REASONABLE SUSPICION REPORT FORM Clause Samples

The Reasonable Suspicion Report Form clause establishes a formal process for documenting and reporting instances where there is a credible belief that an individual may be violating a policy, such as substance use or misconduct. This clause typically requires supervisors or designated personnel to complete a standardized form detailing the observed behaviors, circumstances, and any supporting evidence that led to the suspicion. By providing a structured method for reporting, the clause ensures that concerns are recorded consistently and objectively, helping organizations address potential issues promptly while maintaining fairness and due process.
REASONABLE SUSPICION REPORT FORM. This checklist is intended to assist a supervisor in referring a person for reasonable suspicion/cause drug and alcohol testing. The supervisor must identify at least three (3) contemporaneous indicia of impairment in two separate categories (e.g., Speech and Balance) in Section II, and fill out the Section III narrative. In the alternative, the supervisor must identify one of the direct evidence categories in Section I, and fill out the Section III narrative. Employee Name: Department: ; Division and Work Location: Date and Time of Occurrence: ; Incident Location:
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REASONABLE SUSPICION REPORT FORM. This checklist is intended to assist a supervisor in referring a person for reasonable suspicion/cause drug and alcohol testing. The supervisor must identify at least three (3) contemporaneous indicia of impairment in two separate categories (e.g., Speech and Balance) in Section II, and fill out the Section III narrative. In the alternative, the supervisor must identify one of the direct evidence categories in Section I, and fill out the Section III narrative. Employee Name:
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REASONABLE SUSPICION REPORT FORM. Date: Location of incident/accident: Time: Accident related injuries? Yes No (circle) If yes, provide details. Provide a brief summary of accident: Description of other party(s) involved: Police at scene? Yes No (circle) If yes, provide jurisdiction: Name (Supervisor/Manager) Name (Supervisor/Manager) Date Date
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Related to REASONABLE SUSPICION REPORT FORM

  • Reasonable Suspicion “Reasonable suspicion” or “reasonable cause” is a belief based upon facts gathered from the totality of the circumstances that would cause a reasonable manager to suspect impaired performance or reduced job safety by an employee on the job. Reasonable suspicion is not to be based upon unconfirmed rumors, but shall be based upon individual observation by an individual of managerial rank trained by the District to recognize the symptoms of substance abuse. The Manager is required to take into account other possible explanations for observed behavior, such as illness, lack of sleep, fatigue, and reactions to noxious fumes or smoke. The facts supporting the reasonable suspicion shall be documented and recorded in a manner provided in Attachment I. In determining if reasonable suspicion exists, the manager shall consider factors such as, but not limited to, fatigue, lack of sleep, side effects of prescription and/or over the counter medications, reactions to nauseous fumes or smoke, etc., which may explain the behavior of the employee. The involvement of an employee in an accident or on-the-job injury shall not, standing alone, constitute the reasonable suspicion required by this Policy. The subject employee shall, where possible, be interviewed prior to a reasonable suspicion determination being made. The employee shall have the right to Teamsters, Local 1932 representation during such interview unless acquiring such representation would delay the interview and possible test for an unreasonable period of time. An unreasonable delay is one which may impact the validity of any test results. The suspected employee shall have the right to Teamsters, Local 1932 representation during such interview, if requested, and the employee shall be advised of that right by the Fire Chief or designee prior to any such interview. The employee and, if applicable, the Teamsters, Local 1932 representation shall upon request be given copies of all available documentation of reasonable suspicion and have reasonable time to review these documents before the interview commences. During the interview, the Fire Chief or designee shall give the employee the opportunity to explain his or her condition, and the Fire Chief or designee shall keep a record of the interview. A non-inclusive description of behavior that may constitute evidence of reasonable suspicion is as follows: Slurred speech; Physical altercation; Verbal altercation; On-duty possession of alcohol or drugs; Information obtained from a reliable person with personal knowledge as to an employee’s drug or alcohol use or possession; Disorientation or job impairment (inability to perform employee’s job in a routine manner); Any bargaining unit member arrested and/or convicted for driving any type of vehicle under the influence of alcohol or drugs; Any bargaining unit member arrested and/or convicted of an alcohol or drug-related criminal charge; Odor of alcohol on breath; Unsteady gait or balance Glassy eyes;

  • Reasonable Suspicion Testing All Employees Performing Safety-Sensitive Functions A. Reasonable suspicion testing for alcohol or controlled substances may be directed by the Employer for any employee performing safety-sensitive functions when there is reason to suspect that alcohol or controlled substance use may be adversely affecting the employee’s job performance or that the employee may present a danger to the physical safety of the employee or another. B. Specific objective grounds must be stated in writing that support the reasonable suspicion. Examples of specific objective grounds include but are not limited to: 1. Physical symptoms consistent with alcohol and/or controlled substance use; 2. Evidence or observation of alcohol or controlled substance use, possession, sale, or delivery; or 3. The occurrence of an accident(s) where a trained manager, supervisor or lead worker suspects alcohol or other controlled substance use may have been a factor.

  • Litigation Reporting If Contractor is served with a pleading or other document in connection with an action before a court or other administrative decision making body, and such pleading or document relates to this Participating Addendum or may affect Contractor’s ability to perform its obligations under this Participating Addendum, Contractor shall, within 10 days after being served, notify the State of such action and deliver copies of such pleading or document to the State’s primary contact identified in §5 of the Participating Addendum .