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______________________________________________________________________________________________________________________
Employee Name: Site:
Position: Today’s Date:
Targeted Improvement Date:
Start Finish
Use this form to plan specific steps for an employee to take in order to improve his or her performance. This form should be used at any time an employee’s performance requires improvement. Completion of this form is required for any employee whose overall performance has been evaluated as “Needs Development” or “Unsatisfactory”. At the discretion of management, this form can also be utilized to address any ‘area’ of performance that is “Needs Development” or “Unsatisfactory”. Once the plan is established, the supervisor will provide on-going and constructive feedback regarding performance. Note : It is recommended that you limit performance improvement to 2-3 items.
Step 1 – Part A
Policy or Expectation Not Being Successfully Fulfilled
Step 1 – Part B
Performance Item(s) Describe the performance, skill or behavior that must be improved to meet established expectation (be specific and cite examples).
Step 2 – Part A
Action Plan – Provided by Supervisor Supervisor lists specific actions that the employee will need to take to correct performance as well as available resources and support the supervisor will provide. Step 2 – Part B
Action Plan – Provided by Employee Employee is to articulate an understanding in their own words of action they must take based upon the action plan provided by the supervisor. Step 3 – Check-ins/Follow-up Supervisor sets dates for follow-up and discussion. Employee agrees to specific dates for follow-up and discussion.
______________________________________________________________________________________________________________________
Step 1 – Part A
Policy or Expectation Not Being Successfully Fulfilled
Step 1 – Part B
Performance Item(s) Describe the performance, skill or behavior that must be improved to meet established expectation (be specific and cite examples).
Step 2 – Part A
Action Plan – Provided by Supervisor Supervisor lists specific actions that the employee will need to take to correct performance as well as available resources and support the supervisor will provide. Step 2 – Part B
Action Plan – Provided by Employee Employee is to articulate an understanding in their own words of action they must take based upon the action plan provided by the supervisor. Step 3 – Check-ins/Follow-up Supervisor sets dates for follow-up and discussion. Employee agrees to specific dates for follow-up and discussion.
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Please note: You are required to make immediate, significant and sustained improvement both during and after the period of PIP. As set forth in the Handbook, your employment is “At-Will,” which means that both you and the Employer have the right to terminate your employment at any time, with or without advance notice and with or without cause. This PIP should not be construed as creating a contract for any length of time or for the entire PIP period. Further, successful completion of the PIP does not guarantee your employment for any specified period of time thereafter. This PIP will remain active on file for a period of 12 months. Failure to provide a successful completion of the PIP will merit Formal Discipline up to and including termination.
Supervisor Signature: Date:
Employee Signature: Date:
Next Level Supervisor Signature: Date:
Support Previously Offered/Provided by Management Prior to PIP: Date
Provided
Progress/Comments
GO TO NEXT PAGE TO DOCUMENT THE DETAILED ACTION PLAN AND PROGRESS DURING CHECK-IN MEETINGS
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Detailed Action Plan with Documented Progress
Step 4
Create a Detailed Action Plan, Document Progress and Hold Check-in Meetings
1. Employee and supervisor to build out the action plan for each performance item with due dates and resources for each step in the plan
(what will be done with the help of what resources by when, utilize SMART model).
2. Employee to document progress and share examples of how performance is improved at each check-in.
3. Supervisor to provide performance feedback to employee at each check-in and add comments below using examples.
Supervisor comments should include any improvements or opportunities.
4. Supervisor and Employee initial the plan at each check-in discussion.
Date
Performance Item
Action Plan Step(s)
and Due Dates
Action Plan Step(s) Due Dates
Resources Provided
Future Check-in
Date(s)
Progress/Comments
Initials from
Supervisor and
Employee
______________________________________________________________________________________________________________________
Date
Performance Item
Action Plan Step(s)
and Due Dates
Action Plan Step(s) Due Dates
Resources Provided
Future Check-in
Date(s)
Progress/Comments
Initials from
Supervisor and
Employee
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Creating S.M.A.R.T. Goals
Specific
Measurable
Attainable
Realistic
Timely
Specific: A specific goal has a much greater chance of being accomplished than a general goal. To set a specific goal you must answer the six “W” questions:
Who: Who is involved?
What: What do I want to accomplish?
Where: Identify a location.
When: Establish a time frame.
Which: Identify requirements and constraints.
Why: Specific reasons, purpose or benefits of accomplishing the goal.
EXAMPLE: A general goal would be, “Get in shape.” But a specific goal would say, “Join a health club and workout 3 days a week.”
Measurable - Establish concrete criteria for measuring progress toward the attainment of each goal you set.
When you measure your progress, you stay on track, reach your target dates, and experience the exhilaration of achievement that spurs you on to continued effort required to
reach your goal.
To determine if your goal is measurable, ask questions such as……
How much? How many?
How will I know when it is accomplished?
Attainable – When you identify goals that are most important to you, you begin to figure out ways you can make them come true. You develop the attitudes, abilities, skills, and
financial capacity to reach them. You begin seeing previously overlooked opportunities to bring yourself closer to the achievement of your goals.
You can attain most any goal you set when you plan your steps wisely and establish a time frame that allows you to carry out those steps. Goals that may have seemed far away
and out of reach eventually move closer and become attainable, not because your goals shrink, but because you grow and expand to match them. When you list your goals you
build your self-image. You see yourself as worthy of these goals, and develop the traits and personality that allow you to possess them.
