FSIS 1520-1 (01/16/2024)a REPLACES FSIS FORM 1520-1 (03/03/2006), WHICH IS OBSOLETE Page 1 of 2

U.S. DEPARTMENT OF AGRICULTURE 

FOOD SAFETY AND INSPECTION SERVICE

CIVIL RIGHTS COMPLIANCE OF STATE INSPECTION PROGRAMS

State Name:

Federal Fiscal Year:

PART A. PUBLIC NOTIFICATION PROCESS (To be completed by State Director)

1. Check all locations where the USDA Civil Rights Poster is prominently displayed within the State:

State Office Regional Office(s) In-Plant inspection offices

Other (describe)

2. The following must contain a non-discrimination statement providing notification that the inspection program will be conducted without regard to race, 

color, national origin, age, or disability. Please check to confirm compliance:

Applications for inspection Information/Outreach material provided to the public Meat/Poultry Web site

Official letterhead Other (describe)

PART B. CIVIL RIGHTS TRAINING (To be completed by State Civil Rights/Human Resources Office)

1. List the civil rights training topics given within the past year to all inspection and office personnel who interact with program beneficiaries and the 

public. Include dates of training and number of employees trained:

2. Describe the State's system for tracking civil rights training: 

3. Describe the civil rights training planned for the new Federal fiscal year (may include training schedule, topics, agenda, source of training): 

4. How are inspection and office personnel made aware of their civil rights responsibilities to deliver service in a non-discriminatory manner? 

5. Provide the name, title, phone number and e-mail address of the individual with delegated responsibility for monitoring and oversight of the civil rights 

and disability programs for the inspection program:
FSIS 1520-1 (01/16/2024)a REPLACES FSIS FORM 1520-1 (03/03/2006), WHICH IS OBSOLETE Page 2 of 2

PART C. DISCRIMINATION COMPLAINTS (To be completed by State Director)

1. Have there been any allegations of discrimination involving the delivery of inspection services to program beneficiaries or applicants within the last 

year?

No Yes

If yes, describe the basis(es), issue(s), status, and disposition.

2. Describe how applicants for inspection and program beneficiaries are notified of their right to file a complaint of discrimination with USDA: 

PART D. PROGRAM ACCESSIBILITY (To be completed by State Civil Rights/Human Resources Office)

1. Does the State office provide appropriate access to disabled persons regarding: (Check all that apply)

Placarded parking Automated/assisted door entry Audio or braille equipped elevators

Cut/raised curbing Accessible restrooms Accessible drinking fountains

2. A published text telephone (TTY) and/or State Relay Service number is required for accessible communication. Check to confirm compliance.

Publications available to the public State Meat/Poultry Web

Other (describe)

3. Describe inspection-related program materials made available in alternative formats: (Braille, large print, audio)

4. Has the program received any requests for language interpretation or translation services? No Yes

If yes, how was the request accommodated?

5. Describe the State's participation in educational and outreach activities: (e.g., state or county fairs, elementary, post secondary Career day functions, 4-H events, 

senior citizen programs, partnerships, etc.) 

Willfully false statements on the report are punishable by law. (U.S. Code Title 118, Section 1001)

Print Name and Title of State Official: Signature of State Official: 16. Date: (mm/dd/yyyy)