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AG 2009 04 20
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AG 2009 04 20
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Last modified
2/5/2010 12:34:24 PM
Creation date
11/27/2017 11:25:12 AM
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Template:
Meeting Minutes
Doc Type
Agenda
Meeting Minutes - Date
2/5/2010
Board
Board of Commissioners
Meeting Type
Regular
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<br /> <br /> <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />FORM D <br />CABARRUS COUNTY GOVERNMENT <br />OBSERVATION OF SUSPECT BEHAVIOR <br />Supervisor's Name: <br />Employee's Name: <br />Job Title: <br />Description of Work: Managerial Office/Clerical <br />Other: <br />How long has the employee worked for CABARRUS COUNTY GOVERNMENT: <br />How long have you supervised the employee? <br />Was the employee involved in an accident or near-accident? Yes No <br />If yes, Description: <br />Date and Time: <br />Extent of Injury to persons/Property: <br />Employee's Actions: <br />OBSERVATIONS: <br />Speech: -Mumbled _Slurred Confused Incoherent _Stuttering <br />Condition of Clothes: -Disorderly -Soiled Rumpled _ Orderly <br />Eyes: -Sleepy Blood Shot Glassy -Watery - Dilated Close -Alert <br />Attitude or Demeanor: -Talkative Hyperactive -Hostile Irritable -Nervous <br /> Depressed -Profane Drowsy -Pleasant Wide Mood Swings <br />Unusual Actions: Belching -Vomiting Fighting - Accident Prone <br />- Crying -Laughing Runny Nose None <br />Walking and Turning: Stumbling Swaying -Staggering -Arms Raised for Balance <br /> Falling -Reaching for Support -Feet Wide Apart <br /> Unable to Stand Normal <br />Awareness: - Sleepy or Stupor -Lack of Coordination -Confused Paranoid <br /> Normal <br />18 <br />F-11 <br />Driver <br />Page 199 of 320 <br />
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