A blood donor technician falsely documents the time when a patient’s charting was to have taken place. It was determined via investigation that she was not in the room at the time she supposedly completed working with the patient.
PERFORMANCE CORRECTION NOTICE
Disciplinary Level□ Verbal Correction—(To memorialize the conversation.)□ Written Warning—(State nature of offense, method of correction, and action to
Employee Name:Maryanne Velasquez Department:Blood Donor Room Date Presented:June 24, 2010 Supervisor:Dianne Xavier
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
⊠ Policy/Procedure Violation
⊠ Performance Transgression
□ Behavior/Conduct Infraction
Level of Discipline Date Subject Verbal ___________ __________________________________________ Written 10/14/09 Document falsification Final Written ___________ __________________________________________
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Publication information: Book title: 101 Sample Write-Ups for Documenting Employee Performance Problems: A Guide to Progressive Discipline & Termination. Edition: 2nd. Contributors: Paul Falcone - Author. Publisher: American Management Association. Place of publication: New York. Publication year: 2010. Page number: 221.
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