Information

  • Document No.

  • Jobsite

  • Location
  • Employee name

  • Position

  • Company Name:

  • Contract Number:

  • Team Leader/Manager/Supervisor

Purpose: To provide a formal opportunity for a site supervisor to help internal and external workers understand where improved performance is required and expected, and to provide a written record of each counseling session

  • Select One

  • There is no requirement that all steps in the discipline progression must be followed; the site manager has discretion to decide on the warning depending on the nature of the offense.

Problem Area (Note below specific problems, issues, occurrences, dates, times, etc.)

  • Select one

  • Poor Quality Photo (if available)

  • Note below specific problems

  • Specific problem visual aid (if available)

PROBLEM DEFINITION

  • List the specific reason(s) why this person is being counseled.

IMPROVEMENT REQUIRED

  • List specific actions the employee must take to correct the situation or behavior.

SUGGESTED MEANS OF IMPROVEMENT

  • List specific goals, objectives and measurement standards that you and the employee had agreed to, and in what time frame.

  • FAILURE TO COMPLY WITH THE ABOVE REQUIREMENTS IN THE SPECIFIC PERIOD, OR FURTHER VIOLATIONS OF TRANSGRID POLICIES, PROCEDURES OR CONSTRUCTION SITE RULES WILL RESULT IN REMOVAL FROM THE CONSTRUCTION SITE AND FURTHER DISCIPLINARY ACTION MAY BE ENTERED INTO

  • EMPLOYEE COMMENTS:

  • This counseling decision was either discussed with the employees team leader/manager/supervisor or the report will be provided to them.

  • I acknowledge that I have discussed this warning/acknowledgement with the employee and have given him / her a copy (if so asked) and the original signed copy has been recorded.

Sign off

  • TransGrid Site Supervisor Signature

  • Does the person work for TransGrid?

  • I acknowledge that this issue or problems were discussed with me and I may receive a copy of this report if requested and that this will also become part of my site record.

    I acknowledge that failure to correct the situation will result in removal from the construction site and further disciplinary action may be taken.

  • Employee Signature

  • I acknowledge that this issue or problems were discussed with me and I may receive a copy of this report if requested and that this will also become part of TransGrid's site record.

    I acknowledge that failure to correct the situation will result in the staff member's removal from the construction site.

  • Contractor Site Supervisor

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.