Download for Women and Minorities and Persons with Disabilities PDF

Titlefor Women and Minorities and Persons with Disabilities
TagsUniversity Of California
LanguageEnglish
File Size2.6 MB
Total Pages146
Table of Contents
                            UCLA Staff Affirmative Action Organizational Chart ………………………………………………………………………………………………….……………...6
	Staff Affirmative Action Units………….……………..……………………………………………………………………………………………………………….…..……7
	Department Heads/Directors ..……………………………………………………………………………………………………………………………………..………....8
	Supervisors …..……………………………………………………………………….……………………………………………………………………………………..………....8
	COMPONENTS OF THE AFFIRMATIVE ACTION PLAN………………………………………………………………………….…………………………………………..……...8
	§60-2.11   Organizational profile/Workforce Analysis………………………………………………………………….………………………..…………..………...........8 §60-2.12   Job group analysis………………………………………………………….…………………………………………………………………………….…..……..…………..9
	§60-2.14   Determining Availability …..………………………………………………………………………….…………………………………………………….………….…….9
		§60-2.17(b)(2) Applicant Flow Analysis  …………………………………………………………………………………………………………………………………..10
		§60-2.17(b)(2) Applicant Selection Analysis ………………………………….………………………………………………………………………………………...10
		§60-2.17(b)(3) Compensation Analysis  ………………………………………….……………………………………………………..………………………………..11
		§60-2.17(b)(2) Separation Analysis……………………………………………………………….………………………………………………………………..……….11
		Other Auditing and Review Procedures………………………………………………………………………………………………………………….………..……..11
		Compliance with Sex Discrimination Guidelines ………………………………………………………………………………………………………………..……11
		Compliance with Guidelines on Discrimination Because of Religion or National Origin ……………………………………………………….….11
			UCLA CAMPUS TRAINING & DEVELOPMENT PROGRAMS ……………………………………………………………………………………………………………………….12
			In-Service Training Program ……………………………………………………………………………………………………………………………………………………12
			Staff Enrichment Program (SEP) ………………………………………………………………………………………………………………………………………………13
			The Professional Development Program (PDP)………………………………………………………………………………………………………………………..14
			Staff Development/Other Activities ………………………………………………………………………………………………………………………………………..14
			Community Outreach and Recruitment Programs ……………………………………………………………………………………………………..……………14
		UCLA Staff Diversity & AA/EEO Compliance Office …………………………………………………………………………………………………………….……17
		UCLA Employment Services …………………………………………………………………………………………………………………………………………..………..17
		UCLA Training and Development Programs …………………………………………………………………………………………………………………….………17
		UCLA Hospital System Human Resources …………………………………………………………………………………………………………………………..……17
§60-300.2   Definitions …………………………………………………………………………………..………………………………….….………………………………..18
	§60-300.44(a)   Policy Statement ……………………………………………………………………………………………………………………………………..…..…18
	§60-300.42   Invitation to Self-identify ………………………………………………………………………………………………..…………………………..……..19
41 CFR §60-300.44(b) Review of Personnel Processes ……………………………………………………………………………..……………………..……...19
41 CFR §60-300.44(d) Reasonable Accommodations to Physical and Mental Limitations ……………………………………………….……….20
41 CFR §60-300.44(a)(1)  Filing a Complaint ………………………………………………………………………………………………………………….………..20
§60-300.44(i) DESIGNATION OF RESPONSIBILITY FOR IMPLEMENTING UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PROTECTED VETERANS ……………………………………………………………………………………………………………………………………………………..……………………………..…………..…………20
UCLA Staff Affirmative Action Organizational Chart …………………………………………………………………………………………..……………………21
	Staff Affirmative Action Units ………………………………………………………………………………………………………………………………….….………….22
	Department Heads/Directors …………………………………………………………………………………………………………………………………….…………..23
	Supervisors…………………………………………………………………………………………………………………………………………………………………….……….23
	REPORTING AND AUDITING     ………………………………………………………………..………………………………………………………………………………..……..…24
	§60-300.45   Benchmarks for Hiring ………………………………………………………………………………………………………………………….…………….24
	2014-2015 PROGRAMMATIC ACTIVITIES …………………………………………………………………………………………..……………….…………………….………..25
41 CFR §60-741 UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PERSONS WITH DISABILITIES ………………………………………….……….…………..27
§60-741.2 Definitions …………………………………………………………………………………………………………………………………………………….……….27
§60-741.44 Policy Statement …………………………………………………………………………………………………………………………………….…………….27
§60-741.42 Invitation to Self-Identify ……………………………………………………………………………………………………………….………..…………..29
§60-741.45 Placement Goals …………………………………………………………………………………………………………………………………………………..29
§60-741.44(b) Review of Personnel Processes ………………………………………………………………………………………..…………………….………..29
§60-741.44(c) Physical and Mental Qualifications ………………………………………………………………………………………………..……….………..29
§60-741.44(d) Reasonable Accommodations to Physical and Mental Limitations ………………………………………………………….………..29
§60-741.44(a)(1) Filing a Complaint ………………………………………………………………………………………………………………………………….…….30
41 CFR §60-741.44(i) DESIGNATION OF RESPONSIBILITY FOR IMPLEMENTING UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PERSONS WITH DISABILITIES,………………………………………………………………………………………………………………………………………………………..……………………………..30
UCLA Staff Affirmative Action Organizational Chart ………………………………………………………………………………………………………...……………..…..31
	Staff Affirmative Action Units ………………………………………………………………………………………………………………………………………..………..32
	Department Heads/Directors ……………………………………………………………………………………………………………………………………..……….....33
	Supervisors ………………………………………………………………………………………………………………………………………………………………..……………33
	§60-741.44(B) REPORTING AND AUDITING …………………………………………………………………………………………………………………….….………..……..33
		Records of Individual Personnel Actions……………………………………………………………………………………………………………………………..………33
		Records and Data Analysis …………………………………………………………………………………………………………………………………………………..…….33
		Other Auditing and Review Procedures………………………………………………………………………………………………………………………………..…….34
	2015-2016 STAFF AFFIRMATIVE ACTION FOR PERSONS WITH DISABILITIES PROGRAMMATIC ACTIVITIES ……………………………………….…..34
	UCLA Chancellor’s ADA & Section 504 Compliance Office ……………………………………………………………………………………………………….….…….…34
	2015-2016 STAFF AFFIRMATIVE ACTION FOR PERSONS WITH DISABILITIES PROGRAMMATIC ACTIVITIES ………………………..……….…….….36
A. APPLICANT FLOW ANALYSIS FOR WOMEN AND MINORITIES…………………………………………………………………………………….……….………..………..90
B. APPLICANT SELECTION ANALYSIS FOR WOMEN AND MINORITIES…………..………………………………………………………….…………………………………96
C. SEPARATIONS ANALYSIS FOR WOMEN AND MINORITIES ………………………………………………………………………………………..…………….….…………100
D. COMPENSATION………………………………………………………………………...……………………………………………………………………………………..……………………106
Adopted by the Assembly of the Academic Senate May 10, 2006
	Staff Diversity & Affirmative Action/Equal Employment Opportunity Compliance
	Staff Affirmative Action Units
	The basic organizational units for implementation of this Plan are called Staff Affirmative Action Units, which are structured based on function, size and unique characteristics of the work force.  There are fifteen Staff Affirmative Action Units at U...
	Department Heads/Directors
	Department Heads and Directors are responsible for ensuring compliance with staff affirmative action policies and procedures.  They are responsible for:
	Supervisors
	Supervisors are responsible for:
	Job Group Analysis is presented in Appendix A, Page 37.
	§60-2.14   Determining Availability
	“The purpose of availability is an estimate of the number of qualified minorities or women available for employment in a given job group, expressed as a percentage of all qualified persons available for employment in the job group. The purpose of the ...
		UCLA examines placement of incumbents in job groups, compares incumbency to availability, and establishes placement goals as follows:
		§60-2.17(b)(2) Applicant Flow Analysis
		§60-2.17(b)(2) Applicant Selection Analysis
		§60-2.17(b)(3) Compensation Analysis
		§60-2.17(b)(2) Separation Analysis
		Other Auditing and Review Procedures
		Compliance with Sex Discrimination Guidelines
		Compliance with Guidelines on Discrimination Because of Religion or National Origin
			UCLA CAMPUS TRAINING & DEVELOPMENT PROGRAMS
			In-Service Training Program
			The In-Service Training Program is a series of short courses and programs designed for UCLA employees, in conjunction with campus departments and the Training and Development unit of Campus Human Resources.  These courses and programs are intended to ...
			Staff Enrichment Program (SEP)
			The Professional Development Program (PDP)
			Staff Development/Other Activities
			Community Outreach and Recruitment Programs
		UCLA Staff Diversity & AA/EEO Compliance Office
		For the timeframe from July 1, 2015 – June 30, 2016, the Staff Diversity & AA/EEO Opportunity Compliance Office will continue to review its workforce, applicant flow, and compensation data.  SD&C will continue monitoring its recordkeeping systems to r...
		UCLA Employment Services
The Employment Services Department's goals for the period July 1, 2015 – June 30, 2016 are as follows: continue to inform the community of current job openings through the Department’s website; regularly advertise UCLA vacancies in trade publications,...
	UCLA Training and Development Programs
	The Training and Development unit will continue to offer courses and programs providing women and minorities with opportunities to acquire management, technical, networking, and other skills that will foster their professional development.  The goal o...
	UCLA Hospital System Human Resources
§60-300.2   Definitions
The University is committed to adherence to revised the Vietnam-Era Veterans' Readjustment Assistance Act of 1974 as amended, 38 U.S.C 4212, (VEVRAA) following standards set in 41 CFR Section 60-300.   VEVRAA covers “disabled veterans, recently separa...
	§60-300.44(a)   Policy Statement
	§60-300.42   Invitation to Self-identify
41 CFR §60-300.44(b) Review of Personnel Processes
41 CFR §60-300.44(d) Reasonable Accommodations to Physical and Mental Limitations
41 CFR §60-300.44(a)(1)  Filing a Complaint
§60-300.44(i) DESIGNATION OF RESPONSIBILITY FOR IMPLEMENTING UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PROTECTED VETERANS
UCLA Staff Affirmative Action Organizational Chart
	Staff Affirmative Action Units
	The basic organizational units for implementation of this Plan are called Staff Affirmative Action Units, which are structured based on function, size and unique characteristics of the work force.  There are 15 Staff Affirmative Action Units at UCLA; ...
	Department Heads/Directors
	Department Heads and Directors are responsible for ensuring compliance with staff affirmative action policies and procedures.  They are responsible for:
	Supervisors
	Supervisors are responsible for:
	REPORTING AND AUDITING
	§60-300.45   Benchmarks for Hiring
	2014-2015 PROGRAMMATIC ACTIVITIES
		UCLA Staff Diversity & AA/EEO Compliance Office, SD&C
		For the timeframe from July 1, 2015 – June 30, 2016, the Staff Diversity & AA/EEO Opportunity Compliance Office will:
		 continue to review its workforce, applicant, and compensation data;
		  continue monitoring its recordkeeping systems to retain accurately all information as required by the federal Affirmative Action regulations and VEVRAA;
		 continue to schedule meetings with University officials to discuss affirmative action responsibilities and campus workforce benchmarks with respect to recruiting protected veterans;
		  continue partnering with the Employment Services within Camps Human Recourses and the Hospital System to develop recruitment strategies and outreach programs to assist departments in recruiting qualified protected veterans;
		 continue to offer training programs to develop effective skills for management to address specific diversity issues associated with recruiting and managing a diverse workforce;
		 continue to monitor campus policies and activities to ensure compliance with affirmative action directives for and protected veterans;
		 continue to inform the campus of issues related to Affirmative Action/Equal Employment Opportunity benchmarks for protected veterans;
		The department and the university will continue to participate in diversity-related task forces and committees.
41 CFR §60-741 UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PERSONS WITH DISABILITIES
§60-741.2 Definitions
§60-741.44 Policy Statement
§60-741.42 Invitation to Self-Identify
As part of its affirmative action obligation, UCLA invites applicants to inform university whether the applicant believes that he or she is an individual with a disability as defined in §60-741.2(g)(1)(i) or (ii). The invitation is provided to each ap...
§60-741.45 Placement Goals
	This section of the OFCCP regulations states, “(t)he utilization goal is not a rigid and inflexible quota which must be met, nor is it to be considered either a ceiling or a floor for the employment of particular groups. Quotas are expressly forbidden...
§60-741.44(b) Review of Personnel Processes
§60-741.44(c) Physical and Mental Qualifications
§60-741.44(d) Reasonable Accommodations to Physical and Mental Limitations
§60-741.44(a)(1) Filing a Complaint
41 CFR §60-741.44(i) DESIGNATION OF RESPONSIBILITY FOR IMPLEMENTING UCLA STAFF AFFIRMATIVE ACTION PLAN FOR PERSONS WITH DISABILITIES,
UCLA Staff Affirmative Action Organizational Chart
	Staff Affirmative Action Units
	The basic organizational units for implementation of this Plan are called Staff Affirmative Action Units, which are structured based on function, size and unique characteristics of the work force.  There are 15 Staff Affirmative Action Units at UCLA; ...
	Department Heads/Directors
	Department Heads and Directors are responsible for ensuring compliance with staff affirmative action policies and procedures.  They are responsible for:
	Supervisors
	Supervisors are responsible for:
	§60-741.44(B) REPORTING AND AUDITING
		Records of Individual Personnel Actions
		Records and Data Analysis
		Other Auditing and Review Procedures
	2015-2016 STAFF AFFIRMATIVE ACTION FOR PERSONS WITH DISABILITIES PROGRAMMATIC ACTIVITIES
	UCLA Chancellor’s ADA & Section 504 Compliance Office
	The Chancellor’s ADA & 504 Compliance Office include coordination of and compliance with both the Americans with Disabilities Act of 1990 (ADA) and Section 503 of the Rehabilitation Act of 1973, as amended.  The Chancellor’s ADA & 504 Compliance Offic...
	Chancellor’s ADA & 504 Compliance coordinates efforts to provide individuals with disabilities access to campus programs and facilities; develops procedures to identify and correct access problems; reviews complaints alleging campus noncompliance with...
	In the course of carrying out this charge, the ADA & 504 Compliance Office works closely with campus organizations and departments such as the Office for Students with Disabilities; Facilities Management; Capital Programs; Parking Services; Campus Cou...
	2015-2016 STAFF AFFIRMATIVE ACTION FOR PERSONS WITH DISABILITIES PROGRAMMATIC ACTIVITIES
		For the timeframe from July 1, 2015 – June 30, 2016, the Staff Diversity & AA/EEO Opportunity Compliance Office will:
		 continue to review its workforce, applicant, and compensation data;
		 continue monitoring its recordkeeping systems to retain accurately all information as specified by the federal Affirmative Action regulations and ADAAA;
		 continue to schedule meetings with University officials to discuss affirmative action responsibilities and campus workforce benchmarks with respect to recruiting persons with disabilities;
		 continue partnering with the Employment Services within Camps Human Recourses and the Hospital System to develop recruitment strategies and outreach programs to assist departments in recruiting qualified persons with disabilities;
		 continue to offer training programs to develop effective skills for management to address specific diversity issues associated with recruiting and managing a diverse workforce;
		 continue to monitor campus policies and activities to ensure compliance with affirmative action directives for persons with disabilities;
		 continue to inform the campus of issues related to Affirmative Action/Equal Employment Opportunity benchmarks for persons with disabilities;
		 The department and the university will continue to participate in diversity-related task forces and committees.
			APPENDIX B
			UCLA JOB GROUP AVAILABILITY FOR WOMEN AND MINORITIES
A. APPLICANT FLOW ANALYSIS FOR WOMEN AND MINORITIES
B. APPLICANT SELECTION ANALYSIS FOR WOMEN AND MINORITIES
C. SEPARATIONS ANALYSIS FOR WOMEN AND MINORITIES
Our analysis of separations has identified the following areas in which women and minorities were separated at higher rates than those examined in completely random samples. (Statistical significance does not in and of itself indicate bias in employme...
D. COMPENSATION
                        
Document Text Contents
Page 1

STAFF AFFIRMATIVE ACTION PLAN 

for Women and Minorities and  

Persons with Disabilities and Protected Veterans 

Campus Human Resources 
___________________________________________________________________________________________ 

Staff Diversity & AA/EEO Compliance Office

JULY 1,2015- JUNE 31,2016

FEBRUARY 1,2014- JANUARY 31,215

Page 2

2015‐2016
UCLA STAFF AFFIRMATIVE ACTION PLAN


Employer

University of California, Los Angeles
405 Hilgard Avenue

Los Angeles, CA 90095


Mailing Address
Staff Diversity & AA/EEO Compliance

10920 Wilshire Boulevard
Suite 1050

Los Angeles, CA 90024


UCLA Chancellor
Gene Block

Phone: 310‐825‐2151
Email: [email protected]



Executive Vice Chancellor & Provost
Scott L. Waugh

Phone: 310‐825‐2052
Email: [email protected]


Vice Chancellor of Equity, Diversity and Inclusion

Jerry Kang
Phone: 310‐825‐2411

Email: [email protected]


Acting Administrative Vice Chancellor and Chief Financial Officer
UCLA Administration

Michael Beck
Phone: 310‐825‐3444

Email: [email protected]


Associate Vice Chancellor
UCLA Campus Human Resources

Lubbe Levin
Phone: 310‐794‐0810

Email: [email protected]


Vice Chancellor, Health Sciences
John Mazziotta

Phone: 310‐825‐5687
Email: [email protected]


Interim Associate Vice Chancellor

Hospital System
James Atkinson, M.D.

Phone: 310‐267‐9315
Email: [email protected]


Chief Officer

Health Sciences Human Resources
Susi Takeuchi

Phone: 310‐794‐0512
Email:[email protected]


Staff Affirmative Action Officer

George Tejadilla
Phone: 310‐794‐0691

Email: [email protected]


Staff Affirmative Action Plan
Principal Statistician and Content Reviewer

Olga Lavinthal
Phone: 310‐794‐0383

Email: [email protected]

Page 73

29‐2030 DIAGNOSTIC RELATED TECHNOLOGISTS AND TECHNICIANS 8968 ULTRASOUND TCHNO SR PD

29‐2030 DIAGNOSTIC RELATED TECHNOLOGISTS AND TECHNICIANS 9025 RAD TCHNO PD

29‐2041 EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS 8890 EMERGENCY TRAUMA TCHN PD

29‐2041 EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS 9439 EMERGENCY MED TCHN PD

29-2061 LICENSED PRACTICAL AND LICENSED VOCATIONAL NURSES 8918 VOC NURSE PD

29-2071 MEDICAL RECORDS AND HEALTH INFORMATION TECHNICIANS 4741 CODER PD

29‐2090 MISCELLANEOUS HEALTH TECHNOLOGISTS AND TECHNICIANS 8884 CLIN CARE PARTNER PD

29‐2090 MISCELLANEOUS HEALTH TECHNOLOGISTS AND TECHNICIANS 8894 ADMIN CARE CLIN PARTNER PD

29‐2090 MISCELLANEOUS HEALTH TECHNOLOGISTS AND TECHNICIANS 8932 SURGICAL TCHN PD

29‐2090 MISCELLANEOUS HEALTH TECHNOLOGISTS AND TECHNICIANS 9038 PERFUSIONIST PD

29‐2090 MISCELLANEOUS HEALTH TECHNOLOGISTS AND TECHNICIANS 9039 PERFUSIONIST SR PD

31-2020 PHYSICAL THERAPIST ASSISTANTS AND AIDES 8951 PHYS THER AST PD

31-9097 PHLEBOTOMISTS 9295 PHLEBOTOMIST CERT TCHN 2 PD

31-9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9080 SVC PARTNER PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9168 OPERATING ROOM AST 2 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9244 HOSP AST 2 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9413 CTRL SVC TCHN 1 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9418 LIFT TEAM TECH 1 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9419 LIFT TEAM TECH 2 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9426 PATIENT TRANSPORT TCHN 1 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9427 PATIENT TRANSPORT TCHN 2 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9431 REHAB AID 1 PD

31‐9099 HEALTHCARE SUPPORT WORKERS, ALL OTHER 9432 REHAB AID 2 PD

35-2010 COOKS 5124 MED CTR COOK PD

35-3021 COMBINED FOOD PREPARATION AND SERVING WORKERS,
INCLUDING FAST FOOD

5094 MED CTR FOOD SVC WORKER PD

37-2011 JANITORS AND CLEANERS, EXCEPT MAIDS AND HOUSEKEEPING
CLEANERS

5081 MED CTR CUSTODIAN SR PD

43-4199 INFORMATION AND RECORD CLERKS, ALL OTHER 9094 ACCESS REPR PD

43-5081 STOCK CLERKS AND ORDER FILLERS 5058 STOREKEEPER PD

43-6010 SECRETARIES AND ADMINISTRATIVE ASSISTANTS 4729 BLANK AST 1 PD

43‐6010 SECRETARIES AND ADMINISTRATIVE ASSISTANTS 4730 BLANK AST 2 PD

43‐6010 SECRETARIES AND ADMINISTRATIVE ASSISTANTS 4731 BLANK AST 3 PD

43‐6010 SECRETARIES AND ADMINISTRATIVE ASSISTANTS 9260 HOSP UNIT SVC CRD PD

43-9022 WORD PROCESSORS AND TYPISTS 4686 HOSP MED TRANSCRIBER PD

43-9061 OFFICE CLERKS, GENERAL 4674 CLERK PD











66

Page 74

APPENDIX B


UCLA JOB GROUP AVAILABILITY FOR WOMEN AND MINORITIES



















67

Page 145

SEE REVERSE FOR PRIVACY NOTIFICATIONS
RETN: Destroy after data entry pursuant to
local procedures

VOLUNTARY SELF-IDENTIFICATION OF RACE, ETHNICITY AND VETERAN STATUS
U5605 (R10/14) University of California Human Resources

EMPLOYEE NAME (LAST, FIRST, MIDDLE INITIAL) CAMPUS DEPARTMENT/ORGANIZATIONAL UNIT BIRTHDATE

MO DY YR

INVITATION TO SELF-IDENTIFY RACE AND ETHNICITY

The University of California is a federal contractor and recipient of federal funds subject to affirmative action requirements set forth in
Executive Order 11246, as amended. The University’s status as a federal contractor obligates it to maintain and analyze certain data with
respect to the race and ethnicity of its workforce. In order to comply with these regulations the University requests its employees to voluntarily
self-identify their race and ethnicity. The information provided will be kept con�dential and used only in ways that are in accordance with
federal and state laws, executive orders, and regulations, including those which require the information to be summarized and reported to the
federal government for civil rights enforcement purposes.

Please answer the question below.

Are you Hispanic or Latino?

YES, I am Hispanic or Latino

Mexican/Mexican American/Chicano (E) – A person of Mexican culture or origin regardless of race.

Latin American/Latino (5) – A person of Latin American (e.g. Central American, South American, Cuban,
Puerto Rican) culture or origin regardless of race.

Other Spanish/Spanish American (W) – A person of Spanish culture or origin, not included in any of the Hispanic
categories listed above.

NO, I am not Hispanic or Latino

In addition, select one or more of the following racial categories that best describe you, if applicable.

AMERICAN INDIAN OR ALASKA NATIVE (C) – A person having origins in any of the original peoples of North and South
America (including Central America) who maintains cultural identi�cation
through tribal affiliation or community attachment.
ASIAN

Chinese/Chinese American (2) – A person having origins in any of the original peoples of China.

Filipino/Pilipino (L) – A person having origins in any of the original peoples of the Philippine Islands.

Japanese/Japanese American (B) – A person having origins in any of the original peoples of Japan.

Korean/Korean American (K) – A person having origins in any of the original peoples of Korea.

Pakistani/East Indian (R) – A person having origins in any of the original peoples of the Indian
subcontinent (e.g., India and Pakistan).

Vietnamese/Vietnamese American (I) – A person having origins in any of the original peoples of Vietnam.

Other Asian (X) – A person having origins in any of the original peoples of the Far East or
South East Asia (including Cambodia, Malaysia and Thailand).

BLACK OR AFRICAN AMERICAN (A) – A person having origins in any of the Black racial groups of Africa.

NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (Z) – A person having origins in any of the original peoples of Hawaii, Guam,
Samoa or other Paci�c Island.
WHITE

European (G) – A person having origins in any of the original peoples of Europe.

Middle Eastern (J) – A person having origins in any of the original peoples of the Middle East.

North African (N) – A person having origins in any of the original peoples of North Africa.

White (not speci�ed) (F) – A person having origins in any of the original peoples of Europe, the
Middle East, or North Africa (region not speci�ed).

INVITATION TO SELF-IDENTIFY VETERAN STATUS

The University of California is a Government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as
amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action
to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge
veterans, 4) Armed Forces service medal veterans; and (5) Vietnam Era Veterans. OVER

Page 146

I AM NOT A PROTECTED VETERAN. (O)

I AM A PROTECTED VETERAN, BUT I CHOOSE NOT TO SELF-IDENTIFY THE CLASSIFICATIONS TO WHICH I BELONG. (P)

I belong to the following classifications of protected veterans (choose all that apply):

DISABLED VETERAN (S)
A “disabled veteran” is one of the following:
1. a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired
pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2. a person who was discharged or
released from active duty because of a service-connected disability.

RECENTLY SEPARATED VETERAN Please provide separation date ______/______ (MM, YY)
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran’s discharge or
release from active duty in the U.S. military, ground, naval or air service.

ACTIVE WARTIME OR CAMPAIGN BADGE VETERAN (E)
An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air
service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the
Department of Defense. For a list of officially recognized campaigns, please visit the U.S. Office of Personnel Management website at
http://www.opm.gov/policy-data-oversight/veterans-services/vet-guide/#9

ARMED FORCES SERVICE MEDAL VETERAN (M)
An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service,
participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
To identify the military operations that meet this criterion, check your DD Form 214, Certi�cate of Release or Discharge from Active Duty.

VIETNAM ERA VETERAN (V)
Vietnam Era Veteran means a person who:
1. Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable
discharge, if any part of such active duty occurred: a. in the republic of Vietnam between February 28, 1961, and May 7, 1975; or
b. between August 5, 1964, and May 7, 1975, in all other cases; or 2. Was discharged or released from active duty because of a service-con-
nected disability, if any part of such active duty was performed: a. in the republic of Vietnam between February 28, 1961, and May 7, 1975; or
b. between August 5, 1964, and May 7, 1975, in all other cases.

Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In
particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by
your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information,
call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.

As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor each year
identifying the number of our employees belonging to each speci�ed “protected veteran” category. If you believe you belong to any of the
categories of protected veterans listed above, please indicate by checking the appropriate box above.

If you are a disabled veteran it would assist us if you tell us whether there are accommodations we could make that would enable you to
perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way the job
is customarily performed, provision of personal assistance services or other accommodations. This information will assist us in making
reasonable accommodations for your disability.

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will
be used only in ways that are not inconsistent with the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended.

The information you submit will be kept con�dential, except that (i) supervisors and managers may be informed regarding restrictions on the
work or duties of disabled veterans, and regarding necessary accommodations; (ii) �rst aid and safety personnel may be informed, when and
to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing
laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

The University of California is an Equal Opportunity/Affirmative Action Employer. All quali�ed applicants will receive consideration for
employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

PRIVACY NOTIFICATION STATEMENT (Revised February 22, 2010 for U5605)
The State of California Information Practices Act of 1977 requires the University to provide the following information to individuals who are asked to supply
personal information about themselves.
1. The principal purpose for requesting the information on this form is to comply with the following Federal requirements: (i) Title VII of the Civil Rights Act of 1964, as

amended; (ii) Executive Order 11246, as amended; (iii) Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974, as amended; (iv) Section 503
of the Rehabilitation Act of 1973, as amended; (v) Title IV of the Higher Education Act of 1965, as amended (20usc 1094 (a) (17)); and (vi) Section 490 of the Higher
Education Amendments of 1992 (P.L. 102–325), as well as relevant implementing regulations.

2. The information supplied on this form is kept con�dential. It is used for required aggregated workforce data reporting to the federal government and for internal
workforce statistical analysis, reporting, and outreach. It will be given to government agencies responsible for civil rights laws only when requested, or as
otherwise required by law. The aggregated workforce data serves as a tool to the administration of campus equal employment opportunity/affirmative action
and human resources programs. The information supplied on this form will be used only as described.

3. Furnishing the information requested on this form is voluntary. There is no penalty for not completing the form.
4. Individuals have the right to review their own records in accordance with University personnel policies and collective bargaining agreements. Information on

applicable policies and agreements can be obtained from campus or Office of the President human resources and academic personnel offices.
5. The University offices responsible for maintaining the information supplied on this form are the UC Human Resources Office and UC Academic Advancement

Office, and campus Equal Employment Opportunity and Affirmative Action Offices.

Similer Documents