ࡱ> vxu t"bjbjLL 4.j1g.j1gt  DL+4@@@@@|+~+~+~+~+~+~+$1.0++@@+@@|+|+(!0"@0z/[X"$h++0+|"$}1+^}1H"}1""=Ui+++}1 X b: SECTION 504 SELF EVALUATION AND TRANSITION PLAN STATE OF MAINE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM TOWN/CITY OF ____________________________ The following individual is responsible for inquiries regarding this Section 504 Self-Evaluation and Transition Plan: _________________________________________________________ (name) _________________________________________________________ (title) _________________________________________________________ (address) _________________________________________________________ (telephone) (fax) (e-mail) The Section 504 Self Evaluation and Transition Plan was adopted by the following authorized individuals on behalf of the municipality: DATE ADOPTED: ____________________ AUTHORIZED SIGNATURES NameDateNameDateNameDateNameDateNameDate Municipal Seal 1. EMPLOYMENT 1. Are job announcements put into newspapers that have general circulation? ___ Yes ___ No If No, describe how individuals are made aware of employment opportunities: ________________________________________________________________ ________________________________________________________________ 2. Do job announcements state that the municipality is an Equal Opportunity Employer? ___ Yes ___ No If No, explain why the "Equal Opportunity Employer" statement is not contained within job announcements: ________________________________________________________________ ________________________________________________________________ Has the municipality adopted a Equal Employment Opportunity Policy Statement? ___ Yes ___ No Do job applications inquire as to whether an applicant is a disabled person or as to the nature or severity of a disability? ___ Yes ___ No If Yes, explain: Describe the accommodations that can be made for the known limitations of otherwise qualified disabled persons who are currently employed or applying for employment: ________________________________________________________________ ________________________________________________________________ 2. PROGRAM ACCESSIBILITY 1. Are any of the following services or benefits provided to residents directly by the municipality? ___ Yes ___ No (Please mark an "X" for all services provided by the municipality) ____ Transportation Services ____ Counseling Services ____ Health Services ____ Employment Services ____ Public Housing ____ Food Services ____ General ____ Social, Recreational, or Athletic Services (a) For those services that are provided, describe accommodations that can be taken to make them accessible and usable for persons with disabilities (e.g. provision of auxiliary aids, relocating programs to accessible facilities, use of alternative materials, home visits, etc.): ________________________________________________________________ ________________________________________________________________ 2. Are there any limitations on the number of qualified disabled persons who may participate in or be admitted to the program? ___ Yes ___ No If Yes, list the steps to eliminate the limitations: ________________________________________________________________ ________________________________________________________________ 3. Do applications for these services, in any way discriminate against persons with disabilities? ___ Yes ___ No 4. Describe the nature of the qualifications that are needed in order to be eligible for each respective program: Program Qualifications 1. 2. 3. 4. 5. 6. 7. 3. FACILITIES Note: The definition of "facility" under Section 504 includes all or any portion of buildings, structures, equipment, roads, walks, parking lots or other real or personal property or interest in such property, owned, operated or leased by the municipality) 1.List below all facilities and the programs or operations for which each facility houses. Facility Programs or Operations Housed 1. 2. 3. 4. 5. 6. 7. Using the Uniform Federal Accessibility Standards (UFAS), each facility must be reviewed for compliance: COMPLIANCE COMPONENT FACILITIES #1#2#3#4#5#6#7Accessible RouteOutside Paths and WalksParkingCurb RampsRampsEntrances/interior DoorsElevatorsLiftsToilet RoomsDrinking FountainsWarning SignalsAssembly AreasPublic TelephonesOther Building Elements and Specialized Facilities - Place a "1" in the respective box if item is in compliance with UFAS - Place a "2" in the respective box if item is not in compliance with UFAS - Place a "3" in the respective box if item is not available and is not required * #1 through #7 above must correspond to the specific facility with that same number identified on the preceding page. 2. 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