Employee Communication

Employee Communication

NAME OF EMPLOYEE: Click here to enter text.

POSITION: Click here to enter text.

FACILITY: Click here to enter text.

DEPARTMENT: Click here to enter text.

DATE OF CONFERENCE: Click here to enter a date.

REASON FOR THE CONFERENCE: Suspension of Employment Based on an Allegation of Abuse or Neglect

It has been alleged that you were involved in an incident which is being investigated as abuse or neglect of a person this Agency serves. Your employment is being suspended without pay due to an allegation of Click here to enter abuse or neglectthat occurred on Click here to enter a date of abuse or neglect.atClick here to enter siteuntil an investigation is completed. The investigation will be completed within ten business days or less of your employment suspension date.

If the investigation does not substantiate the allegation, you may receive pay for your regular scheduled work hours that you did not work due to your suspension. If the investigation does substantiate the allegation, you will not be entitled to any wages for hours you did not work.

The Program Director and Director of Human Resource Management will determine if your employment is terminated or if you may return to work with stipulations. Some examples of such a stipulation may be a requirement to successfully complete additional training or be ineligible to work additional hours above your normal schedule.

You are expected to cooperate with all aspects of the investigation and not discuss the investigation with your co-workers. If you fail to cooperate or do not maintain confidentiality, your employment may be terminated. Please provide a working telephone number in the space provided so we may be able to contact you, ______.

You will be provided with a copy of this Employee Communication after you have signed it. Your signature confirms that you have read the information contained in this Employee Communication and is not an acknowledgment of any wrong doing.

It is recommended that you call (supervisor’s name), at (insert supervisor’s cell phone number) every five days for an update on the status of the investigation.

I have read and discussed this report.

______

Employee’s SignatureDate

ROUTE TO: (Sign and date to indicate receipt)

Chief Operating Officer

Director of Human Resources

Department Director

Director of Quality Assurance

Other (Specify by Name):

RETURN TO EMPLOYEE PERSONNEL FILE

Form C-17a 09/10, 10/13Page 1 of 2