Requires that the agency\'s EEO programs be organized                                                                        
  and structured to maintain a workplace that is free                                                                          
  from discrimination in any of the agency\'s policies,                                                                        
  procedures or practices and supports the agency\'s                                                                           
  strategic mission.**                                                                                                         

  ![](media/image1.png){width="0.3541666666666667in"    **The                                             **Measure            **For all
  height="0.16666666666666666in"}**Compliance           reporting                                         has been             unmet
  Indicator**                                           structure for                                     met**                measures,
                                                        the EEO                                                                provide a
                                                        Program                                                                brief
                                                        provides the                                                           explanation
                                                        Principal EEO                                                          in the space
                                                        Official with                                                          below or
                                                        appropriate                                                            complete and
                                                        authority and                                                          attach an
                                                        resources to                                                           EEOC FORM
                                                        effectively                                                            715-01 PART H
                                                        carry out a                                                            to the
                                                        successful EEO                                                         agency\'s
                                                        Program.**                                                             status
                                                                                                                               report**

  ![](media/image2.png){width="0.22916666666666666in"                                                     **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                  

  Is the EEO Director under the direct supervision of                                                                           
  the agency head? **\[see 29 CFR §1614.102(b)(4)\]**\                                                                         
  For subordinate level reporting components, is the                                                                           
  EEO Director/Officer under the immediate supervision                                                                         
  of the lower level component\'s head official?\                                                                              
  (For example, does the Regional EEO Officer report to                                                                        
  the Regional Administrator?)                                                                                                 

  Are the duties and responsibilities of EEO officials                                                                          
  clearly defined?                                                                                                             

  Do the EEO officials have the knowledge, skills, and                                                                          
  abilities to carry out the duties and                                                                                        
  responsibilities of their positions?                                                                                         

  If the agency has 2^nd^ level reporting components,                                                                           
  are there organizational charts that clearly define                                                                          
  the reporting structure for EEO programs?                                                                                    

  If the agency has 2^nd^ level reporting components,                                                                           
  does the agency-wide EEO Director have authority for                                                                         
  the EEO programs within the subordinate reporting                                                                            
  components?                                                                                                                  

  If not, please describe how EEO program authority is                                                                         
  delegated to subordinate reporting components.                                                                               

  ![](media/image1.png){width="0.3541666666666667in"                   **The EEO Director and other EEO   **Measure            **For all
  height="0.16666666666666666in"}**Compliance                          professional staff responsible for has been             unmet
  Indicator**                                                          EEO programs have regular and      met**                measures,
                                                                       effective means of informing the                        provide a
                                                                       agency head and senior management                       brief
                                                                       officials of the status of EEO                          explanation
                                                                       programs and are involved in, and                       in the space
                                                                       consulted on, management/personnel                      below or
                                                                       actions.**                                              complete and
                                                                                                                               attach an
                                                                                                                               EEOC FORM
                                                                                                                               715-01 PART H
                                                                                                                               to the
                                                                                                                               agency\'s
                                                                                                                               status
                                                                                                                               report**

  ![](media/image2.png){width="0.22916666666666666in"                                                     **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                  

  Does the EEO Director/Officer have a regular and                                                                              
  effective means of informing the agency head and                                                                             
  other top management officials of the effectiveness,                                                                         
  efficiency and legal compliance of the agency\'s EEO                                                                         
  program?                                                                                                                     

  Following the submission of the immediately preceding                                                                         
  FORM 715-01, did the EEO Director/Officer present to                                                                         
  the head of the agency and other senior officials the                                                                        
  \"State of the Agency\" briefing covering all                                                                                
  components of the EEO report, including an assessment                                                                        
  of the performance of the agency in each of the six                                                                          
  elements of the Model EEO Program and a report on the                                                                        
  progress of the agency in completing its barrier                                                                             
  analysis including any barriers it identified and/or                                                                         
  eliminated or reduced the impact of?                                                                                         

  Are EEO program officials present during agency                                                                               
  deliberations prior to decisions regarding                                                                                   
  recruitment strategies, vacancy projections,                                                                                 
  succession planning, selections for training/career                                                                          
  development opportunities, and other workforce                                                                               
  changes?                                                                                                                     

  Does the agency consider whether any group of                                                                                 
  employees or applicants might be negatively impacted                                                                         
  prior to making human resource decisions such as                                                                             
  re-organizations and re-alignments?                                                                                          

  Are management/personnel policies, procedures and                                                                             
  practices examined at regular intervals to assess                                                                            
  whether there are hidden impediments to the                                                                                  
  realization of equality of opportunity for any                                                                               
  group(s) of employees or applicants? **\[see 29                                                                              
  C.F.R.** **§** **1614.102(b)(3)\]**                                                                                          

  Is the EEO Director included in the agency\'s                                                                                 
  strategic planning, especially the agency\'s human                                                                           
  capital plan, regarding succession planning,                                                                                 
  training, etc., to ensure that EEO concerns are                                                                              
  integrated into the agency\'s strategic mission?                                                                             

  ![](media/image1.png){width="0.3541666666666667in"    **The agency                                      **Measure            **For all
  height="0.16666666666666666in"}**Compliance           has committed                                     has been             unmet
  Indicator**                                           sufficient                                        met**                measures,
                                                        human                                                                  provide a
                                                        resources and                                                          brief
                                                        budget                                                                 explanation
                                                        allocations to                                                         in the space
                                                        its EEO                                                                below or
                                                        programs to                                                            complete and
                                                        ensure                                                                 attach an
                                                        successful                                                             EEOC FORM
                                                        operation.**                                                           715-01 PART H
                                                                                                                               to the
                                                                                                                               agency\'s
                                                                                                                               status
                                                                                                                               report**

  ![](media/image2.png){width="0.22916666666666666in"                                                     **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                  

  Does the EEO Director have the authority and funding                                                                          
  to ensure implementation of agency EEO action plans                                                                          
  to improve EEO program efficiency and/or eliminate                                                                           
  identified barriers to the realization of equality of                                                                        
  opportunity?                                                                                                                 

  Are sufficient personnel resources allocated to the                                                                           
  EEO Program to ensure that agency self-assessments                                                                           
  and self-analyses prescribed by EEO MD-715 are                                                                               
  conducted annually and to maintain an effective                                                                              
  complaint processing system?                                                                                                 

  Are statutory/regulatory EEO related Special Emphasis                                                                         
  Programs sufficiently staffed?                                                                                               

  Federal Women\'s Program - 5 U.S.C. 7201; 38 U.S.C.                                                                           
  4214; Title 5 CFR, Subpart B, 720.204                                                                                        

  Hispanic Employment Program - Title 5 CFR, Subpart B,                                                                         
  720.204                                                                                                                      

  People With Disabilities Program Manager; Selective                                                                           
  Placement Program for Individuals With Disabilities -                                                                        
  Section 501 of the Rehabilitation Act; Title 5 U.S.C.                                                                        
  Subpart B, Chapter 31, Subchapter I-3102; 5 CFR                                                                              
  213.3102(t) and (u); 5 CFR 315.709                                                                                           

  Are other agency special emphasis programs monitored                                                                          
  by the EEO Office for coordination and compliance                                                                            
  with EEO guidelines and principles, such as FEORP - 5                                                                        
  CFR 720; Veterans Employment Programs; and                                                                                   
  Black/African American; American Indian/Alaska                                                                               
  Native, Asian American/Pacific Islander programs?                                                                            

  ![](media/image1.png){width="0.3541666666666667in"    **The agency                                      **Measure            **For all
  height="0.16666666666666666in"}**Compliance           has committed                                     has been             unmet
  Indicator**                                           sufficient                                        met**                measures,
                                                        budget to                                                              provide a
                                                        support the                                                            brief
                                                        success of its                                                         explanation
                                                        EEO                                                                    in the space
                                                        Programs.**                                                            below or
                                                                                                                               complete and
                                                                                                                               attach an
                                                                                                                               EEOC FORM
                                                                                                                               715-01 PART H
                                                                                                                               to the
                                                                                                                               agency\'s
                                                                                                                               status
                                                                                                                               report**

  ![](media/image2.png){width="0.22916666666666666in"                                                     **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                  

  Are there sufficient resources to enable the agency                                                                           
  to conduct a thorough barrier analysis of its                                                                                
  workforce, including the provision of adequate data                                                                          
  collection and tracking systems                                                                                              
  ----------------------------------------------------- -------------- ---------------------------------- ----------- -------- -------------

  ------------------------------------------------ ---- --- -------------
  Is there sufficient budget allocated to all                
  employees to utilize, when desired, all EEO               
  programs, including the complaint processing              
  program and ADR, and to make a request for                
  reasonable accommodation? (Including subordinate          
  level reporting components?)                              

  Has funding been secured for publication and               
  distribution of EEO materials (e.g. harassment            
  policies, EEO posters, reasonable accommodations          
  procedures, etc.)?                                        

  Is there a central fund or other mechanism for             
  funding supplies, equipment and services                  
  necessary to provide disability accommodations?           

  Does the agency fund major renovation projects             
  to ensure timely compliance with Uniform Federal          
  Accessibility Standards?                                  

  Is the EEO Program allocated sufficient                    
  resources to train all employees on EEO                   
  Programs, including administrative and judicial           
  remedial procedures available to employees?               

  Is there sufficient funding to ensure the                  
  prominent posting of written materials in all             
  personnel and EEO offices? **\[see 29 C.F.R. §            
  1614.102(b)(5)\]**                                        

  Is there sufficient funding to ensure that all             
  employees have access to this training and                
  information?                                              

  Is there sufficient funding to provide all                 
  managers and supervisors with training and                
  periodic up-dates on their EEO responsibilities:          

  for ensuring a workplace that is free from all             
  forms of discrimination, including harassment             
  and retaliation?                                          

  to provide religious accommodations?                       

  to provide disability accommodations in                    
  accordance with the agency\'s written                     
  procedures?                                               

  in the EEO discrimination complaint process?               

  to participate in ADR?                                     
  ------------------------------------------------ ---- --- -------------

  ----------------------------------------------------- -------------------- ------------------------------- ----------- -------- ----------------
  **Essential Element C: [Management and Program                                                                                  
  Accountability]{.smallcaps}\                                                                                                    
  This element requires the Agency Head to hold all                                                                               
  managers, supervisors, and EEO Officials responsible                                                                            
  for the effective implementation of the agency\'s EEO                                                                           
  Program and Plan.**                                                                                                             

  ![](media/image1.png){width="0.3541666666666667in"                         **EEO program officials advise  **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance                                and provide appropriate         has been             measures,
  Indicator**                                                                assistance to                   met**                provide a brief
                                                                             managers/supervisors about the                       explanation in
                                                                             status of EEO programs within                        the space below
                                                                             each manager\'s or                                   or complete and
                                                                             supervisor\'s area or                                attach an EEOC
                                                                             responsibility.**                                    FORM 715-01 PART
                                                                                                                                  H to the
                                                                                                                                  agency\'s status
                                                                                                                                  report**

  ![](media/image2.png){width="0.22916666666666666in"                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                     

  Are regular (monthly/quarterly/semi-annually) EEO                                                                                
  updates provided to management/supervisory officials                                                                            
  by EEO program officials?                                                                                                       

  Do EEO program officials coordinate the development                                                                              
  and implementation of EEO Plans with all appropriate                                                                            
  agency managers to include Agency Counsel, Human                                                                                
  Resource Officials, Finance, and the Chief                                                                                      
  information Officer?                                                                                                            

  ![](media/image1.png){width="0.3541666666666667in"    **The Human                                          **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           Resources Director                                   has been             measures,
  Indicator**                                           and the EEO Director                                 met**                provide a brief
                                                        meet regularly to                                                         explanation in
                                                        assess whether                                                            the space below
                                                        personnel programs,                                                       or complete and
                                                        policies, and                                                             attach an EEOC
                                                        procedures are in                                                         FORM 715-01 PART
                                                        conformity with                                                           H to the
                                                        instructions                                                              agency\'s status
                                                        contained in EEOC                                                         report**
                                                        management                                                                
                                                        directives. \[see 29                                                      
                                                        CFR §                                                                     
                                                        1614.102(b)(3)\]**                                                        

  ![](media/image2.png){width="0.22916666666666666in"                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                     

  Have time-tables or schedules been established for                                                                               
  the agency to review its Merit Promotion Program                                                                                
  Policy and Procedures for systemic barriers that may                                                                            
  be impeding full participation in promotion                                                                                     
  opportunities by all groups?                                                                                                    

  Have time-tables or schedules been established for                                                                               
  the agency to review its Employee Recognition Awards                                                                            
  Program and Procedures for systemic barriers that may                                                                           
  be impeding full participation in the program by all                                                                            
  groups?                                                                                                                         

  Have time-tables or schedules been established for                                                                               
  the agency to review its Employee                                                                                               
  Development/Training Programs for systemic barriers                                                                             
  that may be impeding full participation in training                                                                             
  opportunities by all groups?                                                                                                    

  ![](media/image1.png){width="0.3541666666666667in"    **When findings of                                   **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           discrimination are                                   has been             measures,
  Indicator**                                           made, the agency                                     met**                provide a brief
                                                        explores whether or                                                       explanation in
                                                        not disciplinary                                                          the space below
                                                        actions should be                                                         or complete and
                                                        taken.**                                                                  attach an EEOC
                                                                                                                                  FORM 715-01 PART
                                                                                                                                  H to the
                                                                                                                                  agency\'s status
                                                                                                                                  report**

  ![](media/image2.png){width="0.22916666666666666in"                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                     

  Does the agency have a disciplinary policy and/or a                                                                              
  table of penalties that covers employees found to                                                                               
  have committed discrimination?                                                                                                  

  Have all employees, supervisors, and managers been                                                                               
  informed as to the penalties for being found to                                                                                 
  perpetrate discriminatory behavior or for taking                                                                                
  personnel actions based upon a prohibited basis?                                                                                

  Has the agency, when appropriate, disciplined or                                                                                 
  sanctioned managers/supervisors or employees found to                                                                           
  have discriminated over the past two years?                                                                                     

  If so, cite number found to have discriminated and                                                                              
  list penalty /disciplinary action for each type of                                                                              
  violation.                                                                                                                      

  Does the agency promptly (within the established time                                                                            
  frame) comply with EEOC, Merit Systems Protection                                                                               
  Board, Federal Labor Relations Authority, labor                                                                                 
  arbitrators, and District Court orders?                                                                                         

  Does the agency review disability accommodation                                                                                  
  decisions/actions to ensure compliance with its                                                                                 
  written procedures and analyze the information                                                                                  
  tracked for trends, problems, etc.?                                                                                             
  ----------------------------------------------------- -------------------- ------------------------------- ----------- -------- ----------------

  ----------------------------------------------------- ---------------------------------- ----------- -------- ---------------
  **Essential Element D: [Proactive                                                                             
  Prevention]{.smallcaps}\                                                                                      
  Requires that the agency head makes early efforts to                                                          
  prevent discriminatory actions and eliminate barriers                                                         
  to equal employment opportunity in the workplace.**                                                           

  ![](media/image1.png){width="0.3541666666666667in"    **Analyses to identify and remove  **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           unnecessary barriers to employment has been             measures,
  Indicator**                                           are conducted throughout the       met**                provide a brief
                                                        year.**                                                 explanation in
                                                                                                                the space below
                                                                                                                or complete and
                                                                                                                attach an EEOC
                                                                                                                FORM 715-01
                                                                                                                PART H to the
                                                                                                                agency\'s
                                                                                                                status report**

  ![](media/image2.png){width="0.22916666666666666in"                                      **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                   

  Do senior managers meet with and assist the EEO                                                                
  Director and/or other EEO Program Officials in the                                                            
  identification of barriers that may be impeding the                                                           
  realization of equal employment opportunity?                                                                  

  When barriers are identified, do senior managers                                                               
  develop and implement, with the assistance of the                                                             
  agency EEO office, agency EEO Action Plans to                                                                 
  eliminate said barriers?                                                                                      

  Do senior managers successfully implement EEO Action                                                           
  Plans and incorporate the EEO Action Plan Objectives                                                          
  into agency strategic plans?                                                                                  

  Are trend analyses of workforce profiles conducted by                                                          
  race, national origin, sex and disability?                                                                    

  Are trend analyses of the workforce\'s major                                                                   
  occupations conducted by race, national origin, sex                                                           
  and disability?                                                                                               

  Are trends analyses of the workforce\'s grade level                                                            
  distribution conducted by race, national origin, sex                                                          
  and disability?                                                                                               

  Are trend analyses of the workforce\'s compensation                                                            
  and reward system conducted by race, national origin,                                                         
  sex and disability?                                                                                           

  Are trend analyses of the effects of                                                                           
  management/personnel policies, procedures and                                                                 
  practices conducted by race, national origin, sex and                                                         
  disability?                                                                                                   

  ![](media/image1.png){width="0.3541666666666667in"    **The use of Alternative Dispute   **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           Resolution (ADR) is encouraged by  has been             measures,
  Indicator**                                           senior management.**               met**                provide a brief
                                                                                                                explanation in
                                                                                                                the space below
                                                                                                                or complete and
                                                                                                                attach an EEOC
                                                                                                                FORM 715-01
                                                                                                                PART H to the
                                                                                                                agency\'s
                                                                                                                status report**

  ![](media/image2.png){width="0.22916666666666666in"                                      **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                   

  Are all employees encouraged to use ADR?                                                                       

  Is the participation of supervisors and managers in                                                            
  the ADR process required?                                                                                     
  ----------------------------------------------------- ---------------------------------- ----------- -------- ---------------

  ----------------------------------------------------- --------------- ------------------- -------------------------------- ----------- -------- ----------------
  **Essential Element E: [Efficiency]{.smallcaps}\                                                                                                
  Requires that the agency head ensure that there are                                                                                             
  effective systems in place for evaluating the impact                                                                                            
  and effectiveness of the agency\'s EEO Programs as                                                                                              
  well as an efficient and fair dispute resolution                                                                                                
  process.**                                                                                                                                      

  ![](media/image1.png){width="0.3541666666666667in"                    **The agency has                                     **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance                           sufficient                                           has been             measures,
  Indicator**                                                           staffing, funding,                                   met**                provide a brief
                                                                        and authority to                                                          explanation in
                                                                        achieve the                                                               the space below
                                                                        elimination of                                                            or complete and
                                                                        identified                                                                attach an EEOC
                                                                        barriers.**                                                               FORM 715-01 PART
                                                                                                                                                  H to the
                                                                                                                                                  agency\'s status
                                                                                                                                                  report**

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  Does the EEO Office employ personnel with adequate                                                                                               
  training and experience to conduct the analyses                                                                                                 
  required by MD-715 and these instructions?                                                                                                      

  Has the agency implemented an adequate data                                                                                                      
  collection and analysis systems that permit tracking                                                                                            
  of the information required by MD-715 and these                                                                                                 
  instructions?                                                                                                                                   

  Have sufficient resources been provided to conduct                                                                                               
  effective audits of field facilities\' efforts to                                                                                               
  achieve a model EEO program and eliminate                                                                                                       
  discrimination under Title VII and the Rehabilitation                                                                                           
  Act?                                                                                                                                            

  Is there a designated agency official or other                                                                                                   
  mechanism in place to coordinate or assist with                                                                                                 
  processing requests for disability accommodations in                                                                                            
  all major components of the agency?                                                                                                             

  Are 90% of accommodation requests processed within                                                                                               
  the time frame set forth in the agency procedures for                                                                                           
  reasonable accommodation?                                                                                                                       

  ![](media/image1.png){width="0.3541666666666667in"    **The agency                                                         **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           has an                                                               has been             measures,
  Indicator**                                           effective                                                            met**                provide a brief
                                                        complaint                                                                                 explanation in
                                                        tracking and                                                                              the space below
                                                        monitoring                                                                                or complete and
                                                        system in place                                                                           attach an EEOC
                                                        to increase the                                                                           FORM 715-01 PART
                                                        effectiveness                                                                             H to the
                                                        of the                                                                                    agency\'s status
                                                        agency\'s EEO                                                                             report**
                                                        Programs.**                                                                               

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  Does the agency use a complaint tracking and                                                                                                     
  monitoring system that allows identification of the                                                                                             
  location, and status of complaints and length of time                                                                                           
  elapsed at each stage of the agency\'s complaint                                                                                                
  resolution process?                                                                                                                             

  Does the agency\'s tracking system identify the                                                                                                  
  issues and bases of the complaints, the aggrieved                                                                                               
  individuals/complainants, the involved management                                                                                               
  officials and other information to analyze complaint                                                                                            
  activity and trends?                                                                                                                            

  Does the agency hold contractors accountable for                                                                                                 
  delay in counseling and investigation processing                                                                                                
  times?                                                                                                                                          

  If yes, briefly describe how:\                                                                                                                  
  \                                                                                                                                               
                                                                                                                                                  

  Does the agency monitor and ensure that new                                                                                                      
  investigators, counselors, including contract and                                                                                               
  collateral duty investigators, receive the 32 hours                                                                                             
  of training required in accordance with EEO                                                                                                     
  Management Directive MD-110?                                                                                                                    

  Does the agency monitor and ensure that experienced                                                                                              
  counselors, investigators, including contract and                                                                                               
  collateral duty investigators, receive the 8 hours of                                                                                           
  refresher training required on an annual basis in                                                                                               
  accordance with EEO Management Directive MD-110?                                                                                                

  ![](media/image1.png){width="0.3541666666666667in"                    **The agency has                                     **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance                           sufficient                                           has been             measures,
  Indicator**                                                           staffing, funding                                    met**                provide a brief
                                                                        and authority to                                                          explanation in
                                                                        comply with the                                                           the space below
                                                                        time frames in                                                            or complete and
                                                                        accordance with the                                                       attach an EEOC
                                                                        EEOC (29 C.F.R.                                                           FORM 715-01 PART
                                                                        Part 1614)                                                                H to the
                                                                        regulations for                                                           agency\'s status
                                                                        processing EEO                                                            report**
                                                                        complaints of                                                             
                                                                        employment                                                                
                                                                        discrimination.**                                                         

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  Are benchmarks in place that compare the agency\'s                                                                                               
  discrimination complaint processes with 29 C.F.R.                                                                                               
  Part 1614?                                                                                                                                      

  Does the agency provide timely EEO counseling within                                                                                             
  30 days of the initial request or within an agreed                                                                                              
  upon extension in writing, up to 60 days?                                                                                                       

  Does the agency provide an aggrieved person with                                                                                                 
  written notification of his/her rights and                                                                                                      
  responsibilities in the EEO process in a timely                                                                                                 
  fashion?                                                                                                                                        

  Does the agency complete the investigations within                                                                                               
  the applicable prescribed time frame?                                                                                                           

  When a complainant requests a final agency decision,                                                                                             
  does the agency issue the decision within 60 days of                                                                                            
  the request?                                                                                                                                    

  When a complainant requests a hearing, does the                                                                                                  
  agency immediately upon receipt of the request from                                                                                             
  the EEOC AJ forward the investigative file to the                                                                                               
  EEOC Hearing Office?                                                                                                                            

  When a settlement agreement is entered into, does the                                                                                            
  agency timely complete any obligations provided for                                                                                             
  in such agreements?                                                                                                                             

  Does the agency ensure timely compliance with EEOC AJ                                                                                            
  decisions which are not the subject of an appeal by                                                                                             
  the agency?                                                                                                                                     

  ![](media/image1.png){width="0.3541666666666667in"                    **There is an                                        **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance                           efficient and fair                                   has been             measures,
  Indicator**                                                           dispute resolution                                   met**                provide a brief
                                                                        process and                                                               explanation in
                                                                        effective systems                                                         the space below
                                                                        for evaluating the                                                        or complete and
                                                                        impact and                                                                attach an EEOC
                                                                        effectiveness of                                                          FORM 715-01 PART
                                                                        the agency\'s EEO                                                         H to the
                                                                        complaint                                                                 agency\'s status
                                                                        processing                                                                report**
                                                                        program.**                                                                

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  In accordance with 29 C.F.R. §1614.102(b), has the                                                                                               
  agency established an ADR Program during the                                                                                                    
  pre-complaint and formal complaint stages of the EEO                                                                                            
  process?                                                                                                                                        

  Does the agency require all managers and supervisors                                                                                             
  to receive ADR training in accordance with EEOC (29                                                                                             
  C.F.R. Part 1614) regulations, with emphasis on the                                                                                             
  federal government\'s interest in encouraging mutual                                                                                            
  resolution of disputes and the benefits associated                                                                                              
  with utilizing ADR?                                                                                                                             

  After the agency has offered ADR and the complainant                                                                                             
  has elected to participate in ADR, are the managers                                                                                             
  required to participate?                                                                                                                        

  Does the responsible management official directly                                                                                                
  involved in the dispute have settlement authority?                                                                                              

  ![](media/image1.png){width="0.3541666666666667in"                                        **The agency has effective       **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance                                               systems in place for maintaining has been             measures,
  Indicator**                                                                               and evaluating the impact and    met**                provide a brief
                                                                                            effectiveness of its EEO                              explanation in
                                                                                            programs.**                                           the space below
                                                                                                                                                  or complete and
                                                                                                                                                  attach an EEOC
                                                                                                                                                  FORM 715-01 PART
                                                                                                                                                  H to the
                                                                                                                                                  agency\'s status
                                                                                                                                                  report**

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  Does the agency have a system of management controls                                                                                             
  in place to ensure the timely, accurate, complete and                                                                                           
  consistent reporting of EEO complaint data to the                                                                                               
  EEOC?                                                                                                                                           

  Does the agency provide reasonable resources for the                                                                                             
  EEO complaint process to ensure efficient and                                                                                                   
  successful operation in accordance with 29 C.F.R. §                                                                                             
  1614.102(a)(1)?                                                                                                                                 

  Does the agency EEO office have management controls                                                                                              
  in place to monitor and ensure that the data received                                                                                           
  from Human Resources is accurate, timely received,                                                                                              
  and contains all the required data elements for                                                                                                 
  submitting annual reports to the EEOC?                                                                                                          

  Do the agency\'s EEO programs address all of the laws                                                                                            
  enforced by the EEOC?                                                                                                                           

  Does the agency identify and monitor significant                                                                                                 
  trends in complaint processing to determine whether                                                                                             
  the agency is meeting its obligations under Title VII                                                                                           
  and the Rehabilitation Act?                                                                                                                     

  Does the agency track recruitment efforts and analyze                                                                                            
  efforts to identify potential barriers in accordance                                                                                            
  with MD-715 standards?                                                                                                                          

  Does the agency consult with other agencies of                                                                                                   
  similar size on the effectiveness of their EEO                                                                                                  
  programs to identify best practices and share ideas?                                                                                            

  ![](media/image1.png){width="0.3541666666666667in"    **The agency                                                         **Measure            **For all unmet
  height="0.16666666666666666in"}**Compliance           ensures that                                                         has been             measures,
  Indicator**                                           the                                                                  met**                provide a brief
                                                        investigation                                                                             explanation in
                                                        and                                                                                       the space below
                                                        adjudication                                                                              or complete and
                                                        function of its                                                                           attach an EEOC
                                                        complaint                                                                                 FORM 715-01 PART
                                                        resolution                                                                                H to the
                                                        process are                                                                               agency\'s status
                                                        separate from                                                                             report**
                                                        its legal                                                                                 
                                                        defense arm of                                                                            
                                                        agency or other                                                                           
                                                        offices with                                                                              
                                                        conflicting or                                                                            
                                                        competing                                                                                 
                                                        interests.**                                                                              

  ![](media/image2.png){width="0.22916666666666666in"                                                                        **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                                                     

  Are legal sufficiency reviews of EEO matters handled                                                                                             
  by a functional unit that is separate and apart from                                                                                            
  the unit which handles agency representation in EEO                                                                                             
  complaints?                                                                                                                                     

  Does the agency discrimination complaint process                                                                                                 
  ensure a neutral adjudication function?                                                                                                         

  If applicable, are processing time frames                                                                                                        
  incorporated for the legal counsel\'s sufficiency                                                                                               
  review for timely processing of complaints?                                                                                                     
  ----------------------------------------------------- --------------- ------------------- -------------------------------- ----------- -------- ----------------

  ----------------------------------------------------- ----------------------------------- ----------- -------- -------------
  **Essential Element F: [Responsiveness and Legal                                                               
  Compliance]{.smallcaps}\                                                                                       
  This element requires that federal agencies are in                                                             
  full compliance with EEO statutes and EEOC                                                                     
  regulations, policy guidance, and other written                                                                
  instructions.**                                                                                                

  ![](media/image1.png){width="0.3541666666666667in"    **Agency personnel are accountable  **Measure            **For all
  height="0.16666666666666666in"}**Compliance           for timely compliance with orders   has been             unmet
  Indicator**                                           issued by EEOC Administrative       met**                measures,
                                                        Judges.**                                                provide a
                                                                                                                 brief
                                                                                                                 explanation
                                                                                                                 in the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an
                                                                                                                 EEOC FORM
                                                                                                                 715-01 PART H
                                                                                                                 to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

                                                        Does the agency have a system of                          
                                                        management control to ensure that                        
                                                        agency officials timely comply with                      
                                                        any orders or directives issued by                       
                                                        EEOC Administrative Judges?                              

                                                                                                                 

  ![](media/image1.png){width="0.3541666666666667in"    **The agency\'s system of           **Measure            **For all
  height="0.16666666666666666in"}**Compliance           management controls ensures that    has been             unmet
  Indicator**                                           the agency timely completes all     met**                measures,
                                                        ordered corrective action and                            provide a
                                                        submits its compliance report to                         brief
                                                        EEOC within 30 days of such                              explanation
                                                        completion.**                                            in the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an
                                                                                                                 EEOC FORM
                                                                                                                 715-01 PART H
                                                                                                                 to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

  Does the agency have control over the payroll                                                                   
  processing function of the agency? If Yes, answer the                                                          
  two questions below.                                                                                           

  Are there steps in place to guarantee responsive,                                                               
  timely, and predictable processing of ordered                                                                  
  monetary relief?                                                                                               

  Are procedures in place to promptly process other                                                               
  forms of ordered relief?                                                                                       

  ![](media/image1.png){width="0.3541666666666667in"    **Agency personnel are accountable  **Measure            **For all
  height="0.16666666666666666in"}**Compliance           for the timely completion of        has been             unmet
  Indicator**                                           actions required to comply with     met**                measures,
                                                        orders of EEOC.**                                        provide a
                                                                                                                 brief
                                                                                                                 explanation
                                                                                                                 in the space
                                                                                                                 below or
                                                                                                                 complete and
                                                                                                                 attach an
                                                                                                                 EEOC FORM
                                                                                                                 715-01 PART H
                                                                                                                 to the
                                                                                                                 agency\'s
                                                                                                                 status
                                                                                                                 report**

  ![](media/image2.png){width="0.22916666666666666in"                                       **Yes**     **No**   
  height="0.20833333333333334in"}**Measures**                                                                    

  Is compliance with EEOC orders encompassed in the                                                               
  performance standards of any agency employees?                                                                 

  If so, please identify the employees by title in the                                                           
  comments section, and state how performance is                                                                 
  measured.                                                                                                      

  Is the unit charged with the responsibility for                                                                 
  compliance with EEOC orders located in the EEO                                                                 
  office?                                                                                                        

  If not, please identify the unit in which it is                                                                
  located, the number of employees in the unit, and                                                              
  their grade levels in the comments section.                                                                    

  Have the involved employees received any formal                                                                 
  training in EEO compliance?                                                                                    

  Does the agency promptly provide to the EEOC the                                                                
  following documentation for completing compliance:                                                             

  Attorney Fees: Copy of check issued for attorney fees                                                           
  and /or a narrative statement by an appropriate                                                                
  agency official, or agency payment order dating the                                                            
  dollar amount of attorney fees paid?                                                                           

  Awards: A narrative statement by an appropriate                                                                 
  agency official stating the dollar amount and the                                                              
  criteria used to calculate the award?                                                                          

  Back Pay and Interest: Computer print-outs or payroll                                                           
  documents outlining gross back pay and interest, copy                                                          
  of any checks issued, narrative statement by an                                                                
  appropriate agency official of total monies paid?                                                              

  Compensatory Damages: The final agency decision and                                                             
  evidence of payment, if made?                                                                                  

  Training: Attendance roster at training session(s) or                                                           
  a narrative statement by an appropriate agency                                                                 
  official confirming that specific persons or groups                                                            
  of persons attended training on a date certain?                                                                

  Personnel Actions (e.g., Reinstatement, Promotion,                                                              
  Hiring, Reassignment): Copies of SF-50s                                                                        

  Posting of Notice of Violation: Original signed and                                                             
  dated notice reflecting the dates that the notice was                                                          
  posted. A copy of the notice will suffice if the                                                               
  original is not available.                                                                                     

  Supplemental Investigation: 1. Copy of letter to                                                                
  complainant acknowledging receipt from EEOC of                                                                 
  remanded case. 2. Copy of letter to complainant                                                                
  transmitting the Report of Investigation (not the ROI                                                          
  itself unless specified). 3. Copy of request for a                                                             
  hearing (complainant\'s request or agency\'s                                                                   
  transmittal letter).                                                                                           

  Final Agency Decision (FAD): FAD or copy of the                                                                 
  complainant\'s request for a hearing.                                                                          

  Restoration of Leave: Print-out or statement                                                                    
  identifying the amount of leave restored, if                                                                   
  applicable. If not, an explanation or statement.                                                               

  Civil Actions: A complete copy of the civil action                                                              
  complaint demonstrating same issues raised as in                                                               
  compliance matter.                                                                                             

  Settlement Agreements: Signed and dated agreement                                                               
  with specific dollar amounts, if applicable. Also,                                                             
  appropriate documentation of relief is provided.                                                               
  ----------------------------------------------------- ----------------------------------- ----------- -------- -------------

Footnotes:

1\. *See* 29 C.F.R. § 1614.102.

2\. When an agency makes modifications to its procedures, the procedures
must be resubmitted to the Commission. *See EEOC Policy Guidance on
Executive Order 13164: Establishing Procedures to Facilitate the
Provision of Reasonable Accommodation* (10/20/00), Question 28.

+-----------+--------+-------------+-----------------------------------+
| **EEOC    | *      |             |                                   |
| FORM\     | **U.S. |             |                                   |
| 715-01**  | Equal  |             |                                   |
|           | Empl   |             |                                   |
| **PART    | oyment |             |                                   |
| H**       | Oppor  |             |                                   |
|           | tunity |             |                                   |
|           | C      |             |                                   |
|           | ommiss |             |                                   |
|           | ion*** |             |                                   |
|           |        |             |                                   |
|           | **F    |             |                                   |
|           | EDERAL |             |                                   |
|           | AGENCY |             |                                   |
|           | AN     |             |                                   |
|           | NUAL** |             |                                   |
|           |        |             |                                   |
|           | **EEO  |             |                                   |
|           | P      |             |                                   |
|           | ROGRAM |             |                                   |
|           | STATUS |             |                                   |
|           | RE     |             |                                   |
|           | PORT** |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| \[Insert  |        |             | FY \_\_\_\_\_                     |
| Name of   |        |             |                                   |
| Agency of |        |             |                                   |
| Reporting |        |             |                                   |
| Co        |        |             |                                   |
| mponent\] |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| STATEMENT |        |             |                                   |
| of\       |        |             |                                   |
| MODEL     |        |             |                                   |
| PROGRAM\  |        |             |                                   |
| ESSENTIAL |        |             |                                   |
| ELEMENT\  |        |             |                                   |
| DE        |        |             |                                   |
| FICIENCY: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| O         |        |             |                                   |
| BJECTIVE: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| RE        |        |             |                                   |
| SPONSIBLE |        |             |                                   |
| OFFICIAL: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| DATE      |        |             |                                   |
| OBJECTIVE |        |             |                                   |
| I         |        |             |                                   |
| NITIATED: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| TARGET    |        |             |                                   |
| DATE FOR\ |        |             |                                   |
| C         |        |             |                                   |
| OMPLETION |        |             |                                   |
| OF        |        |             |                                   |
| O         |        |             |                                   |
| BJECTIVE: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| PLANNED   |        | TARGET      |                                   |
| A         |        | DATE\       |                                   |
| CTIVITIES |        | (Must be    |                                   |
| TOWARD    |        | specific)   |                                   |
| C         |        |             |                                   |
| OMPLETION |        |             |                                   |
| OF        |        |             |                                   |
| O         |        |             |                                   |
| BJECTIVE: |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
|           |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
|           |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
|           |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
|           |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
| REPORT OF |        |             |                                   |
| ACCOMP    |        |             |                                   |
| LISHMENTS |        |             |                                   |
| and       |        |             |                                   |
| MODI      |        |             |                                   |
| FICATIONS |        |             |                                   |
| TO        |        |             |                                   |
| OBJECTIVE |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+
|           |        |             |                                   |
+-----------+--------+-------------+-----------------------------------+

+-----------+----------------------+-----------------------------------+
| **EEOC    | ***U.S. Equal        |                                   |
| FORM\     | Employment           |                                   |
| 715-01**  | Opportunity          |                                   |
|           | Commission***        |                                   |
| **PART    |                      |                                   |
| I**       | **FEDERAL AGENCY     |                                   |
|           | ANNUAL**             |                                   |
|           |                      |                                   |
|           | **EEO PROGRAM STATUS |                                   |
|           | REPORT**             |                                   |
+-----------+----------------------+-----------------------------------+
| \[Insert  |                      | FY \_\_\_\_\_                     |
| Name of   |                      |                                   |
| Agency of |                      |                                   |
| Reporting |                      |                                   |
| Co        |                      |                                   |
| mponent\] |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **        |                      |                                   |
| STATEMENT |                      |                                   |
| OF        |                      |                                   |
| CONDITION |                      |                                   |
| THAT WAS  |                      |                                   |
| A TRIGGER |                      |                                   |
| FOR A     |                      |                                   |
| POTENTIAL |                      |                                   |
| B         |                      |                                   |
| ARRIER:** |                      |                                   |
|           |                      |                                   |
| Provide a |                      |                                   |
| brief     |                      |                                   |
| narrative |                      |                                   |
| d         |                      |                                   |
| escribing |                      |                                   |
| the       |                      |                                   |
| condition |                      |                                   |
| at issue. |                      |                                   |
|           |                      |                                   |
| How was   |                      |                                   |
| the       |                      |                                   |
| condition |                      |                                   |
| r         |                      |                                   |
| ecognized |                      |                                   |
| as a      |                      |                                   |
| potential |                      |                                   |
| barrier?  |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **BARRIER |                      |                                   |
| AN        |                      |                                   |
| ALYSIS:** |                      |                                   |
|           |                      |                                   |
| Provide a |                      |                                   |
| de        |                      |                                   |
| scription |                      |                                   |
| of the    |                      |                                   |
| steps     |                      |                                   |
| taken and |                      |                                   |
| data      |                      |                                   |
| analyzed  |                      |                                   |
| to        |                      |                                   |
| determine |                      |                                   |
| cause of  |                      |                                   |
| the       |                      |                                   |
| c         |                      |                                   |
| ondition. |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **        |                      |                                   |
| STATEMENT |                      |                                   |
| OF        |                      |                                   |
| I         |                      |                                   |
| DENTIFIED |                      |                                   |
| B         |                      |                                   |
| ARRIER:** |                      |                                   |
|           |                      |                                   |
| Provide a |                      |                                   |
| succinct  |                      |                                   |
| statement |                      |                                   |
| of the    |                      |                                   |
| agency    |                      |                                   |
| policy,   |                      |                                   |
| procedure |                      |                                   |
| or        |                      |                                   |
| practice  |                      |                                   |
| that has  |                      |                                   |
| been      |                      |                                   |
| d         |                      |                                   |
| etermined |                      |                                   |
| to be the |                      |                                   |
| barrier   |                      |                                   |
| of the    |                      |                                   |
| undesired |                      |                                   |
| c         |                      |                                   |
| ondition. |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **OBJ     |                      |                                   |
| ECTIVE:** |                      |                                   |
|           |                      |                                   |
| State the |                      |                                   |
| al        |                      |                                   |
| ternative |                      |                                   |
| or        |                      |                                   |
| revised   |                      |                                   |
| agency    |                      |                                   |
| policy,   |                      |                                   |
| procedure |                      |                                   |
| or        |                      |                                   |
| practice  |                      |                                   |
| to be     |                      |                                   |
| im        |                      |                                   |
| plemented |                      |                                   |
| to        |                      |                                   |
| correct   |                      |                                   |
| the       |                      |                                   |
| undesired |                      |                                   |
| c         |                      |                                   |
| ondition. |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **RE      |                      |                                   |
| SPONSIBLE |                      |                                   |
| OF        |                      |                                   |
| FICIAL:** |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **DATE    |                      |                                   |
| OBJECTIVE |                      |                                   |
| INI       |                      |                                   |
| TIATED:** |                      |                                   |
+-----------+----------------------+-----------------------------------+
| **TARGET  |                      |                                   |
| DATE FOR  |                      |                                   |
| C         |                      |                                   |
| OMPLETION |                      |                                   |
| OF        |                      |                                   |
| OBJ       |                      |                                   |
| ECTIVE:** |                      |                                   |
+-----------+----------------------+-----------------------------------+

+-----------+---------------------------------------+------------------+
| **EEOC    | **EEO Plan To Eliminate Identified    |                  |
| FORM\     | Barrier**                             |                  |
| 715-01**  |                                       |                  |
|           |                                       |                  |
| **PART    |                                       |                  |
| I**       |                                       |                  |
+-----------+---------------------------------------+------------------+
| **PLANNED |                                       | **TARGET DATE\   |
| A         |                                       | (Must be         |
| CTIVITIES |                                       | specific)**      |
| TOWARD    |                                       |                  |
| C         |                                       |                  |
| OMPLETION |                                       |                  |
| OF        |                                       |                  |
| OBJ       |                                       |                  |
| ECTIVE:** |                                       |                  |
+-----------+---------------------------------------+------------------+
|           |                                       |                  |
+-----------+---------------------------------------+------------------+
|           |                                       |                  |
+-----------+---------------------------------------+------------------+
|           |                                       |                  |
+-----------+---------------------------------------+------------------+
|           |                                       |                  |
+-----------+---------------------------------------+------------------+
| **REPORT  |                                       |                  |
| OF        |                                       |                  |
| ACCOMP    |                                       |                  |
| LISHMENTS |                                       |                  |
| and       |                                       |                  |
| MODI      |                                       |                  |
| FICATIONS |                                       |                  |
| TO        |                                       |                  |
| OB        |                                       |                  |
| JECTIVE** |                                       |                  |
+-----------+---------------------------------------+------------------+
|           |                                       |                  |
+-----------+---------------------------------------+------------------+

<table>
<colgroup>
<col style="width: 14%" />
<col style="width: 2%" />
<col style="width: 16%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 7%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 6%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 7%" />
<col style="width: 0%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2"><p><strong>EEOC FORM<br />
715-01</strong></p>
<p><strong>PART J</strong></p></td>
<td colspan="17"><p><strong><em>U.S. Equal Employment Opportunity
Commission</em></strong></p>
<p><strong>FEDERAL AGENCY ANNUAL</strong></p>
<p><strong>EEO PROGRAM STATUS REPORT</strong></p>
<p><strong>Special Program Plan for the Recruitment, Hiring, and
Advancement of Individuals With Targeted Disabilities</strong></p></td>
</tr>
<tr class="even">
<td rowspan="3"><strong>PART I<br />
Department or Agency Information</strong></td>
<td colspan="4">1. Agency</td>
<td colspan="14">1.</td>
</tr>
<tr class="odd">
<td colspan="4">1.a. 2<sup>nd</sup> Level Component</td>
<td colspan="14">1.a.</td>
</tr>
<tr class="even">
<td colspan="4">1.b. 3<sup>rd</sup> Level or lower</td>
<td colspan="14">1.b.</td>
</tr>
<tr class="odd">
<td rowspan="8"><strong>PART II<br />
Employment Trend and Special Recruitment for Individuals With Targeted
Disabilities</strong></td>
<td colspan="2" rowspan="2">Enter Actual Number at the ...</td>
<td colspan="5">... beginning of FY.</td>
<td colspan="5">... end of FY.</td>
<td colspan="5">Net Change</td>
<td></td>
</tr>
<tr class="even">
<td colspan="3">Number</td>
<td colspan="2">%</td>
<td colspan="2">Number</td>
<td colspan="3">%</td>
<td colspan="3">Number</td>
<td colspan="2">Rate of Change</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Total Work Force</td>
<td colspan="3"> </td>
<td colspan="2">100.00%</td>
<td colspan="2"> </td>
<td colspan="3">100.00%</td>
<td colspan="3"> </td>
<td colspan="2"> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Reportable Disability</td>
<td colspan="3"> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td colspan="3"> </td>
<td colspan="3"> </td>
<td colspan="2"> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Targeted Disability*</td>
<td colspan="3"> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td colspan="3"> </td>
<td colspan="3"> </td>
<td colspan="2"> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="17">* If the rate of change for persons with targeted
disabilities is not equal to or greater than the rate of change for the
total workforce, a barrier analysis should be conducted (see
below).</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="12">1. <strong>Total Number of Applications Received From
Persons With Targeted Disabilities</strong> during the reporting
period.</td>
<td colspan="5"> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="12">2. <strong>Total Number of Selections of Individuals
with Targeted Disabilities</strong> during the reporting period.</td>
<td colspan="5"> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="18"><strong>PART III Participation Rates In Agency
Employment Programs</strong></td>
<td></td>
</tr>
<tr class="even">
<td colspan="4" rowspan="2"><strong>Other Employment/Personnel
Programs</strong></td>
<td colspan="2" rowspan="2"><strong>TOTAL</strong></td>
<td colspan="3"><strong>Reportable Disability</strong></td>
<td colspan="3"><strong>Targeted Disability</strong></td>
<td colspan="3"><strong>Not Identified</strong></td>
<td colspan="3"><strong>No Disability</strong></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>#</strong></td>
<td colspan="2"><strong>%</strong></td>
<td colspan="2"><strong>#</strong></td>
<td><strong>%</strong></td>
<td colspan="2"><strong>#</strong></td>
<td><strong>%</strong></td>
<td colspan="2"><strong>#</strong></td>
<td><strong>%</strong></td>
<td></td>
</tr>
<tr class="even">
<td colspan="4">3. Competitive Promotions</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4">4. Non-Competitive Promotions</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="4">5. Employee Career Development Programs</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4">5.a. Grades 5 - 12</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="4">5.b. Grades 13 - 14</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4">5.c. Grade 15/SES</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="4">6. Employee Recognition and Awards</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4">6.a. Time-Off Awards (Total hrs awarded)</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="even">
<td colspan="4">6.b. Cash Awards (total $$$ awarded)</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
<tr class="odd">
<td colspan="4">6.c. Quality-Step Increase</td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td colspan="2"> </td>
<td> </td>
<td></td>
</tr>
</tbody>
</table>

+-----------+----------------------------------------------------------+
| EEOC FORM | Special Program Plan for the Recruitment, Hiring, and    |
| **        | Advancement of Individuals With Targeted Disabilities    |
| 715-01**\ |                                                          |
| Part J    |                                                          |
+-----------+----------------------------------------------------------+
| **Part    | Agencies with 1,000 or more permanent employees MUST     |
| IV**      | conduct a barrier analysis to address any barriers to    |
|           | increasing employment opportunities for employees and    |
| Ident     | applicants with targeted disabilities **using FORM       |
| ification | 715-01 PART I**. Agencies should review their            |
| and       | recruitment, hiring, career development, promotion, and  |
| El        | retention of individuals with targeted disabilities in   |
| imination | order to determine whether there are any barriers.       |
| of        |                                                          |
| Barriers  |                                                          |
+-----------+----------------------------------------------------------+
| **Part    | Agencies with 1,000 or more permanent employees are to   |
| V**       | use the space provided below to describe the strategies  |
|           | and activities that will be undertaken during the coming |
| Goals for | fiscal year to maintain a special recruitment program    |
| Targeted  | for individuals with targeted disabilities and to        |
| Dis       | establish specific goals for the employment and          |
| abilities | advancement of such individuals. For these purposes,     |
|           | targeted disabilities may be considered as a group.      |
|           | Agency goals should be set and accomplished in such a    |
|           | manner as will effect measurable progress from the       |
|           | preceding fiscal year. Agencies are encouraged to set a  |
|           | goal for the hiring of individuals with targeted         |
|           | disabilities that is at least as high as the anticipated |
|           | losses from this group during the next reporting period, |
|           | with the objective of avoiding a decrease in the total   |
|           | participation rate of employees with disabilities.       |
|           |                                                          |
|           | Goals, objectives and strategies described below should  |
|           | focus on internal as well as external sources of         |
|           | candidates and include discussions of activities         |
|           | undertaken to identify individuals with targeted         |
|           | disabilities who can be (1) hired; (2) placed in such a  |
|           | way as to improve possibilities for career development;  |
|           | and (3) advanced to a position at a higher level or with |
|           | greater potential than the position currently occupied.  |
+-----------+----------------------------------------------------------+