Disciplinary Form

Disciplinary Form

 

Date: April 24,2026

Client Name;Haven Wilburn

Action by Client that Warranted Disciplinary Action: failure to comply

Haven Wilburn was asked two previous times to communicate with staff before taking action in decisions she made which that had been reviewed at intake. Haven deliberatly disregaurded them and continued the behavior.

Follow Up Steps for Staff: 

Sit down with house manager and had one on one coversation with Haven. Second time was a conversation held with House Manger and Case Manager.

Will Client be Discharged: 

No

 

Client Signature: haven wilburn

Staff Signature: Alexsis Pinson