CLS Employee Corrective Action Form – Collins Land Services, LLC

Corrective Action

This form is to be utilized when implementing the corrective action process for an employee. Once this form is submitted, Administration will follow up with you for next steps. Do not implement any action on the employee until/unless the violation constitutes Gross Misconduct as outlined in the Corrective Action Policy. If an employee is immediately discharged from CLS as a result of this corrective action, you MUST notify Administration immediately.

Employee Name(Required)

Employee Email Address(Required)

Employee will also receive a copy of this violation upon submission.

Supervisor Submitting Corrective Action(Required)

Supervisor Email Address(Required)

Job Site or Location where Violation Occurred(Required)

Date and Approximate Time of Violation(Required)

Violation Type(Required)

Description of the incident(Required)

Include what the employee did or did not do, the policy violated, and how the employee knows this was wrong or not appropriate. **Must be a statement of facts and not opinion**

Expectation of Employee(Required)

If violation is Performance related to Work Quality and Quantity, you must provide measurable expectations for the employee. Example: "David was tasked with completing 300 feet of ditch clearing by the end of day. David was told to communicate any issues that may affect the daily goal. There was no communication from him, and only 150 feet had been cleared by end of day."

Employee's Response to Violation(Required)

Management: If employee chooses not to respond, at this time please type "No employee response" in this field.

Supervisor Signature(Required)

Employee Signature(Required)

Management: If employee refuses to sign, please write "refused to sign" in this field.