Employee Warning Form

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This form should be used to formally document a warning given to an employee.

Email *

Employee Name *

Employee Number if Known

Today's Date *

YYYY

Date of Violation

YYYY

Person completing the form *

Shift

1st Shift

2nd Shift

3rd Shift

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Place Violation Occurred

Time of Violation

Time

Department

Administration

Assembly

Business Operations

Customer Service

Inventory Control

Maintenance

Molding

Purchasing

Quality

Tooling

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Nature of Violation *

Failure to comply with 5S policies

Parking Violation

Passing too many failing parts

Destruction of ADMO property

Leaving ADMO location without punching out

Stealing (taking or removing from premises without permission) property belonging to the Company, another employee, or a customer.

Opening, removing or tampering with locks or safety devices on Company property without proper authority.

Refusal to comply with a work assignment or work instruction or refusing to perform assigned work.

Leaving the plant during working hours without management permission. (This may be considered job abandonment.)

Reporting to work or working under the influence of alcohol or drugs, or using or having such in one’s possession on Company property (including parking lots or in lockers).

Concealing defective work.

Restricting production output or encouraging others to do so, or engaging in any work stopped.

Sabotage, destruction, misuse, or hiding of Company property, or that of a customer or another employee.

Falsifying Company record, altering Company records without Company permission, or intentionally giving false information in preparation of any Company records, including employment applications (no matter when discovered).

Fighting on Company property, assaulting or attempting to assault any person to engage in an assault or fight.

Possession of any dangerous weapon (firearm, knife, club, etc.) or explosives on Company property (including parking lots).

Being insubordinate or disobedient (including failure to follow directions of management).

Conviction of a crime or other evidence that you actually engaged in a crime (we will not rely on arrest record alone or a record of conviction that has been expunged or sealed).

Removal or adjustment of safety devices without authorization.

Failing to timely return from a leave of absence or vacation.

Violation of the Company’s discrimination, sexual harassment or anti-harassment policies.

Failing to report to work or call in absences for three (3) consecutive weekdays. (This will be considered job abandonment).

Smoking in unauthorized areas on Company property, including anywhere on site and/or within fifteen (15) feet of any entrance to the building.

Failing to follow prescribed safety and health procedures, practices or policies, including smoking except where permitted outdoors, and including careless operation of any motorized equipment.

Failing to maintain satisfactory work performance or causing excessive rework, scrap or waste, or incompetent or inefficient work performance.

Interfering with other employees on the job.

Failing to obtain Foreman’s permission before leaving work station and/or Company premises during working hours (except for such matters as going to the washroom).

Destruction of Company bulletin boards or posting anything on Company bulletin boards, without Company permission.

Not working during working time or engaging in personal business during working time, such as personal work, personal telephone calls, sleeping, reading, visiting other employees, etc., without foreman’s permission.

Overstaying rest periods or lunch periods.

Failing to call before your designated starting time, when not reporting for work.

Unauthorized entry into, or being on, Company property other than during scheduled work time, or bringing non-employees on Company property without the permission of the Company.

Failing to maintain satisfactory standards of dress, grooming, cleanliness, personal conduct or speech, including using obscene or threatening or intimidating language, or spreading malicious gossip or rumors, or making false, vicious or malicious statements concerning any employee, the Company, or its services.

Refusal to work a reasonable amount of overtime.

Engaging in horseplay or disorderly conduct.

Failing to report immediately to a Foreman any accident or injury.

Leaving your assigned work place at any time, or preparing or leaving your work station before the regular rest period, lunch or quitting time, without permission.

Violation of Absence Reporting Policy.

Violation of Smoking Policy.

Failing to return tools at end of work shift and/or loss of tools due to employee carelessness or negligence.

Any other act or omission deemed harmful to Admo, its customers, property, employees or reputation.

Other:

Required

Type of Disciplinary Action Being Taken *

Verbal Warning

Written Warning

Termination

Is the employee being suspended?

Yes

Clear selection

If the employee is being suspended please list the dates of suspension and when the employee is expected to return to work

Details of Violation

Employee Statement

Submit

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