Performance Appraisal: Interim (30/60/90 Day) Evaluation

Employee name: _______________________          Position: ______________________

Supervisor name: ______________________          Department: ___________________

Review period: ________________________           Date: _________________________

To be completed by the employee's immediate supervisor. Copies will be provided to the employee being reviewed and the employee's supervisor. The original will be retained by the human resources department.

SECTION 1 - PERFORMANCE REVIEW

Employees are evaluated on each of the factors listed below. Please use space on the back for comments if the rating circled is D or U and specify which factor you are commenting on.

Outstanding—Results significantly surpass expectations. Superior contribution to the objectives of the employee's performance in assigned areas of responsibility.

Proficient—Results are very good. Significant contribution to objectives of the department and functional area.

Competent—Results are good. Performance is consistent with expectations. No important areas of failure or lack of accomplishment.

Developing—Results do not consistently meet expectations. May lack experience but has the capacity to improve the overall level of performance within a reasonable period of time.

Unacceptable—Performance does not meet expectations. Significant failure to meet job expectations. Performance improvement plan to be established.

SECTION 2 - OVERALL PERFORMANCE RATING

Varying degrees of importance should be placed on those factors measuring performance in a given job. The overall performance rating represents a composite of the reviewer's opinion, judgment and impressions of the employee's performance.

Circle One: O  P  C  D  U

SECTION 3 - KEY DEVELOPMENT AREAS

Identify two or three key developmental areas the employee should focus on over the next year. Develop a plan to provide formal or informal training in these areas.

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SECTION 4 – EMPLOYEE COMMENTS

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SECTION 5 - APPROVALS/CONCURRENCES

Employee signature: _______________________________________Date _______________

(This report has been discussed with me. I understand that my signature does not necessarily indicate agreement; I can make my disagreement, if any, known by a written communication to my immediate supervisor, with a copy to the Human Resource Department.)

Reviewer ______________________________________________  Date ______________

Department head _______________________________________   Date ______________

Human resources _______________________________________  Date ______________