In the space provided below, address specific performance or behavior problems, identify specific expectations for improvement, and establish a time frame for improvement, generally three months during a follow-up rating period. The follow-up rating will be due within 28 days of the established review period. The follow-up rating must address the employee’s performance or behavior in relation to expectations established for the follow-up rating period.
Evaluation Satisfactory (Applicable for Follow-up Only) Unsatisfactory (Initial or Follow-up Rating)
I certify that this rating report constitutes my evaluation of the performance by this employee for the period covered.
I certify that I have had an opportunity to review this evaluation and understand that I am to receive a copy of it. I understand that my signature does not necessarily mean that I agree with the evaluation.
I certify that I have reviewed this evaluation and concur with the rating given.
Appointing Authority’s Signature/Date
Receipt of an unsatisfactory rating may result in demotion or separation from state employment.
Interim Employee Rating Form (CS-375)
Instructions for Completion
The Interim Employee Rating form (CS-375) is used to document interim employee ratings and follow-up ratings after an interim rating is issued.
The interim rating is used to document an employee’s unsatisfactory performance or behavior during a review period.
The supervisor shall record the specific performance or behavior problems, identify specific expectations for improvement and establish a time frame for improvement, generally three months, during a follow-up rating period. The follow-up rating will be due within 28 days of the end of the established review period.
The supervisor and appointing authority shall sign and date the form before issuing the interim rating.
The supervisor shall review the rating with the employee and then obtain the employee’s signature in the appropriate space on the form. The employee’s signature does not necessarily mean that the employee agrees with the evaluation and rating assigned. The supervisor shall retain a copy of the form, give the employee a copy, and forward the original to the appointing authority.
At the end of the follow-up rating period, the supervisor shall evaluate the employee’s performance and assign a rating of either satisfactory or unsatisfactory. The employee’s achievement in relation to the performance or behavior problems should be considered in determining the employee’s overall rating. The supervisor’s comments should be noted on the form. The supervisor shall review the evaluation with the employee.
The employee shall sign and date the form to certify having reviewed the evaluation and rating. The employee’s signature does not necessarily mean that the employee agrees with the evaluation and rating category. The supervisor and appointing authority shall certify to the accuracy of the evaluation and rating. If an employee refuses to sign the form, the form will be processed as if the employee had signed.
An employee must be in satisfactory standing to receive a step increase or a position reclassification.
An appointing authority may demote or dismiss an employee based on an unsatisfactory rating. If such a rating is issued, but the employee is not demoted or dismissed, the appointing authority must establish a follow-up rating period. The follow-up rating will be due within 28 days of the end of the follow-up period.
If the follow-up rating is not issued within the 28 days at the end of the follow-up rating period, the employee has fourteen days to request a written rating. If the appointing authority fails to comply with the employee’s request within fourteen days of receipt of the request, the employee shall be returned to satisfactory standing, effective the end of the new rating period.