Intake complaint form - UTLA 2026

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  1. Click ‘Get Form’ to open the intake complaint form in the editor.
  2. Begin by entering your personal information in the designated fields, including your name, employee number, school/chapter, job title/position, and contact details.
  3. Identify the charter school that is co-located with your school by filling in the appropriate field.
  4. In the UTLA AREA section, circle one of the options provided to indicate your area of concern.
  5. Check all applicable concerns or violations from the list provided. If you have additional complaints not listed, use the space below to elaborate on them.
  6. Answer the important questions regarding communication with your principal and Chapter Chair, as well as details about any Co-Location Committee at your school.
  7. If necessary, provide further elaboration on any points mentioned above in the space provided or attach additional sheets if needed.
  8. Once completed, fax or scan/email your form to Jenny Lam at (213) 487-1618 or jlam@utla.net.

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If you have contacted your school and Local District and still require assistance, referrals or resources, contact the Educational Equity Compliance Office at (213) 241-7682 or EquityCompliance@lausd.net. 1. Please give facts about your complaint.
For CSEA employees hired on or after September 1, 2018, years of qualifying service and age must total at least eighty-seven (87) in order to qualify for retiree health benefits. This must include a minimum of thirty (30) consecutive years of service with the District immediately prior to retirement.
Completed forms may be submitted via email to Charters@cde.ca.gov. You may also file a complaint to the Charter Schools Division by phone at 916-322-6029 or via email to Charters@cde.ca.gov.
Any complainant has the right to file a written complaint of unlawful discrimination, harassment, intimidation, or bullying within six months from the date the alleged incident occurred or the complainant first obtained knowledge/facts of the alleged incident unless the time for filing is extended by the District
Visit the OCR Complaint Assessment System site to file an electronic complaint form, or file a complaint by using the fillable PDF complaint form. Learn how to file a discrimination or retaliation complaint with the ED Office for Civil Rights (OCR).

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If you need immediate assistance, please email contact@utla.net or call (213) 487-5560.

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