Fillable Suny Orange Employee Disciplinary Report Rev 5 2017 (Orange County Community College)

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Suny Orange Employee Disciplinary Report Rev 5 2017 (Orange County Community College)

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The Suny Orange Employee Disciplinary Report Rev 5 2017 (Orange County Community College) form is 1 page long and contains:

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File type: PDF

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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
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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.
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Suny Orange Employee Disciplinary Report Rev 5 2017 (Orange County Community College)

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Completed 18 July 2020

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