Disciplinary/Counseling Report - GES

• Company Name

  JBI Electrical Systems Inc.

• Date

  Date

• Jobsite

  Select

• Employee Name

• Issued by

• Location
  Address

• Company Name

  JBI Electrical Systems Inc.

• Employee name

• Position

  Select Superintendent Foreman Safety Monitor Apprentice E-5 Apprentice E-4 Apprentice E-3 Apprentice E-2 Apprentice E-1

  • Superintendent
  • Foreman
  • Safety Monitor
  • Apprentice E-5
  • Apprentice E-4
  • Apprentice E-3
  • Apprentice E-2
  • Apprentice E-1

• Reporting Manager

Purpose: To provides formal opportunity for a supervisor to help and employee understand where improved performance is expected, and to provide a written record of each counseling session

• Select One

  Select Counseling Session Verbal Warning Written Warning Final Written Warning Failure to comply with safety policies 2018

  • Counseling Session
  • Verbal Warning
  • Written Warning
  • Final Written Warning
  • Failure to comply with safety policies 2018

• There is no requirement that all steps in the discipline progression must be followed; depending on the nature of the offense, JBI Electrical reserves the right to skip any steps at its discretion.

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

• Select one

  Select Disregard supervisor/co-worker/client/customer absenteeism / Tardiness Failure to do a job Gross misconduct failure to comply with company policy and/or procedure SAFETY POLICY

  • Disregard supervisor/co-worker/client/customer
  • absenteeism / Tardiness
  • Failure to do a job
  • Gross misconduct
  • failure to comply with company policy and/or procedure
  • SAFETY POLICY

• Serious Safety Violation

  Life Changing Violations

  Zero tolerance

• Specific Problem Area

  Select Serious Safety Violation Life Changing Violations Zero tolerance

  • Serious Safety Violation
  • Life Changing Violations
  • Zero tolerance

• Specific problem visual aid (if available)

  Media

• Specific problem visual aid (if available)

  Media

• Specific Problem Area

  Select Failure to wear fall protection Standing on the rails of a lift w/o PFAS Failure to wear a harness on boomlift Working on excavations w/o cave in protection Working on extension ladder w/o fall protection

  • Failure to wear fall protection
  • Standing on the rails of a lift w/o PFAS
  • Failure to wear a harness on boomlift
  • Working on excavations w/o cave in protection
  • Working on extension ladder w/o fall protection

• Specific Problem Area

  Select Unauthorized work on energized circuits

  • Unauthorized work on energized circuits

• Specific problem visual aid (if available)

  Media

• Specific Problem

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 COMPANY POLICIES AND PROCEDURES MAY RESULT IN FURTHER DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION.

• EMPLOYEE COMMENTS:

• Was this counseling decision discussed with an Human Resources Professional.

• I acknowledge that I have discussed this warning/acknowledgement with the employee, set an action plan and had given him/ her a copy (if so asked) and the original signed copy has been recorded in the employees personnel file.

• Supervisor Signature

  Sign

• Safety Director Signature

  Sign

• I acknowledge that this issue or problems were discussed with me and I may receive a copy if requested and that this will also become part of my personal record.
  I acknowledge that failure to correct the situation within the time frame indicated will result in further disciplinary action up to including termination of employment.

• Employee Signature

  Sign