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OFM 12-073 (9/16/19) Performance & Development Plan Evaluation - Alternate Version Page 1

Performance and Development Plan (PDP) Evaluation Alternate Version

Type of Evaluation Interim Review Final Evaluation

Performance Period From To

Purpose of Plan and Review Annual Trial Service Probationary Transitional Other (specify)

Employee Last Name Employee First Name Employee Middle Initial

Personnel Number Class Title Working Title

Position Number Agency/Division/Unit Evaluator’s Name

Part 1: Results & Competencies Key Results Assignment Title & Status: Complete Ongoing

In Progress Deleted Not Started Modified

Success Measure(s):

Assessment of Performance:

Assignment Title & Status: Complete Ongoing In Progress Deleted Not Started Modified

Success Measure(s):

Assessment of Performance:

Assignment Title & Status: Complete Ongoing In Progress Deleted Not Started Modified

Success Measure(s):

Assessment of Performance:

OFM 12-073 (9/16/19) Performance & Development Plan Evaluation - Alternate Version Page 2

Assignment Title & Status: Complete Ongoing In Progress Deleted Not Started Modified

Success Measure(s):

Assessment of Performance:

Assignment Title & Status: Complete Ongoing In Progress Deleted Not Started Modified

Success Measure(s):

Assessment of Performance:

Key Competencies Short Title Description of Progress

Other Relevant Information (optional)

OFM 12-073 (9/16/19) Performance & Development Plan Evaluation - Alternate Version Page 3

Part 2: Training & Development Title Status

Complete Ongoing In Progress Deleted Not Started Modified

Description of Key Learning Observed

Complete Ongoing In Progress Deleted Not Started Modified Complete Ongoing In Progress Deleted Not Started Modified

Part 3: Employee Comments (Optional) The employee may use this section to comment on the evaluation, share observations, and/or evaluate how well the organization has met the expectations stated in Part 3 (Organizational Support) of the PDP Expectations form.

Part 4: (Interim Use Only) New Expectations for the Remainder of the Performance Period Assignment Title:

Assignment Description:

Assessment by: • Supervisor Observation:

Describe the assessment method(s) that apply:

• Feedback:

• Other:

Success is (measure):

OFM 12-073 (9/16/19) Performance & Development Plan Evaluation - Alternate Version Page 4

Competency Short Title Description of Knowledge, Skill, or Behavior

Training/Development Title Key Learning Expected

Acknowledgement Of Performance Evaluation The signatures below indicate that the supervisor and employee have discussed the contents of this evaluation. This report is based on my best judgment. Date Evaluator’s Signature

This report has been discussed with me. Date Employee’s Signature

I have reviewed this report and in my judgment, the process has been properly followed. In addition, the following comments are offered concerning the employee’s performance. Comments: Date Reviewer’s Signature

NOTE: Typically, once the performance evaluation is completed and signed by all parties, the supervisor provides the employee a copy and the original is forwarded to Human Resources to be placed in the employee’s personnel file. Supervisors should check with their Human Resources office for organization specific instructions.

OFM 12-012 (9/16/2019) Performance & Development Plan Evaluation Page 1

Performance and Development Plan (PDP) Evaluation

Type of Evaluation Interim Review Final Evaluation

Performance Period From To

Purpose of Plan and Review Annual Trial Service Probationary Transitional Other (specify)

Employee Last Name Employee First Name Employee Middle Initial

Personnel Number Class Title Working Title

Position Number Agency/Division/Unit Evaluator’s Name

Part 4: Interim Reviews (Optional) Part 4 is an optional section that may be used during the course of the performance period to adjust performance expectations if circumstances change, and/or to document interim feedback sessions.

Part 5: Performance Assessment Provide a narrative assessment of the employee’s performance in relation to the Key Results and Competencies Expected that were outlined in Part 1. The assessment must be based on performance observed or verified. Key Results To what degree did the employee accomplish the expected results and how well were they done?

OFM 12-012 (9/16/2019) Performance & Development Plan Evaluation Page 2

Key Competencies How well (or how frequently) did the employee demonstrate the knowledge, skills, abilities, and behaviors expected?

Other Relevant Information (Optional)

Acknowledgement Of Performance Evaluation The signatures below indicate that the supervisor and employee have discussed the contents of this evaluation.

This report is based on my best judgment. Date Evaluator’s Signature

This report has been discussed with me. Date Employee’s Signature

I have reviewed this report and in my judgment, the process has been properly followed. In addition, the following comments are offered concerning the employee’s performance. Comments Date Reviewer’s Signature

NOTE: Typically, once the performance evaluation is completed and signed by all parties, the supervisor provides the employee a copy and the original is forwarded to Human Resources to be placed in the employee’s personnel file. Supervisors should check with their Human Resources office for organization specific instructions.

  • Performance and Development Plan (PDP)
  • Evaluation
  • Part 4: Interim Reviews (Optional)
  • Part 5: Performance Assessment
  • Acknowledgement Of Performance Evaluation
  1. Annual: Off
  2. Trial Service: Off
  3. Probationary: Off
  4. Transitional: Off
  5. Other specify: Off
  6. Employee Last Name:
  7. Employee First Name:
  8. Employee Middle Initial:
  9. Personnel Number:
  10. Class Title:
  11. Working Title:
  12. Position Number:
  13. AgencyDivisionUnit:
  14. Evaluators Name:
  15. In Progress_2: Off
  16. Not Started_2: Off
  17. Ongoing_2: Off
  18. Deleted_2: Off
  19. Modified_2: Off
  20. In Progress_3: Off
  21. Not Started_3: Off
  22. Ongoing_3: Off
  23. Deleted_3: Off
  24. Modified_3: Off
  25. Complete_4: Off
  26. In Progress_4: Off
  27. Not Started_4: Off
  28. Ongoing_4: Off
  29. Deleted_4: Off
  30. Modified_4: Off
  31. In Progress_5: Off
  32. Not Started_5: Off
  33. Ongoing_5: Off
  34. Deleted_5: Off
  35. Modified_5: Off
  36. Other Relevant Information optional:
  37. Complete_6: Off
  38. In Progress_6: Off
  39. Not Started_6: Off
  40. Ongoing_6: Off
  41. Deleted_6: Off
  42. Modified_6: Off
  43. TitleRow1:
  44. Complete_7: Off
  45. In Progress_7: Off
  46. Not Started_7: Off
  47. Ongoing_7: Off
  48. Deleted_7: Off
  49. Modified_7: Off
  50. Complete_8: Off
  51. In Progress_8: Off
  52. Not Started_8: Off
  53. Ongoing_8: Off
  54. Deleted_8: Off
  55. Modified_8: Off
  56. Evaluators Signature:
  57. Employees Signature:
  58. Comments:
  59. Date_3:
  60. Reviewers Signature:
  61. TitleRow2:
  62. TitleRow3:
  63. Description of Key Learning Row 1:
  64. Description of Key Learning Row 2:
  65. Description of Key Learning Row 3:
  66. Employee Comments Text Box:
  67. Evaluators Date:
  68. Employees Date:
  69. Performance Period From:
  70. Performance Period To:
  71. Complete: Off
  72. In Progress: Off
  73. Not Started: Off
  74. Ongoing: Off
  75. Deleted: Off
  76. Modified: Off
  77. Success Measure 1:
  78. Assessment of Performance 1:
  79. Assignment Title and Status 1:
  80. Assessment of Performance 2:
  81. Success Measure 2:
  82. Assignment Title and Status 2:
  83. Success Measure 3:
  84. Assessment of Performance 3:
  85. Assignment Title and Status 3:
  86. Assignment Title and Status 4:
  87. Assignment Title and Status 5:
  88. Success Measure 4:
  89. Assessment of Performance 4:
  90. Success Measure 5:
  91. Assessment of Performance 5:
  92. Key Competencies Short Title 2:
  93. Key Competencies Short Title 3:
  94. Key Competencies Short Title 4:
  95. Key Competencies Short Title 5:
  96. Key Competencies Short Title 1:
  97. Key Competencies Description of Progress 1:
  98. Key Competencies Description of Progress 2:
  99. Key Competencies Description of Progress 3:
  100. Key Competencies Description of Progress 4:
  101. Key Competencies Description of Progress 5:
  102. New Expectations Assignment Title:
  103. New Expectations Assignment Description:
  104. New Expectations Supervisor Obervation:
  105. New Expectations Feedback:
  106. New Expectations Other:
  107. New Expectations Success Measure:
  108. Competency Short Title 2:
  109. Description of Knowledge, Skill or Behavior 2:
  110. Description of Knowledge, Skill or Behavior 3:
  111. Competency Short Title 3:
  112. Competency Short Title 1:
  113. Description of Knowledge, Skill or Behavior 1:
  114. Training Development Title 1:
  115. Key Learning Expected 1:
  116. Training Development Title 2:
  117. Key Learning Expected 2:
  118. Training Development Title 3:
  119. Key Learning Expected 3:
  120. Interim Review: Off
  121. Final Evaluation: Off
  122. Complete_2: Off
  123. Complete_3: Off
  124. Complete_5: Off
  125. AgencyDivision/Unit:
  126. Part 4 Interim Reviews Text Box:
  127. Key Results Text Box:
  128. Key Competencies Text Box:
  129. Other Relevant Information Text Box:
  130. Evaluator's Date:
  131. Employee's Date:
  132. Reviewer's Date: