CALIFORNIA LABOR COMMISSIONER'S OFFICE
Bureau Of Field Enforcement (BOFE) Unit
Report of Labor Law Violation
The Report of Labor Law Violation filing is designed to report labor violations affecting a group of employees. Labor code § 90.5 (b) requires that the Labor Commissioner’s Office identify priorities for investigation to be undertaken in industries, occupations and areas in which employees are relatively low paid and unskilled and occupations and there has been a history of violations.
Consequently, not all Report of Labor Law Violation are assigned for investigation. Inspections are commonly targeted in industries or areas where employees are subject to violations involving minimum wage, overtime requirements, child labor, unreported wages and or Workers Compensation Violations that affect a large group of employees. The Bureau of Field Enforcement does not pursue individual claims.
Click
here
for overview of the Bureau of Field Enforcement. Please keep in mind that even in cases where the Bureau of Field Enforcement starts an investigation, we will not be able to provide details on the course of the investigation as is considered confidential until an action is brought in court or an administrative hearing. The reporting party is normally contacted
only
if there is a need for additional information. No updates on the investigation will be provided.
IMPORTANT NOTICE
If you are seeking unpaid wages as well as reporting a labor law violation, you should also
file a wage claim
.
I have read and understand the above instructions.
Is this report related to COVID-19?
Yes
No
Related to Paid Sick Leave (PSL/SPSL)?
Yes
No
Section 1. Reporting Party (Individual or Representative)
Reporting Party
First Name of Reporting Party
Last Name
If Interpreter is Needed, Indicate Language:
Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Zip
Home Phone
Cell/Other Phone
Email
If you are an ADVOCATE, or are represented by a lawyer or other advocate, enter your ADVOCATE and ORGANIZATION information:
Advocate Information
Advocate Name
Organization Name
Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Zip
Home Phone
Cell/Other Phone
Email
Section 2. Employer Reported
Entity Type
Please select...
Corporation
Individual
Partnership
LLC
LLP
Other (Explain)
Entity Type "Other" Explanation
First Name
Last Name
Employer Business Name
Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Zip
DBA
If Address is Unknown, What is the Nearest Intersection?
Phone
Total Employees
Type of Business
Employer Industry
Please select...
Agriculture
Car Wash
Construction
Garment
Hotel
Janitorial
Restaurant
Security Guard
Warehouse
Nail Salon
Res Care
Port
Cannabis
Manufacturing
Retail
Health Care
Other
Employer Industry "Other"
Owner's Name
Name and Job Title of Person in Charge
Work Locations
Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
Zip
If Address is Unknown, What is the Nearest Intersection?
Employer Still Operating There?
Yes
No
Unknown
Business Hours
Total Employees
Is the Employer covered by Workers' Compensation Insurance?
Yes
No
Unknown
Is There a Union Contract
Yes
No
Did your Job involve Public Works?
Yes
No
Employer's Vehicle License Plate Number
Section 3. Work Hours and Wages
Did you or do you work for the Employer?
Yes
No
Date of Hire
Last Day of Work (if applicable)
Quit
Fired
Still Employed
Did the Employer designate what time the workday began for employees?
Yes
No
Don't Know
If Yes: What Time Did The Employer Designate
AM
PM
Did the Employer Designate which day of the week the workweek began?
Yes
No
Don't Know
If Yes: What day did the employer designate
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What is the
Normal or Standard Work Schedule
for employees during the week? Provide your best estimate for the start and end times and number of hours worked for each work day. (If employees did not work standard schedules, skip to the next question.)
Enter all time in ##:## format, for example, 09:30, or 12:45
Sunday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Monday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Tuesday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Wednesday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Thursday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Friday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Saturday
Start Time
AM
PM
End Time
AM
PM
Hours Worked
Total Hours Worked Per Week
Do employees work different schedules or irregular hours so you cannot provide a standard work schedule?
Yes
No
If "Yes", briefly describe the different schedules or irregular work hours as best as you can
When is the normal or standard scheduled meal period for employees?
Start Time
AM
PM
End Time
AM
PM
There is no standard scheduled meal period
What is the average length of time for an employee's meal period
Minutes
Hours
Who set the work schedule? (Full name and job title/position)
What Day is Pay Day
Daily
Bi-Weekly (Once Every Two Weeks)
Weekly
Semi-Monthly (Twice a month)
Monthly
Which day(s) is payday on
Such as Every 2nd Friday, or 1st and 15th of the month.
Who pays employees? (Full name and job title/position)
Are employees paid by the hour?
Yes
No
If "yes", how much $
PER (Describe Unit)
Varies (Explain)
Are employees paid a fixed amount of wages (or salary), regardless of the number of hours worked?
Yes
No
If "Yes," how much? $
Per Day
Per Week
Every 2 Weeks
Semi-Monthly
Monthly
Varies (Explain)
Are employees paid by piece rate?
Yes
No
If "yes", how much $
Piece Rates Vary (Explain)
PER (Describe Unit)
How are employees paid?
Check
Cash
Both Check & Cash
Other Method (Explain)
Method of Payment Varies per Employee or Job Position (Explain)
Other / Varies Explanation
If employees are paid in cash, does the employer keep cash payment record or logs?
Yes
No
Don't Know
Does the Employer keep time record of hours worked by Employees?
Yes
No
Don't Know
What languages are spoken by employees?
English
Spanish
Mixtec
Trique
Cantonese
Mandarin
Korean
Vietnamese
Tagalog
Cambodian
Hmong
Thai
Punjabi
Hindi
Russian
Other (Please List)
Other Languages
Section 4. Suspected Violations of Employer
The boxes below describe conduct by an employer that violates the law. Please put a check mark in the box(es) if the employer engages in, or any employee or employees have experienced, any of the following violations:
No Workers' Compensation Insurance
Minimum Wage Violations
Paid below minimum wage
Not paid at all for overtime hours worked
Not paid for all hours worked, including unpaid travel time and try-out time
Paycheck issued with insufficient funds
Asked employee to pay back wages paid
No split shift premium pay
Estimated number of employees affected (min wage)
Overtime Violations
Not paid daily overtime for hours worked over 8 per day (or 10 hours per day for farmworkers)
Not paid weekly overtime for hours worked over 40 hours per week
Not paid double time for over 12 hours per day
Not paid overtime for working on the 7th consecutive workday in a workweek
Estimated number of employees affected (overtime)
Other Unpaid Wages
Wages are not paid at the contracted rate
No reporting time premium pay
No premium pay for missing meal or rest periods.
Estimated number of employees affected (other unpaid)
Pay Stub Violations
Paid by check or cash without an itemized wage deduction statement
Itemized wage deduction statement provided but not accurate and/or incomplete
Itemized wage deduction statement not provided at least semi-monthly
Estimated number of employees affected (pay stub)
Meal Period Violations
30-minute off-duty meal period not provided by the end of the 5th hour of work
Second 30-minute off-duty meal period not provided when working more than 10 hours
Meal period provided but less than 30 minutes
Warehouse Distribution Center: quota prevents compliance with meal period.
Estimated number of employees affected (meal period)
Rest Break Violations
For work days between 3.5 hours and up to 6 hours per day, not allowed to take a 10-minute rest break
For work days of more than 6 hours and up to 10 hours per day, not allowed to take two 10-minute rest breaks
For work days of more than 10 hours and up to 14 hours per day, not allowed to take three 10-minute rest breaks
Warehouse Distribution Center: quota prevents compliance with rest period.
Estimated number of employees affected (rest break)
Warehouse distribution centers
Description of quota not provided
Quota prevents compliance with meal period
Quota prevents compliance with rest period
Quota prevents use of bathroom facilities
Quota prevents compliance with health and safety laws
Other (briefly explain):
Estimated number of employees affected (rest break)
Pay Date Violations
No fixed pay date
Late payment of wages
Estimated number of employees affected (pay date)
Garment Manufacturing
Piece rate pay
Estimated number of employees affected (Garment Manufacturing)
Paid sick leave violations
No paid sick leave
No notice of available sick leave on itemized wage statement or separate writing
Estimated number of employees affected (
Paid sick leave violations)
Record Keeping Violations
Daily time records are not kept or inaccurate
Payroll records are not kept or inaccurate
No notice to new hires (under Labor Code Section 2810.5)
Business Expense Violation
Uniforms not reimbursed or illegally charged to employees
Tools, supplies or equipment not reimbursed or illegally charged to employees
Illegal charges for cash shortages, breakage, or loss of equipment
Estimated number of employees affected (business expense)
Failure to Post
Applicable Industrial Welfare Commission Order not posted
Current Minimum Wage Order not posted
Pay day notice not posted
Workers’ compensation insurance notice not posted
Rate of compensation not posted (for farmworkers only)
Misclassification
Employees misclassified as independent contractors
Salaried employees misclassified as exempt employees
Estimated number of employees affected (misclassification)
Licensing / Registration Violations
Unlicensed construction contractor
Contracted with unlicensed construction contractor
Unlicensed farm labor contractor
Unregistered garment contractor or manufacturer
Unregistered car wash
Unregistered janitorial contractor
California WARN Act Violation(s)
California WARN Act Violation(s)
COVID-19 Rehire Violation(s)
COVID-19 Rehire Violation(s) - Employer failed to rehire employee employed for at least 6 months laid off due to COVID-19
Failure to Provide Lactation Accommodations
Estimated number of employees affected (lactation)
Other Violations (briefly explain)
Estimated number of employees affected (other violations)
Please provide any other information about your complaint that you believe is important for the Labor Commissioner to know
Child Labor Violations
No valid work permit(s)
No valid entertainment work permit(s)
Minor(s) work excessive or prohibited hours
Minor(s) work in hazardous conditions
Estimated number of minors affected
Please provide the following information for any minors under the age of 18 who work for the employer
Minor Employees
Check this box if there are any Minor Employees to enter their information
Minor Employee
Full Name
Age
Job Position / Type of Work Performed
Normal Work Schedule
How was the minor paid
By check, in cash, both cash and check, or other method
May your name be used in an investigation?
Yes
No
Do you want the Labor Commissioner to keep your name and contact information confidential?*
Yes
No
* The Labor Commissioner will maintain confidentiality as appropriate in each case and to the extent provided for under the law. Information may need to be released in some cases.
I Hereby Certify That The Information Above Is a True Statement to the Best of my Knowledge
Signed (Enter Full Name)
Contact Information
