Notice of Occurrence form - Harassment and Violence in the Workplace

Instructions

Before filling out the form, please review the definition of Workplace Harassment and Violence:

The DAOD 5014-0 and policy manual define harassment and violence as:

“any action, conduct or comment, including of a sexual nature, that can reasonably be expected to cause offence, humiliation or other physical or psychological injury or illness to a DND employee or CAF member, including any prescribed action, conduct or comment.”- Record 696528.

This includes any behaviours based on the prohibited grounds of discrimination identified in the Canadian Human Rights Act, which include race, national or ethnic origin, colour, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, genetic characteristics, disability and conviction for an offence for which a pardon has been granted or in respect of which a record suspension has been ordered.

You can submit your Notice of Occurrence (NoO) either:

• to the Chain of Command (CoC)/manager verbally, or in writing by submitting the NoO form, If the CoC/manager is involved in the occurrence, the NoO must be provided to the Designated Recipient (DR).
• to the Designated Recipient verbally by calling 1-833-451-1604 for a secure voicemail box or in writing by submitting the NoO to the following email address: DesignatedRecipientHVP-DestinataireDesignedelaPHV@forces.gc.ca.

Note: The form must be downloaded and opened in Adobe Acrobat. If you are unable to complete the NoO form, you may submit an email instead, as long as it includes the following information:

• the name of the principal party and the responding party, if known;
• the date of the occurrence; and
• a detailed description of each occurrence.

Instructions for Chain of Command/manager

If the principal party or witness wants to make a verbal notification, please ask them to provide the information for each of the fields below. If they wish to remain anonymous, do not record their first and last name.

Before you fill out the form, please be sure to review the following with the principal party or the witness:

• If you need emergency assistance or feel unsafe
• Definition of Harassment and Violence,
• Protection of privacy and confidentiality

You will be required to track and send this NoO, stating the date you have received it, to the WHVP Center of Expertise (CoE): WHVPCoE-PHVCE@forces.gc.ca, in accordance with DAOD 5014-0 and the WHVP policy manual.

Protection of privacy and confidentiality

Personal information provided in the NoO form is collected by the Department of National Defence (DND) and Canadian Armed Forces (CAF) in accordance with the National Defence Act, the Public Service Staff Relations Act, Canada Labour Code, the Work Place Harassment and Violence Prevention Regulations and DAOD 5014-0. The information is collected for the purposes of documenting and investigating workplace harassment and violence occurrences.

The information provided in a NoO by members of the Workplace Harassment and Violence Prevention (WHVP) team, including the Designated Recipient, Intake Officer, Senior Manager, and Team Lead and the Chain of Command/manager. If the resolution process proceeds to conciliation/Alternative Dispute Resolution (ADR) or WHVP investigation, a summary of the NoO will be shared with the conciliator/ADR practitioner or a WHVP investigator. If the resolution process proceeds to a WHVP investigation, the NoO will also be shared with the responding party and may be shared with witnesses. Personal information may also be disclosed for labour relations, security, legal claims, or for health and safety purposes, in accordance with subsection 8(2) of the Privacy Act.

Completion of the NoO is voluntary and any personal information provided will be used and protected in accordance with the Privacy Act, and as described in the Standard Personal Information Bank Harassment - PSE 919. Filing a report anonymously may limit DND/CAF's ability to fully investigate or resolve the occurrence. Occurrences filed anonymously will be used primarily to track and review workplace risks and to inform policies and preventive measures. The Privacy Act provides you the right to request access to and correction of your personal information. For more information about these rights - or about our privacy practices - please contact the DND/CAF Access to Information and Privacy Coordinator. You also have the right to file a complaint with the Privacy Commissioner of Canada regarding our handling of your personal information.

Definitions

Occurrence

An occurrence refers to an alleged incident of harassment and violence in the workplace.

Principal party (PP)

A DND employee(s) or CAF member(s) who is the object of an occurrence.

Responding party (RP)

A person(s) who is alleged to have been responsible for the occurrence and is identified in the NoO.

Witness

A person who witnessed an occurrence or is informed of an occurrence by the PP or RP. A witness cannot be a support person to either party.

Designated recipient

A person designated to receive and respond to notices of occurrences and facilitate the WHVP process as per the regulations and DND/CAF policy.
Note: For DND/CAF, the only designated recipients are the centralized team of Designated Recipients established within this policy’s functional authority.

Level One (L1) organization

A senior official, either civilian or military, who has direct accountability to the Deputy Minister or the Chief of the Defence Staff (i.e. Royal Canadian Navy, Royal Canadian Air Force, Assistant Deputy Minister (Human Resources – Civilian), Vice Chief of Defence Staff.

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Principal Party or witness information

Note: You can submit a NoO anonymously. For verbal NoOs, inform the CoC/manager or DR of your wish to remain anonymous. For written NoOs, check the anonymity box.

If a NoO is submitted by a witness or anonymously, and a PP is named, the CoC/manager or the DR will contact the PP to ask if they wish to begin the resolution process. If the PP refuses to participate in the resolution process, the resolution process is considered closed, and a version of the NoO (with all identifying information removed) will be shared with the applicable Workplace Health and Safety Committees (WHSC)/ Health and Safety Representatives (HSR)/ Canadian Armed Forces Safety Committees (CAFSC),who will review and, if necessary, update the WHVP assessment to determine if any additional preventive measures are required.

Note: All information regarding the identity of parties must not be provided to the applicable safety committee or representative to maintain privacy and confidentiality of the person(s) involved. This includes any reference to work locations, dates, division/group names or additional information that would directly or indirectly reveal the identity of a person involved.

Description of the Occurrence

Please provide the date on which you experienced or witnessed the occurrence, a detailed description of the occurrence (specify the action, conduct or comment that meets the definition of harassment and violence stated above), the name(s) or a detailed description of the parties involved, as well as their positions in relation to each other if known (i.e. employee/employee, employee/member, employee/CoC or manager, member/member). You may consult the Negative Behaviour Matrix to help identify and describe the nature of the occurrence. Supporting documents can also be included if relevant.

(ex: At our last staff meeting, on XX-XX-XXXX, I was publicly shamed and called out in front of my peers. The responding party, XX, who is my supervisor laughed while saying this comment to me: "...That is a pretty bad powerpoint, even my kid could do a better job".)

Resolution Process and Desired Outcome

As outlined in para. 44 of the WHVP policy manual all parties are encouraged to make reasonable efforts to address occurrences through negotiated resolution or conciliation/Alternative Dispute Resolution (ADR). This process is preventive in nature and aims to foster a respectful and healthy workplace environment by resolving issues early and constructively. With that in mind, what is your desired outcome?

Note: I understand that by submitting this NoO that this process will not bring about administrative or disciplinary results. If the CoC/manager becomes aware of misconduct or conduct deficiencies, they must initiate a parallel process by consulting the appropriate legal or labour relations advisor to explore disciplinary or administrative recourse mechanisms.

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