Discipline Form Designed to Save Time and Improve Performance!
Written Warning using a Discipline Form
Employee: Alice R. Blacksmith Title: Hotel Housekeeper
Supervisor: Bruce T. Longfellow Title: Housekeeping Manager
Type of Disciplinary Action
(check only one)
_ Counseling X 1st Written Warning
_ 2nd Written Warning _ 3rd Written Warning _ Termination
Previous Disciplinary Action Issued
(List date(s) and Type issued only)
Date: 3/23/10 Type: Counseling
Explain Behavior or Performance
(List date(s) & approximate time(s). Explain who, what, why and where. Only facts)
After being instructed you failed to properly clean the guest
room shower curtain and toilet bowl on April 21, 2010. >
Action Necessary to Correct Behavior or Performance
(List training needed or explain the correct type of behavior expected)
One of the most important parts of the cleaning process is to
clean the hotel guest room bathroom thoroughly and to standard.
Going forward it is critical that you remove the soiled restroom
shower curtain on each room you clean. It is important to use the
acid bowl cleaner each time.
Explain Consequences of Future Behavior or Performance Issues
Any additional violations of company policies or procedures may result
in disciplinary action up to and including possible termination.
(Note to Employee: By signing this form it only indicates that you have been informed of the issue, not that you necessarily agree or disagree.)
Employee: Alice R. Blacksmith Date: 6/20/10
Supervisor: Bruce T. Longfellow Date: 6/20/10
Complete the Open Blocks to Prepare an Employee Written Warning Notice
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Simply to memorialize the event!
Yes, to capture who, what, where, when, how, and finally what happens if it occurs again!
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Thank you and May God Bless You!
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