Employee Formal Written Reprimand (Page 3 of 4) in pdf

Employee Formal Written Reprimand Page 3

( ) Repeated Tardiness

( ) Unacceptable appearance; violation of

department dress code

( ) Extended Meal/Rest Periods

( ) Removal of Nazareth Property without

( ) Unexcused Absence

authorization

( ) Insubordination

( ) Carelessness

( ) Repeated Smoking in Restricted

( ) Failure to report any workrelated

Areas

accident or injury

( ) Soliciting Money from Residents,

( ) Breaking of department policies, rules

Employees

or procedures

( ) Repeated use of Abusive or Profane

( ) Other (be specific):

Language

Explanation of Offense:

Oral Instructions given to employee:

___________________________________________ _______________________________

Supervisor=s Signature Date

I have read and received a copy of this document. I do/do not wish to submit written comments of my

own. (Employee may write a response in the space provided below or submit a separate page that will be

attached to this document.)

Comments:

Employee Signature Date ___________________

Witness________________________________

Guidelines for Using Progressive Disciplinary Procedures

Whenever appropriate, directors and supervisor will offer feedback to employees to correct performance

deficiencies or workplace behavior problems. If problems persist, a progressive series of corrective steps

Employee Formal Written Reprimand Page 3