Sample: Employee Situation Investigation Form

Parish/ School Name:
Department:
Investigation Date:
Investigator Name:

Section 1: Employee Information

Employee Name:

Employee ID:

Position/Title:

Date of Hire:

Supervisor/ Mgr:

Section 2: Description of Incident/Situation

Date of Incident:

Time of Incident:

Location of Incident:

Describe the nature of the incident or situation in detail:

Section 3: Individuals Involved

Employee(s) directly involved:

Name:

Role:

Witness/Other parties involved (if any):

Name:

Role:

Name:

Role:

Section 4: Preliminary Assessment

Has this incident been reported before?
Yes No

Has any disciplinary action been taken previously for similar behavior?
Yes No

Initial assessment of the situation:
(Provide a brief description of your preliminary analysis based on available information)

Section 5: Actions Taken (If Any)

Was the employee informed of the investigation?
Yes No

Date of Notification:

Method of Notification:

Has the employee provided their statement or response to the situation?
Yes No

Date of Statement:

Have any corrective actions or measures been taken?
Yes No

Please describe the action(s) taken:

Section 6: Additional Information

Are there any supporting documents or evidence?
Yes No
If yes, please list or attach relevant documents/evidence (e.g., emails, reports, etc.).

Section 7: Investigation Summary and Recommendations

Summary of findings (brief overview):

Recommendations (if any):
No action needed
Verbal warning
Written warning
Training or coaching
Suspension
Termination
Other (specify):

Section 8: Investigator's Signature

Investigator Name:
Position/Title:
Signature:
Date:

Employee Acknowledgment:
I acknowledge that I have been informed about the situation being investigated and understand the investigation process.

Employee Signature:
Date:

This form should be used as part of the investigation process for any employee-related situations that require formal documentation. Please ensure that all information provided is accurate and reflects the situation clearly.