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COMING SOON
Concerns and Feedback
Basic Info
Please provide your basic information so we know how to respond to your Concern/Feedback
Date
(Required)
MM slash DD slash YYYY
Today’s Date
Location
(Required)
Arbor Cove
Antioch Hillcrest
Antioch Rivertown
Buttes Christian Manor
Beth Eden
Bishop Roy
Bancroft Senior
Canterbury
Carquinez Vista Manor
Dogwood Plaza
Disciples Village 1
Disciples Village 2
Flower Park Plaza
Fargo Senior Center
Garfield Park Village
Hatler May Village
Hayward Senior
Hotel Redding
Harrison Street Senior
Jarvis Gardens
Jefferson Street Senior
K. David Cole
Lorenz Senior
Mountain Falls I
Mountain Falls II
Margaret McDowell
Mattie Younkin Manor
Oak Meadows
Percy Abram Senior
Plaza de las Flores
Pecan Grove Manor
Providence Senior
Powell Vista Manor
Piper Way Senior
Southlake Tower
Sierra meadows
St. Mary's Gardens
Sycamore Place I
Sycamore Place II
Syringa Plaza
Sylvester Rutledge
Sister Thea Bowman
Tree House Senior
Via Pacifica Gardens
Westlake Christian Terrace East
Westlake Christian Terrace West
Woodland Christian Towers
Christian Church Homes
1855 Olympic Boulevard
Name
(Required)
First
Last
Phone
(Required)
Email
Submission Type
Are you submitting for an APPEAL
(Required)
Yes
No
Appeal – Your application was denied, and you want to be reconsidered.
Are you submitting for a COMPLAINT
(Required)
Yes
No
Complaint – You have a complaint about the property where you live, will be living NOT related to a management decision.
Are you submitting for a GRIEVANCE
(Required)
Yes
No
Grievance – You have a grievance against a management decision that you would like to be reconsidered.
SUBMISSION ERORR
You have selected NO to Appeal, Complaint, or Grievance. NOTHING WILL BE SUBMITTED
Appeal Section
APPEAL STAGES: (1) Denial made by Building Management (On-Site Staff); (2) First Appeal made to Compliance Staff (impartial member of CCH); (3) Further Appeals must be filed as a grievance (see grievance section).
Date of Denial
(Required)
MM slash DD slash YYYY
Please provide the date you received the denial of your application.
First Appeal
(Required)
Yes
No
Is this the first time you are appealing the denial of your application?
Reason for Denial
(Required)
Failure to Response
Criminal Hisotry
Over Income Limit
Under Minimum Income
Denied Adding Occupant
Denied Reasonable Accommodation/Modification
Other
What were the stated reason(s) for the denial of your application?
Appeal Response
(Required)
Review/Contact in WRITING
Review/Schedule VIRTUAL meeting
Review/Schedule IN-PERSON meeting
How would you like your appeal or concerns addressed.
Reason for Appeal
(Required)
Please provide the reason(s) your appeal should be granted, and you can submit any supporting documents via email to appeals@cchnc.org
Appeal Supporting Documents
Drop files here or
Select files
Max. file size: 100 MB.
Complaint Section
COMPLAINT STAGES: (1) First Level Resolution to be made with Building Management (On-Site Staff); (2) Second Level Resolution to be made with Portfolio Manager (Oversight of On-Site Staff; (3) Third Level Resolution to be filed as a grievance (see grievance section).
First Complaint
(Required)
Yes
No
Is this your first time filing a complaint on this specific
What Happened
(Required)
Excessive Noise
Tenant/Guest Inappropriate Behavior
Trafficking/Trespassing
Staff Misconduct
Vandalism
Other
Date of Complaint Issue
(Required)
MM slash DD slash YYYY
What is the date of the issue or when did it happen?
Time of Complaint Issue
(Required)
Hours
:
Minutes
AM
PM
AM/PM
What is the time, approximately, of the issue when it happened?
Where it Happened
(Required)
List the location or locations the issue happened.
Who was Involved
(Required)
List the name or names of those involved in the issue.
Who was a Witness
(Required)
List name or names of any witness, if none, write “none”
Complaint Response
(Required)
NONE, INFORMATIONAL purposes only
Review/Contact in WRITING
Review/Schedule VIRTUAL meeting
Review/Schedule IN-PERSON meeting
How would you like your complaint/concerns addressed?
Additional Details
Complaint Supporting Documents
Drop files here or
Select files
Max. file size: 100 MB.
Grievance Section
GRIEVANCE STAGES: (1) First Level Resolution to be made with Portfolio Manager (Oversite of On-Site Staff), if Portfolio Manager has already responded or was involved, it will go to the Associate Director of Property Management for an Informal Hearing; (2) Second Level Resolution to be made with Compliance Staff (impartial member of CCH) and can be an Informal or Formal Hearing; (3) Third Level Resolution to be made with Director of Property Management; (4) Final Decision to be mad with a CCH Executive with oversight of Property Management Department.
First Grievance
(Required)
Yes
No
Disability Grievance
(Required)
Yes
No
Unsure
Is your grievance related to your claimed disability? If so, the Section 504 Grievance Procedures apply.
Date of Grievance Issue
(Required)
MM slash DD slash YYYY
What is the date of the issue or when did it happen?
Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
What is the time, approximately, of the issue when it happened?
Where it Happened
(Required)
List the location or locations the issue happened.
Grievance Response
(Required)
Review/Contact in WRITING
Review/Schedule VIRTUAL meeting
Review/Schedule IN-PERSON meeting
What Happened
(Required)
Grievance Supporting Documents
Drop files here or
Select files
Max. file size: 100 MB.
PLEASE TAKE NOTICE – Grievances
The following considerations of circumstances when determining to deny or terminate assistance or evict because of action or failure to act by members of the family: (1) Management and Hearing Officers must consider all relevant circumstances; (2) Management and Hearing Officers may impose requirements that other family members not reside in the unit or receive assistance; (3) Admission Denials, assistance termination or evictions due to illegal use of drugs or alcohol abuse by a member no longer engaged in such behavior: Management and Hearing Officers should consider any successful and completed supervised drug or alcohol rehabilitation program, or otherwise successfully rehabilitated (42 U.S.C. 13661). Requests for evidence may be required; (4) If the family includes person(s) with disabilities any decision concerning such action is subject to considerations of reasonable accommodation in accordance with 24CFR, Part 8; (5) Management and Owner’s actions must be consistent with fair housing and equal opportunity provisions of 24 CFR SS 51.05 and 24 CFR Part 5, Subpart L, for protections for victims of domestic violence, dating violence, sexual assault, or stalking; (6) Evictions considered as a last resort, non-payment cases should offer fair and reasonable payment plan must be offered, and considerations of health, safety and quiet enjoyment must be balanced with a consideration that residents may have no other housing options nor complete control over all household members and guests.