California Domestic Violence, Sexual Assault, Stalking Leave Policy

[Company Name] provides reasonable and necessary unpaid leave and other reasonable accommodations to employees who are victims of domestic violence, sexual assault or stalking to attend legal proceedings or obtain other needed relief.

Employees who are victims of domestic violence, sexual assault or stalking.

Unpaid leave under this policy is available for an employee who is the victim of domestic violence, sexual assault or stalking to attend legal proceedings or to obtain or attempt to obtain any relief necessary, including a restraining order, to ensure the employee’s own health, safety or welfare, or that of the employee’s child or children. Employees may also request unpaid leave for the following purposes:

1. Obtain services from a domestic violence shelter or rape crisis center.
2. Seek medical attention for injuries caused by domestic violence or sexual assault.
3. Obtain psychological counseling for the domestic violence or sexual assault.
4. Take action, such as relocation, to protect against future domestic violence or sexual assault.

To request leave under this policy, an employee should provide [his or her supervisor/human resources/other job title] with as much advance notice as practicable under the circumstances. If advance notice is not possible, the employee requesting leave under this policy should provide [his or her supervisor/human resources/other job title] one of the following certifications upon returning back to work:

1. A police report showing that the employee was a victim of domestic violence or sexual assault.
2. A court order protecting the employee from the perpetrator or other evidence from the court or prosecuting attorney that the employee appeared in court.
3. Documentation from a medical professional, domestic violence or sexual assault victim advocate, health care provider, or counselor showing that the employee’s absence was due to treatment for injuries from domestic violence or sexual assault.

Employees requesting leave under this policy may choose to use accrued paid [PTO/vacation/sick] leave.

In addition, the company will provide reasonable accommodations to employees who are victims of domestic violence, sexual assault or stalking for the employees’ safety while at work. A reasonable accommodation may include the implementation of safety measures, such as a transfer, reassignment, modified schedule, changed work telephone, changed work station or installed lock; assistance in documenting domestic violence, sexual assault or stalking that occurs in the workplace; an implemented safety procedure; or another adjustment to the employee’s job duties and position.

To request an accommodation under this policy, an employee should contact [human resources/other job title]. The company will engage the employee in a timely, good faith and interactive process to determine effective reasonable accommodations.