Employee Corrective Action Plan

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CONFIDENTIAL
SOUTHSIDE COMMUNITY SERVICES BOARD
Employee Corrective Action Plan
INSTRUCTIONS:
This plan is to be completed by the first-line supervisor within ten (10) workdays of notification
to employee that there is a deficiency or deficiencies in their job performance. The completed
plan may incorporate input from the employee and is to be reviewed with them prior to its
implementation.
The supervisor will provide completed copies to:
Employee
Employee's Immediate Supervisor
Disability Supervisor
Executive Director
Human Resource Office
PART I:
GENERAL INFORMATION
Employee's
Name:____________________________________________________________
First
Middle
Last
Reason for Corrective Action Plan (check one)
Unsatisfactory Performance Evaluation
Critical Job Performance Incident
Employee Standards of Conduct Violation
Other (Please provide explanation(s)
_________________________________________________________________
_________________________________________________________________
PART II:
CORRECTIVE ACTION TIMEFRAMES
Implementation Date
________
Month
Day
Year
Completion Date
________
Month
Day
Year
PART III:
SIGNATURES/DATES
Employee: _____________________________________________________________
Name
Position Title
Work Unit
Date
Supervisor: _____________________________________________________________
Name
Position Title
Work Unit
Date

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