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Notice of Infraction
Formal Written Notice of Disciplinary Action
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* Indicates required question
Email
*
Your email
The email above should be the EMPLOYEE who is receiving the infraction and not the directors email. This is how the employee will receive, if you would like a copy send me an email.
Location
*
Allen, TX
Tyler Road
Derby
Country Acres
Supervisor Name (who is completing write up)
*
Your answer
Employee Name
*
Your answer
Date of Infraction
*
MM
/
DD
/
YYYY
This is notice is for a(n)
*
Infraction Slip (A written warning/purple slip)
Write Up (formal written disciplinary action)
Incident # for same infraction (how many times have you went over this with employee)
*
1st
2nd
3rd
Classroom or Work Area
*
Infants
Toddlers
Preschool
Floater
Kitchen
Other:
Violation Type (Check all that apply)
*
Tardiness (Late to shift)
Absenteeism (Not showing up and/or Improper notice for absence)
Insubordination (Not following direction, refusal, or argumentative)
Quality of Work (Parent Complaint, State Citation, Supervisor Observing inadequate work)
Neatness and/or Cleanliness
Safety/Supervision
Drug or Alcohol Use
Carelessness
Other:
Required
Details of Occurrence
*
Your answer
Corrective Action to be Taken
*
Verbal Warning
Written Warning
Suspension (with pay)
Suspension (without pay)
Termination
Other:
Expected Improvement (if termination, write 'termination of employment')
Your answer
If termination or suspension, as of what date
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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