Management Evaluation Form

Name	Department

Position	Rating Period: From Click here to enter a date.

To Click here to enter a date.

ITEMIZED CHECKLIST

Unsatisfactory Performance	Needs Improvement	Meets/Exceeds Performance Standards
1. Provides Leadership
Comments:
2. Manages Area Responsibilities
Comments:
3. Supervises, Evaluates, and Promotes Professional Growth
Comments:
4. Develops a Positive and Effective Organizational Climate
Comments:

Recommendations/Goals:

OVERALL RATING

Employee’s immediate supervisor should check the degree that best describes the overall performance of the employee during this period. Step increases are subject to an overall rating of “Meets or Exceeds Standards.”

Evaluated By:	Date

Immediate Supervisor

Reviewed By:	Date

Evaluator’s Supervisor

Reviewed By:	Date

Chief Human Resources Officer

If an area is marked “Needs Improvement” or “Unsatisfactory”, an improvement plan is required.

Please consult with HR prior to giving the plan to the employee, and then attach it to this document with the required signatures.

I hereby certify that I have reviewed this report. I understand my signature does not necessarily mean I agree with all the items checked. I also understand that if I do not agree with this report, a response may be attached to this form and submitted within ten days after signature.

Employee’s Signature:	Date: