- - - - - - Notice- - - - - In accordance with State Personnel Board Rule NMAC 1.7.9.

8; performance and development appraisal of all employees must be documented on a “State Personnel Director Approved Form”. The EDA form that follows is the “Director Approved Form” and must not be altered other than to add space to accommodate more wording in job assignments or action plans.

SPB: 232

New Mexico State Personnel Board State Personnel Office
Employee Development and Appraisal
EDA
Supervisor and employee should become familiar with all parts of this Employee Development and Appraisal form prior to completion.

Part 1:

Identifying Information

Instructions: The Employee Development and Appraisal form is designed to assist in the collection and use of information for the development and appraisal of an employee. It also provides a process for initiation of constructive dialogue between supervisor and employee. Employee Name: SSN: Working Title: Perm Number: Supervisor Name: Agency Code: SPO Position Title: Date Supervisor Reviewed Position’s PAQ:

Job Performance Review or Appraisal and Date (Check √ appropriate action and date.)

□Initial
Date:

□1

Interim Review Date:

st

□2

nd

Interim Review

□3

rd

Interim Review

□Final
Date:

□Promotion
Date:

Date:

Date:

Part 2:

Job Assignments & Applicable Skills

Instructions: List a minimum of four job assignments along with applicable skills. Job assignment is to be attainable, measurable, and specific to the position. Applicable skills are expertise required to best accomplish job assignment. For promotions, each job assignment is to be supported by an action plan. All job assignments and revisions to job assignments are to be reviewed by and discussed with employee. The supervisor may weight job assignments, but weighting must be specified in job assignment block and discussed with employee. Documentation is to be retained by agency and a copy provided to the employee. To document employee and supervisor signatures, see Part 4: Signatures.

Job Assignment:
Applicable Skills:

Job Assignment: Applicable Skills:
Rating

Job Assignment: Applicable Skills:

Rating

Job Assignment:
Rating

Applicable Skills:

(Use additional sheets/space as necessary)

EDA (Employee Development and Appraisal) SPB-232

Employee Name:

SSN:

Part 3:

Employee Self Review Worksheet (Optional)

Instructions: As an employee, you may want to complete this worksheet to help you prepare for your performance discussion with your supervisor. Your completed worksheet should be given to your supervisor prior to the review or appraisal discussion. This worksheet can be used for all reviews and appraisals.

1.

List what you believe are the major elements of your job from the last review period.

2.

List special contributions you made to your unit, section, bureau, division or agency during the review period.

3.

List notable obstacles encountered when performing your job duties during the last review period.

4.

What job assignment-related goals do you want to achieve in the next year? What are your plans to achieve these goals?

5.

What can your supervisor do to better assist you in accomplishing your job duties?

6.

Add any other information you wish to have considered in your performance discussion.

Employee Signature: ___________________________________

Date: _________________

(Use additional sheets/space as necessary) EDA (Employee Development and Appraisal) SPB-232

Employee Name:

SSN:

Part 4:

Performance Discussion

Instructions: Discussion between supervisor and employee at interim reviews or final appraisal is to include all discussion topics listed below. Both employee and supervisor must initial after discussion of each topic has been completed. Discussion Topics Employee Supervisor Initial when discussion is complete Initial when discussion is complete 1st 2nd 3rd Final 1st 2nd 3rd Final Interim Interim Interim Interim Interim Interim Employee’s performance on job
assignments during past year, or since last appraisal. Employee’s strengths/growth areas regarding job assignment(s). Barriers to employee’s work performance and job satisfaction. Possible work performance improvements or enhancements. Resources needed by employee to achieve job assignments. Employee’s feedback and suggestions for supervision. Anything else the employee/ supervisor would like to address.

Appraisal System: Employee’s Performance at Interim Review and Final Appraisal
Instructions: At interim review or final appraisal, use this appraisal system to determine employee’s performance for each job assignment. Not Acceptable = [N]; Requires Attention = [R]; Successful = [S]; and Exceptional = [E]. Action plan is required when employee’s job assignment performance is determined to be Not Acceptable [N], Requires Attention [R], or when requested by employee. Placing a √ in the appropriate plan box to identify type of plan.

Job Assignment 1
Employee’s performance (Circle) 1st Interim N R S E 2nd Interim N R S E 3rd Interim N R S E
(Check √ Proper Plan) Supervisor Employee Required Requested Plan Plan

Job Assignment 2
Employee’s performance (Circle) 1st Interim N R S E 2nd Interim N R S E 3rd Interim N R S E
(Check √ Proper Plan) Supervisor Employee Required Requested Plan Plan

Job Assignment 3
Employee’s performance (Circle) 1st Interim N R S E 2nd Interim N R S E 3rd Interim N R S E
(Check √ Proper Plan) Supervisor Employee Required Requested Plan Plan

Job Assignment 4
Employee’s performance (Circle) 1st Interim N R S E 2nd Interim N R S E 3rd Interim N R S E
(Check √ Proper Plan) Supervisor Employee Required Requested Plan Plan

Job Assignment 5
Employee’s performance (Circle) 1st Interim N R S E 2nd Interim N R S E 3rd Interim N R S E
(Check √ Proper Plan) Supervisor Employee Required Requested Plan Plan

Final Appraisal of Employee’s Performance (Circle)
Not Acceptable [N] Requires Attention [R] Successful [S] Exceptional [E]

Signature and Initials
Instructions: Signature required during Initial Contact and Final Appraisal. Initials required during interim review. Signature at Initial Contact Initials at Interim Review Signature at Final Appraisal
1st 2nd 3rd

Reviewer: Supervisor: Employee:

_________________________ ________________________ ________________________

_____ _____ _____

_____ _____ _____

_____ _____ _____

__________________________ __________________________ __________________________

(Use additional sheets/space as necessary)

EDA (Employee Development and Appraisal) SPB-232

Employee Name:

SSN:

Part 5:

Performance Action Plan

Instructions: An action plan for a job assignment is required when supervisor determines employee’s performance is Not Acceptable or Requires Attention or when requested by employee. Action plans require the identification and use of specific, measurable and achievable tasks relevant to the job assignment and the performing of specific actions by employee and supervisor for accomplishing the job assignments. Anticipated completion dates are to be documented when action plan is initiated, and completion dates are to be documented when plan is completed. If needed, job assignments can be revised. Updated copy is to be provided to employee. Required or Requested Actions to be Performed by Anticipated Actual Action Plan Employee and Supervisor Completion Completion Job Assignment Date Date # of Job Assignment from Part 2 ___ Actions to be performed by employee.
List specific, measurable & achievable tasks.

_________

_________

Actions to be performed by supervisor.
Action Plan Date Initiated:_____________

_________

_________

# of Job Assignment from Part 2 ___
List specific, measurable & achievable tasks.

Actions to be performed by employee.

_________

_________

Actions to be performed by supervisor.

_________

_________

Action Plan Date Initiated: _____________

# of Job Assignment from Part 2 ___
List specific, measurable & achievable tasks.

Actions to be performed by employee.

_________

_________

Actions to be performed by supervisor.

_________

_________

Action Plan Date Initiated: _____________

# of Job Assignment from Part 2 ___
List specific, measurable & achievable tasks.

Actions to be performed by employee.

_________

_________

Actions to be performed by supervisor.

_________

_________

Action Plan Date Initiated: _____________

(Use additional sheets/space as necessary) EDA (Employee Development and Appraisal) SPB-232