Senior Level Executive Performance Plan and Appraisal

Employee / [Click here to enter employee name.] / Appraisal Period / [mm/dd/yyyy-mm/dd/yyyy] /
Employee Title / Click here to enter employee title. /
Service Unit / Click here to enter service unit. /
Supervisor/Title / Click here to enter supervisor name and title. /

Performance Plan Signatures

Performance requirements for the above period have been established in consultation with the employee, who has received a copy.
Employee Signature ______Date______
Supervisor Signature ______Date______

Progress Review Signatures

At a minimum, one progress review must be conducted annually, generally mid-way during the appraisal period.
A progress review was conducted and included a discussion of:
  • the progress being made toward meeting the performance requirements and objectives of the critical elements included in the performance plan;
  • the need for changes in the plan based on changes in performance requirements, objectives, or responsibilities; and
  • the identification of any performance deficiencies and recommendations on how to improve them by the supervisor.
Employee Signature ______Date______
Supervisor Signature ______Date______

Performance Appraisal Signatures – Proposed Summary Rating is not final until reviewed by the Performance Review Board and approved by the Librarian.

The employee and supervisor should sign the appraisal before it is sent to the Performance Review Board and Librarian for consideration.
Employee Signature ______Date______
Supervisor Signature ______Date______

Instructions: Use the following table to calculate the overall summary rating. First, choose the critical element rating and enter the corresponding points. Then, multiply points by the designated critical element weight to get the weighted rating. Finally, add the weighted ratings to get the overall summary rating.

Critical Element Rating Symbol/Points: (Use assigned whole numbers only)Outstanding (O) = 5 pts.;
Commendable (C) = 4 pts.; Successful (S) = 3 pts.; Minimally Successful (MS) = 2 pts.; Unsatisfactory (U) = 0 pts.

Critical Element / Rating Symbol / Points / Weight / Weighted Rating / Overall Summary Rating
☐Outstanding (4.70-5.00) ☐Commendable (3.70-4.69) ☐Successful (2.70-3.69)
☐Minimally Successful (2.00-2.69)
☐Unsatisfactory (less than 2.00)
  1. Results Driven
/ Symbol / Points / Weight / Weighted Rating /
  1. Leading Change
/ Symbol / Points / Weight / Weighted Rating /
  1. Leading People
/ Symbol / Points / Weight / Weighted Rating /
  1. Business Acumen
/ Symbol / Points / Weight / Weighted Rating /
  1. Building Coalitions
/ Symbol / Points / Weight / Weighted Rating /
Total / 100% / Weighted Rating /
Employee / [Click here to enter employee name.] / Appraisal Period / [mm/dd/yyyy-mm/dd/yyyy] /

Performance Plan Goal Alignment

Instructions: Identify at least one strategy, Annual Performance Goal(APG) or unit priority to which the performance requirements arealigned and for which the employee is responsible and/or to which he or she will contribute.

Goal # / Goal Alignment
1. / LC Strategic Plan Strategy:Click to choose an LC Strategic Plan Strategy.
APG or Unit Priority:Click here to enter APG or Unit Priority.
2. / LC Strategic Plan Strategy:Click to choose an LC Strategic Plan Strategy.
APG or Unit Priority:Click here to enter APG or Unit Priority.
3. / LC Strategic Plan Strategy: Click to choose an LC Strategic Plan Strategy.
APG or Unit Priority:Click here to enter APG or Unit Priority.
4. / LC Strategic Plan Strategy:Click to choose an LC Strategic Plan Strategy.
APG or Unit Priority:Click here to enter APG or Unit Priority.
5. / LC Strategic Plan Strategy:Click to choose an LC Strategic Plan Strategy.
APG or Unit Priority:Click here to enter APG or Unit Priority.
Employee / [Click here to enter employee name.] / Appraisal Period / [mm/dd/yyyy-mm/dd/yyyy] /
Performance Plan and Appraisal
Critical Element 1. Results Driven (Must be weighted higher than any other critical element) / Weight: ## %
Minimum Weight=10%
Definition: This critical element involves the ability to meet organizational goals and customer expectations. Inherent to this element is the ability to make decisions that produce high-quality results by applying technical knowledge, analyzing problems and calculating risks.
Performance Requirements for Successful Level of Performance
Instructions: Include 3-5 specific performance requirements expected of the executive during the appraisal period, focusing on measurable outcomes from the strategic plan or other measurable outputs and outcomes clearly aligned to organizational goals. / Goal Alignment
Instructions: Include the goal # from the previous page to which the performance requirement aligns.
1. / Click here to enter performance requirement. / #
2. / Click here to enter performance requirement. / #
3. / Click here to enter performance requirement. / #
4. / Click here to enter performance requirement. / #
5. / Click here to enter performance requirement. / #
Employee / [Click here to enter employee name.] / Appraisal Period / [mm/dd/yyyy-mm/dd/yyyy] /
Performance Appraisal Narrative
Instructions: In the space provided, describe specific achievements, results, and behaviors justifying the employee’s performance rating based on the performance plan and check the rating for this critical element at the end of the appraisal period. Refer to attached accomplishments if provided by the employee.
Click here to enter text. /
Results Driven Rating
☐Outstanding ☐Commendable ☐Successful ☐Minimally Successful ☐Unsatisfactory
Employee / [Click here to enter employee name.] / Appraisal Period / [mm/dd/yyyy-mm/dd/yyyy] /
Critical Element 2.Leading Change / Weight: ##%
Minimum Weight=10%
Definition: This critical element involves the ability to bring about strategic change, both within and outside the organization, to meet organizational goals. Inherent to this element is the ability to establish an organizational vision and to implement it in a continuously changing environment.
Performance Requirements for Successful Level of Performance
  • Develops and implements an organizational vision that integrates key organizational and program goals, priorities, values and other factors
  • Assesses and adjusts to changing situations, implementing innovative solutions to make organizational improvements, ranging from incremental improvements to major shifts in direction or approach, as appropriate
  • Balances change and continuity
  • Continually strives to improve service and program performance
  • Creates a work environment that encourages creative thinking, collaboration and transparency
  • Maintains program focus, even under adversity

Performance Appraisal Narrative
Instructions: In the space provided, describe specific achievements, results, and behaviors justifying the employee’s performance rating based on the performance plan and check the rating for this critical element at the end of the appraisal period. Refer to attached accomplishments if provided by the employee.
Click here to enter text. /
Leading Change Rating
☐Outstanding ☐Commendable ☐Successful ☐Minimally Successful ☐Unsatisfactory
Employee / Appraisal Period
Critical Element 3.Leading People / Weight: ##%
Minimum Weight=10%
Definition: This critical element involves the ability to lead people toward meeting the organization's vision, mission, and goals. Inherent to this element is the ability to provide an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts.
Performance Requirements for Successful Level of Performance
  • Designs and implements strategies that maximize employee potential and fosters high ethical standards in meeting the organization’s vision, mission and goals
  • Ensures employee performance plans are aligned with the organization’s mission and goals, that employees receive constructive feedback and that employees are realistically appraised against clearly defined and communicated performance standards, if applicable
  • Completes workforce performance management documents for subordinates by established due dates, according to LC regulations, policies, and directives, if applicable
  • Holds employees accountable for appropriate levels of performance and conduct, if applicable
  • Seeks and considers employee input
  • Provides an inclusive workplace that fosters the development of others to their full potential, allows for full participation by all employees, facilitates collaboration, cooperation and teamwork and supports constructive resolution of conflicts
  • Recruits, retains and develops the talent needed to achieve a high quality, diverse workforce that reflects the nation, with skills needed to accomplish organizational performance objectives while supporting workforce diversity, workplace inclusion and equal employment policies and programs

Performance Appraisal Narrative
Instructions: In the space provided, describe specific achievements, results, and behaviors justifying the employee’s performance rating based on the performance plan and check the rating for this critical element at the end of the appraisal period. Refer to attached accomplishments if provided by the employee.
Leading People Rating
☐Outstanding ☐Commendable ☐Successful ☐Minimally Successful ☐Unsatisfactory
Employee / Appraisal Period
Critical Element 4.Business Acumen / Weight: ##%
Minimum Weight=10%
Definition: This critical element involves the ability to manage human, financial, and information resources strategically.
Performance Requirements for Successful Level of Performance
  • Assesses, analyzes, acquires and administers human, financial, material and information resources in a manner that instills public trust and accomplishes the organization’s mission
  • Uses technology to enhance processes and decision making
  • Executes the operating budget, prepares budget requests with justifications and manages resources

Performance Appraisal Narrative
Instructions: In the space provided, describe specific achievements, results, and behaviors justifying the employee’s performance rating based on the performance plan and check the rating for this critical element at the end of the appraisal period. Refer to attached accomplishments if provided by the employee.
Business Acumen Rating
☐Outstanding ☐Commendable ☐Successful ☐Minimally Successful ☐Unsatisfactory
Employee / Appraisal Period
Critical Element 5.Building Coalitions / Weight: ##%
Minimum Weight=10%
Definition: This critical element involves the ability to build coalitions internally and with other Federal agencies, State and local governments, nonprofit and private sector organizations, foreign governments, or international organizations to achieve common goals.
Performance Requirements for Successful Level of Performance
  • Solicits and considers feedback from internal and external stakeholders or customers
  • Coordinates with appropriate parties to maximize input from the widest range of appropriate stakeholders to facilitate an open exchange of opinion from diverse groups and strengthen internal and external support
  • Explains, advocates and expresses facts and ideas in a convincing manner and negotiate with individuals and groups internally and externally, as appropriate
  • Develops a professional network with other organizations and identifies the internal and external politics that affect the work of the organization

Performance Appraisal Narrative
Instructions: In the space provided, describe specific achievements, results, and behaviors justifying the employee’s performance rating based on the performance plan and check the rating for this critical element at the end of the appraisal period. Refer to attached accomplishments if provided by the employee.
Building Coalitions Rating
☐Outstanding ☐Commendable ☐Successful ☐Minimally Successful ☐Unsatisfactory
Employee / Appraisal Period
Summary Level Rating Definitions
Outstanding: A level of exceptional, high-quality performance. The individual has performed so well that Library goals have been achieved that would not have otherwise been accomplished. The individual's mastery of technical skills and thorough understanding of the Library’s and service unit’s mission and values have been fundamental to the completion of program objectives. The individual has exerted a major positive influence on management practices, operating procedures, and program implementation, which has contributed substantially to the Library's growth and recognition. Preparing for the unexpected, the individual has planned and used alternate ways of reaching goals. Difficult assignments have been handled intelligently and effectively. In writing and speaking, the individual presents complex ideas clearly on a wide range of difficult issues. The individual is a strong leader who works well with others and handles difficult situations effectively. The individual encourages independence and risk-taking among subordinates and/or colleagues, yet takes responsibility for his or her actions. The individual serves as a major positive influence in fulfilling the Library's commitment to inclusiveness, fairness, and diversity. The individual makes unique and noteworthy contributions to facilitate a professional and ethical environment and the development of his or her and/or colleagues.
Commendable: A level of high-quality performance. The individual has exceeded expectations in critical areas and shows sustained support of Library goals. The individual's performance and initiative are worthy of special notice. Many job aspects are performed in an outstanding manner. The effective planning of the individual has improved the quality of management practices, operating procedures, or program activities. The individual has developed or implemented workable and cost-effective approaches to meeting Library goals. The individual has demonstrated an ability to get the job done well in more than one way, while handling difficult and unpredicted problems. The individual writes and speaks clearly on difficult subjects to a wide range of audiences. The individual is an effective leader, establishes sound working relationships, and shows good judgment when dealing with peers and subordinates. He or she provides opportunities for staff to have a meaningful role in accomplishing organizational objectives and makes special efforts to improve the performance of peers and subordinates. The individual serves as a major positive influence in fulfilling the Library's commitment to inclusiveness, fairness and diversity. The individual makes significant contributions to the Library’s diversity goals.
Successful: A level of sound performance. The individual has contributed positively to Library and service unit goals. All critical element activities that could be completed are. The individual effectively applies technical skills and organization knowledge to get the job done. The individual is a capable leader who works successfully with others. If a supervisor, the individual rewards good performance and corrects poor performance through sound use of the Library’s performance management system. Subordinates are selected and assigned in ways which use their skills effectively. The individual shows a strong commitment to fair treatment, diversity, and inclusiveness goals of the Library. The individual makes contributions to the Library’s diversity goals.
Minimally Successful: A level of performance that is minimally acceptable but shows significant deficiencies that require correction. The individual's work is marginal in one or more major activities of the critical element, jeopardizing attainment of the element and the Library's mission and goals. Most of the following deficiencies are typically, but not always, characteristic of the individual's work: lack of awareness of Library-wide policy implications of assignments; reluctance to accept responsibility; incomplete performance of one or more important areas of the field of work; and lack of clarity in writing and speaking. With respect to leadership skills, most of the following deficiencies are typically, but not always, characteristic of the individual's work: failure to motivate subordinates and/or colleagues; and failure to provide sufficient motivation to realize the Library's needs and his or her subordinates' and/or colleagues’ roles in meeting those needs. The individual is committed to diversity and inclusiveness only to the minimum extent required, as is evidenced through inadequate coordination and monitoring of programs and inadequate or inappropriate use of human and other resources.
Unsatisfactory: A level of unacceptable performance. Work products do not meet the minimum requirements of the critical element. Most of the following deficiencies are typically, but not always, characteristic of the individual's work: little or no contribution to Library mission or goals; failure to meet work objectives; failure to work well with peers or subordinates; failure to respond to client needs; and inattention to organizational priorities and administrative requirements. With respect to leadership skills, most of the following deficiencies are typically, but not always, characteristic of the individual's work: if a supervisor, inadequate guidance to subordinates; inattention to work progress; and failure to motivate subordinates to meet goals. The individual does not exhibit a commitment to diversity and inclusiveness and makes little or no contribution to improving the employment profile of minorities, women, and persons with disabilities at the Library.

SL Form 1793 (2017/6) 1