Occur. #
Absence: mm/dd/yyyy - mm/dd/yyyy | FMLA 020 | |
---|---|---|
mm/dd/yyyy - mm/dd/yyyy | [insert Pay Code] | Hours: 00:00 |
Source comments go here. | Work Days Missed: [insert #] | |
mm/dd/yyyy - mm/dd/yyyy | [insert Pay Code] | Hours: 00:00 |
Source comments go here. | Work Days Missed: [insert #] |
Chargeable Absence Dates:
# | DATE(S) | PAY CODE |
---|---|---|
6 | 07/06/2016 - 07/07/2016 | 1024 - Sick |
5 | 07/01/2016 | 1024 - Sick |
4 | 06/28/2016 | 2029 - Request Off Chargeable |
3 | 06/27/2016 | 2006 - No Show |
2 | 06/20/2016 | 2005 - Late for Work |
1 | 06/13/2016 | 2005 - Late for Work |
A review of your absenteeism record shows that you have had [populate occurrence number] absence occurrences in a 12-month period from [populate first occurrence date] to the most recent on [populate most current occurrence date]. This is not acceptable, and poor attendance will not be tolerated by Metro Transit.
It is your responsibility to improve your attendance record if you are to avoid future disciplinary action.
The Absenteeism Policy/Program specifies that within a rolling calendar year:
|
Regular attendance is a critical component of your job. Customers expect and need our services to be on time; employees with dependable attendance patterns are necessary to succeed in that effort.
Management believes you can be successful in turning this record around. The commitment to do so must come from you.
If you feel personal problems may be contributing to your poor performance, you may want to contact Sand Creek, Metro Transit’s Employee Assistance Program, at 651-430-3383. Metro Transit also offers several other free-of-charge, confidential services to assist its employees. Please contact a manager or ATU representative to get information on the following:
If there is any way that we can help you to succeed, please don’t hesitate to talk to your manager about possible accommodations. Metro Transit may be able to offer support in the form of a Leave of Absence, etc.
Describe events or behavior leading to this counseling:
Action Plan:
1. What are the consequences if performance does not improve?
2. Describe the actions employee will take to improve performance.
Employee Assistance Program (EAP) discussed; phone number and website information provided.
Call Sand Creek EAP at 651-430-3383 or visit online at SandCreekEAP.com.
Yes |
Chargeable Absence Dates:
# | DATE(S) | PAY CODE |
---|---|---|
7 | 08/01/2016 - 08/03/2016 | 1024 - Sick |
6 | 07/06/2016 - 07/07/2016 | 1024 - Sick |
5 | 07/01/2016 | 1024 - Sick |
4 | 06/28/2016 | 2029 - Request Off Chargeable |
3 | 06/27/2016 | 2006 - No Show |
2 | 06/20/2016 | 2005 - Late for Work |
1 | 06/13/2016 | 2005 - Late for Work |
Metro Transit Expectations: Regular and consistent attendance is critical for meeting our mission to provide reliable transportation services to the region. Your attendance record is lacking in this regard, and has failed to meet our expectations.
The Absenteeism Policy/Program specifies that within a rolling calendar year:
If you feel personal problems may be contributing to your poor performance, you may want to contact Sand Creek, Metro Transit’s Employee Assistance Program, at 651-430-3383 or online at SandCreekEAP.com.
Describe events or behavior leading to this warning:
Action Plan:
1. What are the consequences if performance does not improve?
2. Describe the actions employee will take to improve performance.
Employee Assistance Program (EAP) discussed; phone number and website information provided.
Call Sand Creek EAP at 651-430-3383 or visit online at SandCreekEAP.com.
Yes |
Chargeable Absence Dates:
# | DATE(S) | PAY CODE |
---|---|---|
10 | 08/30/2016 | 2006 - No Show |
9 | 08/29/2016 | 2006 - No Show |
8 | 08/28/2016 | 2006 - No Show |
7 | 08/01/2016 - 08/03/2016 | 1024 - Sick |
6 | 07/06/2016 - 07/07/2016 | 1024 - Sick |
5 | 07/01/2016 | 1024 - Sick |
4 | 06/28/2016 | 2029 - Request Off Chargeable |
3 | 06/27/2016 | 2006 - No Show |
2 | 06/20/2016 | 2005 - Late for Work |
1 | 06/13/2016 | 2005 - Late for Work |
Metro Transit Expectations: Regular and consistent attendance is critical for meeting our mission to provide reliable transportation services to the region. Your attendance record is lacking in this regard, and has failed to meet our expectations.
The Absenteeism Policy/Program specifies that within a rolling calendar year:
Should you fall below 10 occurrences, you will remain in a Record of Warning status until such a time that your occurrence count falls below 7.
If you feel personal problems may be contributing to your poor performance, you may want to contact Sand Creek, Metro Transit’s Employee Assistance Program, at 651-430-3383 or online at SandCreekEAP.com.
Describe events or behavior leading to this warning:
Action Plan:
1. What are the consequences if performance does not improve?
2. Describe the actions employee will take to improve performance.
Employee Assistance Program (EAP) discussed; phone number and website information provided.
Call Sand Creek EAP at 651-430-3383 or visit online at SandCreekEAP.com.
Yes |
Chargeable Absence Dates:
# | DATE(S) | PAY CODE | WDM |
---|---|---|---|
13 | 09/02/2016 | 2006 - No Show | 1 |
12 | 09/01/2016 | 2006 - No Show | 1 |
11 | 08/31/2016 | 2006 - No Show | 1 |
10 | 08/30/2016 | 2006 - No Show | 1 |
9 | 08/29/2016 | 2006 - No Show | 1 |
8 | 08/28/2016 | 2006 - No Show | 1 |
7 | 08/01/2016 - 08/03/2016 | 1024 - Sick | 3 |
6 | 07/06/2016 - 07/07/2016 | 1024 - Sick | 2 |
5 | 07/01/2016 | 1024 - Sick | 1 |
4 | 06/28/2016 | 2029 - Request Off Chargeable | 1 |
3 | 06/27/2016 | 2006 - No Show | 1 |
2 | 06/20/2016 | 2005 - Late for Work | 1 |
1 | 06/13/2016 | 2005 - Late for Work | 1 |
Chargeable Absence Dates:
# | DATE(S) | PAY CODE | WDM |
---|---|---|---|
5 | 09/02/2016 | 2006 - No Show | 1 |
4 | 09/01/2016 | 2006 - No Show | 1 |
3 | 08/31/2016 | 2006 - No Show | 1 |
FMLA certification number: [ ]
Certificate start date: [ ]
Condition Descriptions:
- Employee Illness: Serious Health Condition
Note: If you visit your health care provider for this reoccurring condition and there is a change in your condition or treatment, the Council requests documentation of your visit.- Pregnancy/Prenatal Care
- Eligible Family Member's Serious Health Condition
This includes spouse, child, or parent. The employee's child is covered if he/she is a dependent child under 18 years of age, or a dependent child above the age of 18 who is incapable of self-care because of a physical or mental disability.
Employee was contacted by phone.
FMLA certification number: 001
Certificate start date: 12/01/2015
Certificate end date: 12/01/2016
Remaining FMLA hours available: 170:30
Condition Descriptions:
- Employee Illness: Serious Health Condition
Note: If you visit your health care provider for this reoccurring condition and there is a change in your condition or treatment, the Council requests documentation of your visit.- Pregnancy/Prenatal Care
- Eligible Family Member's Serious Health Condition
This includes spouse, child, or parent. The employee's child is covered if he/she is a dependent child under 18 years of age, or a dependent child above the age of 18 who is incapable of self-care because of a physical or mental disability.
Employee was contacted by phone.
FMLA certification number: [ ]
Certificate start date: [ ]
Condition Descriptions:
- Employee Illness: Serious Health Condition
Note: If you visit your health care provider for this reoccurring condition and there is a change in your condition or treatment, the Council requests documentation of your visit.- Pregnancy/Prenatal Care
- Eligible Family Member's Serious Health Condition
This includes spouse, child, or parent. The employee's child is covered if he/she is a dependent child under 18 years of age, or a dependent child above the age of 18 who is incapable of self-care because of a physical or mental disability.
Intermittent leave begins on: [ ]
Expected return date: [ ]
Worker's Compensation: Yes/No/Unsure