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Employee Disciplinary Write-Up Form

Company: ACM Creative Concepts Applies To: Graffiti Pasta · The Nook · HEYDAY Version: 1.0 Date: April 24, 2026 Prepared by: ALICE + Optimus / ACM Creative Concepts Status: DRAFT — Pending Anthony Review


Manager Instructions: Complete this form any time a formal verbal warning, written warning, or final warning is issued. Be specific and factual — no opinions, no generalizations. Both manager and employee sign. Original goes in the employee file. Notify Anthony the same day any write-up is issued.


EMPLOYEE INFORMATION

Employee Name: _______________________

Location: [ ] Graffiti Pasta — Denton [ ] The Nook — Celina [ ] HEYDAY — Celina

Position/Role: _______________________

Date of Hire: _______________________ Date of This Write-Up: _______________________

Manager Issuing Write-Up: _______________________


TYPE OF ACTION

[ ] Verbal Warning (documented for the record) [ ] Written Warning — First [ ] Written Warning — Final [ ] Suspension — Number of days: _______ [ ] Termination (requires Anthony approval before issuing — do NOT check this without Anthony's explicit go-ahead)


REASON FOR WRITE-UP

Check all that apply:

Attendance & Punctuality [ ] No-call / No-show [ ] Excessive tardiness [ ] Leaving early without manager approval [ ] Excessive absenteeism

Performance [ ] Failure to meet service standards [ ] Failure to follow opening/closing procedures [ ] Poor guest interaction [ ] Failure to complete assigned duties [ ] Failure to follow manager instructions

Conduct [ ] Insubordination [ ] Unprofessional behavior toward guests [ ] Unprofessional behavior toward coworkers [ ] Inappropriate use of phone during shift [ ] Violation of uniform/appearance policy [ ] Violation of social media policy

Integrity [ ] Cash handling violation [ ] Suspected or confirmed theft [ ] Dishonesty

Safety & Compliance [ ] Food safety violation [ ] TABC violation [ ] Substance use on the job

Other: _______________________


DESCRIPTION OF INCIDENT

Be specific. Include: date and time of incident, what happened, who was involved, any witnesses. Facts only — no opinions.

Date / Time of Incident: _______________________

Description:






Witnesses (if any): _______________________


PRIOR INCIDENTS

Has this employee been warned about this behavior before?

[ ] No — this is the first incident [ ] Yes — describe prior warnings:

Date of prior warning: _______________________ Type: [ ] Verbal [ ] Written Issue: _______________________


EXPECTED IMPROVEMENT

What specific behavior must change, and by when?




Improvement deadline (if applicable): _______________________


CONSEQUENCES IF BEHAVIOR CONTINUES

[ ] Next offense will result in a final written warning [ ] Next offense will result in termination [ ] Employee is on a performance improvement plan (PIP) — attach PIP document [ ] Other: _______________________


SIGNATURES

By signing below, the employee acknowledges receipt of this write-up. Signing does not mean the employee agrees with the contents — only that they have received and read this document.

Employee Signature: _______________________ Date: _______________________

Employee Comments (optional):



Manager Signature: _______________________ Date: _______________________

Anthony Notified: [ ] Yes — Date/Time: _______________________


FILING INSTRUCTIONS

[ ] Original: Employee file [ ] Copy: Given to employee [ ] Copy: Sent to Anthony (email or text same day) [ ] Logged in MDR under "Team Callouts"


ACMCC Employee Write-Up Form | v1.0 | April 24, 2026 ACM Creative Concepts | Prepared by ALICE + Optimus