Forms
Employee Information
Employee Name:
Email:
Phone:
Department/Unit: 47, Housing Department, South Wilmington Center for Men
Background Information and Instructions
Orlando J. McClain was terminated from employment with Wake County Government. The premise alleged is that he threatened to physically harm a guest of the center, and, Candice Brown had to intervene to prevent an assault by him against the guest.
Counter allegations by Mr. McClain include creating a hostile work environment and falsification of official government records.
You help in fact finding is being requested. To that end, please, truthfully complete this affidavit and return it as soon as possible. It is requested that this document be notarized, but, if you cannot get it notarized, then please have two witnesses confirm your signature, and those witnesses must be 18 years or older and legal citizens of the United Stated.
A copy of the dismissal document is being provided for your review. Application sections of the Wake Government Policy Manual are:
Unacceptable Person Conduct, 6203 and Section 3.15 Expectation of Staff, 6200 Unacceptable Personal Conduct, 6203 Negligence of Job Duties; 6203 Grossly Inefficient Job Performance and Posing a Danger to Others Including Employees and Guests; Section 6205 with regards to investigation and conferences.
Please answer freely and completely the following question regarding the alleged incident between Orlando and the Guest that occurred on (Please attach any supporting documentation)
1. Are you a current or former employee that works at the South Wilmington Center for Men?
__ Yes __ No
2. Were you at work on July 5th 2021 during the evening hours between 11:00 PM and 12:00 AM?
__ Yes __ No
3. If you were present, then, please describe what you saw happen during that time, with regards to the actions of Orlando McClain and the specific guest that is alleged to have not followed COVID protocol (what did you see and hear, also, if you were not present and reviewed some video and/or audio footage of the incident, then please describe what you saw).
4. Did Orlando verbally threaten to physically harm the guest?
__ Yes __ No
5. Did Orlando physically harm the guest?
__ Yes __ No
6. Was Orlando restrained to prevent physically harming the guest?
__ Yes __ No
7. Did Supervisor Candice Brown restrain Orlando?
__ Yes __ No
8. Did the guest verbally threaten Orlando?
__ Yes __ No
9. Did the guest physically assault Orlando?
__ Yes __ No
10. Did Orlando respond appropriately to the situation (using a professional standard in that situation)?
__ Yes __ No
11. Did the guest appropriately respond to Orlando?
__ Yes __ No
12. Did the guest comply with COVID protocol?
__ Yes __ No
13. Please feel free here to elaborate on your answers to questions 4 to 12:
With regards to the counter claim:
1. Do you feel and/or believe you are working in a hostile work environment?
__ Yes __ No
2. Do you feel and/or believe that Candice Brown is executing her duties faithfully as a supervisor for Wake County?
__ Yes __ No
3. Do you feel and/or believe that Frank Lawrence is executing his duties faithfully as a supervisor for Wake County?
__ Yes __ No
4. Do you feel and/or believe David Harris is executing his duties faithfully as a lead administration for the Housing Program?
__ Yes __ No
5. Do you feel and/or believe Lorena McDowell is executing her duties faithfully as housing director?
__ Yes __ No
6. Do you feel the work environment at South Wilmington Center for Men is a safe environment?
__ Yes __ No
7. Do you feel and/or believe the environment for guest is a safe environment at the South Wilmington Center for Men?
__ Yes __ No
8. Please elaborate on your answers to questions 1 through 7 in this section:
9. Please feel free to express your professional opinion about working at the South Wilmington Center for Men:
10. Have you been verbally threatened by guest(s) at the center? __ Yes __ No
11. Have you been physically assaulted by guest(s) at the center? __ Yes __ No
12. Did you report physical or verbal threats at the center by guest? __ Yes __ No
13. Did the administration respond properly to your reports? __ Yes __ No
General comments here:
Certification
I hereby certify that all information submitted on this form is true and complete to the best of my knowledge and belief.
Employee Signature: Date:
Witness signature 1:
Print Your name:______________________________
Signature: ___________________________________
Date: _______________________________________
Witness signature 2:
Print Your name:______________________________
Signature: ___________________________________
Date: _______________________________________