Corrective Action Form

1. 15869
CORRECTIVE ACTION REPORT
NAME: Jane Doe Employee ID: 004755 JOB TITLE: Cashier
EMPLOYMENT DATE: November 4, 2016 STORE #: 999 DATE: June 4, 2019
PREVIOUS WARNINGS (dates and nature of offence):
CAR # 15818 October 12, 2018 Verbal Warning – Late for scheduled shift
CAR # 15827 December 23, 2018 Written Warning – Late for scheduled shift
CAR # 15839 February 17, 2019 1-day suspension – Late for scheduled shift
CURRENT INFRACTION:
Late for scheduled shift – 8 to 4:30 on Sunday June 2, 2019.
SUMMARY OF CIRCUMSTANCES SURROUNDING THE INFRACTION:
Jane was an hour late for her scheduled shift on Sunday June 2nd. Her shift was to start at 8am
and she did not arrive until 9am. When questioned, Jane stated that she slept in.
ADDITIONAL COMMENTS:
It is Jane’s responsibility to show up for scheduled shifts on time. Any future incidents of similar
nature may result in more severe corrective action, up to and including termination.
ACTION TAKEN: WARNING ________ SUSPENSION 3-days TERMINATION: _____
(check one)
_______________________ _________________________
EMPLOYEE’S SIGNATURE (acknowledging receipt) MANAGER’S SIGNATURE
*note – manager should sign last
_______________________ _________________________
SHOP STEWARD/WITNESS(Signature) MANAGER (print name)
_______________________
SHOP STEWARD/WITNESS (print name)
Distribution of Copies:
1. Original - Retain at Store [personnel file]
2. Copy - Employee
3. Copy - [shop steward]