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EMPLOYEE WORK PROFILE AND PERFORMANCE APPRAISAL REPORT State Form 52403 (R / 10-08) Name of Employee Employee ID Number/Last 4 Digits of SSN Agency/Division Business Unit Department of Child Services/Staff Development Class Title/Class Code Review Period From r TYPE OF EVALUATION to Six Month Working Test (Merit Agencies Only) Annual Successfully Completed.. Results: Meets Exceeds Does Not Meet NOTE: Failure to meet expectations for any goal or objective may result in employee being placed on a Work Improvement Plan or separation, and may result in employee receiving an Overall Performance Rating of “Does Not Meet Expectations” or “Needs Improvement.” OVERALL PERFORMANCE RATING Outstanding Consistently exceeds expectations on all evaluation factors Exceeds Expectations Overall high performance frequently exceeds expectations on many factors Meets Expectations Consistently meets the requirements of the job in all aspects Needs Improvement Sometimes acceptable, but not consistent needs improvement to meet expectations Does Not Meet Expectations Does not meet the minimum standards of performance Yes No Is a Work Improvement Plan (WIP) generated as a result of this appraisal If so, please attach the WIP and ensure that the WIP pertains to the specific competency(s) and/or expectation(s) for which a Does Not Meet rating was given..
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