MANAGER’S CHECKLIST FOR FINAL DISCIPLINE	
Complete prior to decision.	
Employee’s Name:      	Date:      	
Time With Company:      	Department:      	

PROBLEM:
	
Employee(s) involved.      
	
Details of what happened.      

	
How did it happen?      

	
Specific facts to be considered (no opinions).      

	
Did you give the employee a chance to tell his/her side of the story?	 Yes	 No

Explain.      

	
Was your interview with the employee in private? 	 Yes	 No	
Was the employee aware of the rule, procedure, or policy being breached? 	 Yes	 No	
Was the rule published in writing and disseminated to all employees? 	 Yes	 No	
Do you have written confirmation of receipt of that communication? 	 Yes	 No	
Explain how the rule has been enforced in the past.      

	
What changes in behavior need to be made?      

	
Have past changes affected current situations?                                                     Yes  No

Explain.

What is the employee’s past record?      

Can you back up this record with facts?	 Yes	 No	
Did the employee have any previous warning?	 Yes	 No	
Has this violation been previously overlooked? 	 Yes	 No	
According to policy, what is appropriate and justifiable discipline?
	 Verbal warning
	 Written warning
	 Placed on probation
	 Discharge	
In your opinion, will corrective action prevent a recurrence and encourage better performance?
	 Yes	 No	
Did you check with any/all of the following before taking disciplinary action?
	 Your Manager
	 Human Resources
	 Other Executives	     

FUTURE ACTION
	
Is any follow-up action necessary?  How do you plan to monitor?      

	
Have you recorded this incident and put a copy in the employee’s personnel file? 	 Yes	 No	
Have you allowed the employee to impart a rebuttal? 	 Yes	 No