PERFORMANCE CORRECTION NOTICE

DISCIPLINARY LEVEL

Verbal Correction—(To memorialize the conversation.)

Written Warning—(State nature of offense, method of correction, and action to be taken if offense is repeated.)

Investigatory Leave—(Include length of time and nature of review.)

Final Written Warning

Without decision-making leave

With decision-making leave (Attach memo of instructions.)

With unpaid suspension

SUBJECT:Inappropriate removal of company property; breach of confidentiality policy

Policy/Procedure Violation

Performance Transgression

Behavior/Conduct Infraction

Absenteeism/Tardiness

PRIOR NOTIFICATIONS

Incident Description and Supporting Details: Include the following information: Time, Place, Date of Occurrence, and Persons Present as well as Organizational Impact.

Patricia,

Yesterday State Care Licensing (SCL) audited Rogers Family Services. The auditor performed a random check of our client files. The auditor discovered that seven client files from your caseload were not in the file cabinet. When I asked you if you knew where they were, you stated, “I know I shouldn’t have, but I brought them home over the weekend to catch up on my progress notes. I’ve been having some personal problems and have fallen behind in my work.” You then stated that had you known an audit was occurring on Monday, you would not have removed the files from the cabinet.

Because I was unable to produce the requested files for the auditor during her spot check, our agency received a citation. It is strictly against company policy to remove client files from the premises. As a social worker at Rogers Family Services, it is your responsibility to adhere to confidentiality mandates. Your actions directly violated client confidentiality and have also jeopardized our agency’s SCL audit.

PERFORMANCE IMPROVEMENT PLAN

1. Measurable/Tangible Improvement Goals: Patricia, I expect you to never again remove client files from the premises. Similarly, I expect you to uphold all standards of confidentiality as found in the Employee Confidentiality Agreement and policy 6.1, Confidential Information. In addition, if you again fall behind in your work, I expect you to inform me of that fact so that we can work together to manage your workload.

2. Training or Special Direction to Be Provided: Attached is a copy of policy 6.1. Please read it immediately and see me if you have any questions. Please review your Employee Confidentiality Agreement as well to ensure that you understand your responsibilities to our patients.

3. Interim Performance Evaluation Necessary? No

4. Our Employee Assistance Program (EAP) provider, Prime Behavioral Health Group, can be confidentially reached to assist you at (800) 555-5555. This is strictly voluntary. A booklet regarding the EAP’s services is available from Human Resources.

5. In addition, I recognize that you may have certain ideas to improve your performance. Therefore, I encourage you to provide your own Personal Improvement Plan Input and Suggestions:

(Attach additional sheets if needed.)

OUTCOMES AND CONSEQUENCES

Positive: I will remain available to help you and discuss areas where you require additional support. If you meet your performance goals, no further disciplinary action will be taken regarding this issue.

Negative: Failure to meet company confidentiality standards is a serious offense. If you ever again fail to abide by our organization’s Client Confidentiality policy in any way or if you remove company property from the premises without prior approval, further disciplinary action up to and including dismissal may result. A copy of this document will be placed in your personnel file.

Scheduled Review Date: None

EMPLOYEE COMMENTS AND/OR REBUTTAL

EMPLOYEE ACKNOWLEDGMENT GOES HERE