HomeMy WebLinkAboutN-226 - Bereavement CITY OF PASCO
ADMINISTRATIVE ORDERS
Administrative Order No. 226
Personnel Policies & Procedures
Subject: Bereavement
Initial Effective Date:
November 22, 1993
Revised 5/7/07 9/7/12
Approved GC
This Administrative Order is effective September 7, 2012 and supersedes Administrative Order
No. 226 dated 5/7/07, and Administrative Order No. 72, Section V "Leave for Death in
Immediate Family" (Bereavement), dated 11 /22/93 .
I. PURPOSE:
To allow employees time off in the case of death of a close family member.
II. DEPARTMENTS AFFECTED:
This Order shall apply to all full and regular part-time hourly employees; to the extent,
however, a union contract lawfully conflicts with the provisions of this Order, such
contract provisions shall prevail.
III. POLICY:
Up to four days paid leave shall be available to any regular employee in the event of
death of a member of the employee' s immediate family. This leave is available within
fourteen days ( 14) of the death for the purpose of observing a period of mourning, unless
extended by the City Manager upon written request and justification relating to time
required to accommodate family travel or other relevant considerations. All time off for
a death in the immediate family in excess of four days shall be charged to sick leave.
Documentation shall accompany the time sheet for the pay period in which pay for
bereavement leave is requested. Examples of documentation are: obituary, funeral
notice, funeral bulletin, copy of death certificate.
IV. DEFINITIONS :
■ Immediate family includes: spouse of the employee; children, parents, siblings,
grandparents, grandchildren of the employee and those of the employee's spouse.
V. PROCEDURE:
■ The employee shall notify his/her manager as soon as the need for bereavement leave
is known, using the Request for Absence form. The manager shall be informed of the
relationship between the employee and the deceased.
The leave may be split in the situation of a death and a delayed memorial service with
approval of the department director. However, use of bereavement leave shall not
exceed four days in any event.
Time sheets are to be completed appropriately and accompanied by documentation of
the death of the family member.
AO #226 'Bereavement"
Page 2
1� �1 ABSENCE REPORT
(Copy must be attached to time sheet)
Name Dept Division
From am Month/Day/Year
pm
To am Month/Day/Year
pm
No. of work days No. of hours
REASON FOR ABSENCE (Check one)
❑ Vacation ❑ Floating Holiday ❑ Jury Duty*
❑ Leave W/O Pay** ❑ Accident on Duty (Attach incident report) ❑ Military*
❑ Sick Leave** ❑ Accident off Duty ❑ Bereavement
❑ Illness/Self ❑ Comp Time ❑ Other
❑ Illness/Family
**If sick leave or LWOP greater than 3 days is requested see Department Secretary for original absence
request form
Respond To By Phone B Messen er Other Means Date Hour
HOW DO YOUR SYMPTOMS AFFECT YOUR ABILITY PERFORM YOUR JOB? (Attach additional sheet of necessary...)
Requested By: Date:
Approved : Date:
Division Manager
Approved : Date:
Department Head