Domestic Violence Leave (PER-18, Rev.1) CITY OF DELRAY BEACH
= ADMINISTRATIVE POLICIES AND PROCEDURES
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DEPARTMENT: Human Resources POLICY NUMBER: PER-18
SUBJECT: Domestic Violence Leave SUPERSEDES: N/A
REVISION: 1 EFFECTIVE DATE:
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APPROVED BY: Terrence R. Moore, ICMA-CM, Ci y Manager
PURPOSE
The purpose of this directive is toprovide administrative procedures for Domestic Violence Leave for all
City employees. The City of Delray Beach has established the Domestic Violence Leave Policy in
accordance with Florida Statutes 741.313, (2007) requiring that certain employers permit an employee to
take leave from work to undertake activities resulting from an act of domestic violence.
DEFINITIONS
Words used in this policy shall have the meanings attributed to them in the law. In addition, the following
definitions apply:
1. Eligible employee means an employee who has worked for the employer for at least three (3)
calendar months before the date of the requested leave and who can establish the need for leave
as outlined under the law.
2. Family or household member shall be defined as spouse,former spouse, domestic partner, persons
related by blood or marriage, persons who are presently residing together as if a family) or who
have resided together in the past as if a family, and persons who are parents of a child in common
regardless of whether they have been married. With the exception of persons who have a child in
common, the family or household member must be currently residing or have in the past resided
together in the same single dwelling unit.
3. Domestic Violence Leave means up to three (3) working days of leave available for an eligible
employee's use for the purposes outlined in Florida Statues 741.313 in any one 12-month period.
Unless employee has paid leave available, Domestic Leave shall be unpaid. An employee who has
any type of paid leave available to him or her shall substitute all of the paid leave before unpaid
leave is granted under this policy.
4. 12-month period shall mean a time period of twelve calendar months beginning the date of the first
period of domestic violence leave and continuing for 12 calendar months from that date.
5. Perpetrator means a person who perpetrates, or commits, an illegal, criminal, or evil act; the person
documented to have committed an act of domestic violence.
Domestic Violence Leave
PER-18 Rev. 1
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POLICY
Employee must complete a minimum of three (3) months of employment before being eligible to take up
to three (3) days of leave in any 12-month period if the employee or a family or household member of an
employee is the victim of domestic violence. Employee must exhaust all vacation leave, personal leave,
FLSA and sick leave, if applicable, that is available before Domestic Violence Leave is granted as unpaid
leave.
Domestic Violence Leave may be used for an employee to:
1. Seek an injunction for protection against domestic violence or an injunction for protection in cases
of repeat violence, dating violence, or sexual violence.
2. Obtain medical care or mental health counseling, or both,for the employee or a family or household
member to address physical or psychological injuries resulting from the act of domestic violence;
3. Obtain services from a victim-services organization, including, but not limited to, a domestic
violence shelter or program or a rape crisis center as a result of the act of domestic violence.
4. Make the home secure from the perpetrator of the domestic violence or to seek new housing to
escape the perpetrator;
5. Seek legal assistance in addressing issues arising from the act of domestic violence or to attend
and prepare for court related proceedings arising from the act of domestic violence.
PROCEDURE
Except in cases of imminent danger to the health or safety of the employee or the employee's family or
household member, the employee must provide to Human Resources at least three (3) working days'
notice of the need for leave along with adequate documentation of the act of domestic violence. Adequate
documentation may include copies of restraining orders, police reports, order to appear in court, etc.
Adequate documentation establishing the reason for the leave under these provisions is required to be
submitted with the request for leave, using the form in Appendix 1. In cases of imminent danger to the
safety of the employee or the employee's family or household member, such documentation may be
submitted after the leave is taken, but shall be submitted within three(3)working days from the employee's
return to the workplace unless an extension is granted by Human Resources. Failure to submit requested
documentation will result in the denial of the leave and may result in discipline for unauthorized leave.
The City of Delray Beach will maintain confidentiality as required by Florida Statutes 741.313.
Domestic Violence Leave
PER-18 Rev. 1
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Appendix 1
CITY OF DELRAY BEACH
Domestic Violence Leave Request/Reporting Form
Florida Law requires the City of Delray Beach to allow employees to take three (3) working days of leave
within a 12 month period if the employee or a family or household member is the victim of domestic violence
and if the leave is sought for specific reasons related to the domestic violence. Please refer to the
Administrative Policies and Procedures Manual, PER-18, Rev. 0 for additional information. This completed
form must be submitted to Human Resources at least three days in advance except in cases of imminent
danger.
Employee Name Department
Date(s) of Leave:
I will return to work on:
Explanation of Leave Request:
Note: Adequate documentation must be provided to Human Resources, such as copies of restraining
orders, police reports, order to appear in court, etc.
The information provided on this form is confidential and will not be communicated to my department;
however, it is my responsibility to notify my supervisor of my absence. I may refer him/her to Human
Resources for any questions related to the Administrative Policies and Procedures, Per-18 Rev. 1, on
Domestic Violence Leave.
I affirm my intention to return to work as specified above and I understand that if I fail to comply with the
terms of this leave, I will be subject to disciplinary actions in accordance with PER-18, Rev. 1.
Employee Signature Date
This form will be retained separate from the employee's official personnel file and is exempt public records
disclosure requirements until one year after the leave is taken.
Human Resources Approval Date