Smmusd Form: Complaint Against An Employee printable pdf download

Santa Monica – Malibu Unified School District

1651 16

Street

Santa Monica, California 90404

COMPLAINT AGAINST AN EMPLOYEE

From: (Last Name, First Name) ________________________________________________

(Address) ____________________________________________________________

(Phone) ____________________________________________________________

Name of person(s) against whom complaint is made: _______________________________

__________________________________________________________________________

To:

________________________________________

(The supervisor of the person against whom the complaint is made.)

Please complete all requests for information on both pages of the form. A copy of the form will

be provided to the employee against whom the complaint is made.

Nature of the Complaint. (This should be a description in your own words of the grounds of your

complaint, including all names, dates, and places necessary for a

complete understanding of your complaint. You may attach additional

pages.)

______________________________________________________________________________

Have you discussed the complaint with the employee(s) listed above?

Yes ___

No ___

To whom have you spoken about this complaint? Please list all district employees you have

discussed it with, and the dates you discussed it with them.

______________________________________________________________________________

_____________________________________________________________________________________

SMMUSD Form: Complaint Against an Employee (BP 1312.1)

Smmusd Form: Complaint Against An Employee