F.

Performance Improvement Plan (PIP)

Name of Employee

Title
Review Period

From :

Employee No. & Range

Group & Location
Name of Supervisor

To :

The Performance Improvement Plan form MUST be completed when an employee receives a rating of Partially Performing on any Goal or Core Behavioural Competency during a MidYear Review or Final Appraisal. This form will be attached with the employees Performance Agreement at the end of the Performance Management Cycle.

Performance Improvement Areas

Action Plan and Timescales

(Be sure to indicate the Goals and/or Core Behavioural Competencies that
relate to the deficiency and whether they are currently meeting
expectations.

Identify specific corrective action to be implemented by the employee

and steps taken by the supervisor. Also, include consequences for
failure to meet specified actions.

Evaluation
Describe how performance
improvement will be measured.

Performance Improvement Plan (PIP)

Employee Signature:

Date:

Supervisor Signature:

Date:

Date(s) for a follow-up discussion:

2. If NO, what further actions will be/have been taken?

_____________________________
Employee Signature/Date

PIP Follow Up
1. Did the employee implement corrective action? ___Yes ___ No

______________________________
Supervisor Signature/Date

_______________________________
Next Level Supervisor Signature/Date