Reducing Unemployment Costs

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1 Reducing Unemployment Costs Documentation Verbal Warnings Written Warnings Suspensions Call Ins No Call / No Show Tardiness Performance Customer Complaints Loss of Revenue What was the final incident surrounding the termination? Dates Time Witnesses Circumstances Communication s Text Messages Phone Calls Termination Management First Genuine Interest Hiring Practices Accident Prevention Updated Safety Policy Loss of Revenue Indemnity vs. Medical Only Return to Work Program Monthly Safety Meetings Reducing Workers Compensation Costs Report Injuries Immediately Call HR Sunday through Monday 7am to 11pm Submit the Clinic Incident Report to HR

2 Human Capital Strategies Human Resources Department NOTICE OF CORRECTIVE ACTION Name: Position: Client Company: Date: Rule or Policy Involved: Corrective Action Taken: Date Implemented: [ ] Written Counseling [ ] Written Warning [ ] Discharge [ ] Suspension From: To: Performance or behavior in need of correction: Employee Explanation: Previous corrective actions taken (preceding 12 months): Employee Signature: Date: (Acknowledges the corrective action given, but does not necessarily indicate agreement) Manager Signature: Date: Title:

3 Effective Date Employee Name Personnel Action Request Form Client Company Change of Personal Information Name Social Security Marital Status Home Address City State Zip Address Home Phone Mobile Phone Change of Emergency Contact Name Home Phone Mobile Phone Change of Status/Salary From Job Title Department Name Job Title Department Name To Department # Hourly Rate Annual Rate Department # Hourly Rate Annual Rate Pay Status F/T Status Pay Status F/T Status One Time Payment Reason: Federal Withholding (W-4)* Status Exemptions Additional Deduction: Leave of Absence Arizona Withholding (A-4)* % Additional Deduction: * Attach the signed withholding form(s) Placed on Returned from (submit a second PAR upon employee s return) Effective Date Estimated End Date Actual End Date Type of Leave FMLA Eligible? Duration Yes No Termination Last Day Worked PTO Hours Eligible for Rehire Mail Final Check: Termination is: Approval Comments: Owner/Manager: Please complete Separation Notice for Involuntary Termination so HCS can respond to any requests for Unemployment Compensation. Date: Please fax completed form to Human Capital Strategies (480) Check here, if you would like us to call and confirm receipt. Phone # K: HR/Forms/Personnel Action Request Form

4 Separation Notice Employee Name: Company: Position: Supervisor: Start Date: Separation Date: Last Day Worked: [ ] Voluntary Termination (attach Resignation Letter) [ ] Involuntary Termination Reason for Separation (please be specific): Was the employee given a reason for discharge? Yes [ ] No [ ] Had the employee been warned about their conduct, attendance, work, etc.? Yes [ ] No [ ] Is employee eligible for rehire? Yes [ ] No [ ] Employee Signature [ ] Employee Refused to sign. [ ] Employee unavailable for signature, copy mailed. Supervisor Signature President Signature Date Date Forward completed copy to Human Capital Strategies HCS/Payroll use only Total hours worked: Vacation/PTO: Other: Final Check Amount: K: HR/Forms/Separation Notice

5 Because you are in a unique position to offer us invaluable insights and information about your employment with a Human Capital Strategies/Massage Envy, we would like to ask for your constructive feedback. The information you provide will be compiled on a quarterly basis, analyzed, shared with our senior management and used to develop and enhance responsive employee programs. We appreciate your candor as you answer the questions below. Thank you in advance for your help. We wish you the best in all of your future endeavors. Employee Name: Hire Date: Last Day of Work: Job Title: Client Company: 1. Please choose the category that best indicates why you are leaving the company. Another Position Education Relocate Retire Take time off from work Stay home with family Other (explain) 2. What was the overall issue that prompted you to leave the company? 3. What attracted you to your new company (if this is applicable to your situation)? 4. What does the new position offer that the company does not? 5. Had you been actively seeking opportunity outside of the company? Yes No Please indicate the top 3 reasons for you leaving the company. Rank them in the following order (1=most important, 2=next important, etc.) Work not interesting or challenging Compensation issues Opportunity to learn new skills Insufficient Training Not appreciated/lack of recognition by management Job found not to be as presented Poor supervision Lack of promotional opportunities Inadequate equipment/tools Benefits Issues Reasons unrelated to my job Commute Issues related to our service or Company s performance

6 Please identify the top 3 things that the company could have taken to retain your services. Rank them in the following order, (1=most important, 2=next important, etc) More effective representation of job responsibilities from the beginning Better working environment A more manageable workload Flexibility in work schedule/balance between work and family Challenging and diverse assignments Autonomy and/or ability to set the direction of assignments and goal Expanded Benefits Expanded time-off policies Support by immediate supervisor Opportunity for Training and Development Effective performance measures and timely evaluations Formal and Informal individual recognition Open upward communication/feedback channels Other Please comment on any of above areas or anything else that the company could have done to retain your services How would you rate your immediate supervisor at the company? a. Treats employees fairly Excellent Good Fair Poor b. Recognizes and rewards accomplishments Excellent Good Fair Poor c. Effectively develops employees Excellent Good Fair Poor d. Resolves workplace issues fairly and in a timely manner Excellent Good Fair Poor e. Understands and communicates policies and procedures Excellent Good Fair Poor f. Effectively implements and follows policies and procedures Excellent Good Fair Poor g. Communicates the company mission, vision and values Excellent Good Fair Poor

7 h. Encourages feedback and welcomes suggestions Excellent Good Fair Poor i. Gives clear instructions and adequate direction Excellent Good Fair Poor j. Has realistic expectations of job demands Excellent Good Fair Poor k. Fosters teamwork Excellent Good Fair Poor l. Considerate of need to balance work and personal life Excellent Good Fair Poor m. Provides guidance and coaching Excellent Good Fair Poor n. Communicates clear job expectations Excellent Good Fair Poor o. Values diversity Excellent Good Fair Poor p. Creates/sustains a productive and satisfying workplace Excellent Good Fair Poor q. Enables effective problem solving and decision making Excellent Good Fair Poor r. Listens to employees input and suggestions Excellent Good Fair Poor s. Encourages cooperation within the department Excellent Good Fair Poor t. Encourages cooperation with other departments Excellent Good Fair Poor u. Immediate supervisors overall performance Excellent Good Fair Poor Do you wish to comment on any other the company supervisors? Overall Experience Overall, how you rate your experience? Excellent Good Fair Poor Would you recommend us as a good place to work to a close friend? Yes No Would you consider returning to the company? Yes No Is there anything else? Thank you, we value your input!

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