Fillable SUNY Orange Employee Disciplinary Report Rev5 2017 (Orange County Community College)

Fill Online, Printable, Fillable, Blank SUNY Orange Employee Disciplinary Report Rev5 2017 (Orange County Community College) Form

Use Fill to complete blank online ORANGE COUNTY COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

SUNY Orange Employee Disciplinary Report Rev5 2017 (Orange County Community College)

On average this form takes 9 minutes to complete

The SUNY Orange Employee Disciplinary Report Rev5 2017 (Orange County Community College) form is 1 page long and contains:

  • 2 signatures
  • 3 check-boxes
  • 26 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Orange County Community College

BROWSE ORANGE COUNTY COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Orange County Community College
EMPLOYEE DISCIPLINARY REPORT
Date of Report: _______________________________________________________________________
Employee Name: _____________________________________________________________________
Supervisor: __________________________________________________________________________
DESCRIPTION OF THE PROBLEM
Mark the appropriate one(s):
Late to work Absenteeism Leaving early Insubordination
Harassment Poor performance Other: ____________________________________
Description of Incident and Statement of Facts – if applicable, include previous actions: (Attach additional
sheets if necessary)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Plan of Correction: ____________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Employee comments: __________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Action to be taken:
Verbal warning Written warning Formal Written Reprimand Suspension Without Pay
Next Action Step If Problem Continues: ____________________________________________________
Please be advised that further acts of misconduct may be cause for additional disciplinary action taken up
to and including termination.
□ Union representative was present. □ Employee waived right to have Union representative present.
Supervisor’s signature: ________________________________________________________________
EMPLOYEE ACKNOWLEDGMENT
I acknowledge receipt of this disciplinary action and that its contents have been discussed with me. I
understand that my signature does not necessarily indicate agreement. Refusal to sign will not invalidate
the disciplinary action.
Employee’s signature: _________________________________ Date: __________________________
□ Employee declined to sign
click to sign
signature
click to edit
click to sign
signature
click to edit
Orange County Community College
Employee Disciplinary Report – Instructions
1. Description of Incident: Identify the problem i.e. unexcused or excessive
absence, tardiness, violation of policy or work rules, insubordination,
harassment of other employees, abuse of sick leave or other privileges or
benefits, negligence or carelessness, failure to follow appropriate safety
procedures, etc.
2. Statement of Facts: Give dates(s) and specific policy, work rule or
standard which was violated. Give specific examples of behavior or
conduct being addressed such as: “John reported 15 minutes late for his
assigned shift on Oct. 3
rd
.” “The monthly report for which Ann is
responsible was submitted 5 days late.” Be objective. Stick to the facts
that you have personal knowledge of or which can be verified by records
or witnesses.
3. Previous Actions: Check the employee’s file to see if there is a record of
similar or related problems. A record of numerous unrelated problems
may also be a basis for more strict disciplinary measures.
4. Plan of Correction: Counseling or disciplinary actions should be
constructive. Address the problem, do not attack the employee. Explain
why the performance or conduct is a problem for the department. Try to
involve the employee in establishing a realistic plan for resolving the
problem and setting a time period to evaluate progress. Consider
increased supervision, additional training, changes in work assignments or
methods, counseling through the Employee Assistance Program, etc.
5. Action To Be Taken: Meet with the employee privately and give them an
opportunity to explain. Take a progressive approach using the following
basis steps: informal verbal warning, written warning, formal written
reprimand, suspension without pay. In determining at what level to initiate
progressive action, take into consideration the seriousness of the matter
and whether the employee knew or should have known the rule,
procedure or standard. Consider whether the rule, policy or standard has
been published in writing, how it was communicated to the employees,
how easy it is to understand, how long it has been in effect, how
consistently it has been enforced. Also take into account the employee’s
work record and actions taken in similar cases.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

SUNY Orange Employee Disciplinary Report Rev5 2017 (Orange County Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document