Performance Improvement Plan Final Assessment Form

Using the JEM Performance Improvement Plan Final Assessment Form

Overview
The Performance Improvement Plan (PIP) Final Assessment Form is used to formally evaluate an employee’s progress at the conclusion of a PIP period. It documents whether the employee met the objectives outlined in the original plan and determines the appropriate next steps.

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When to Use This Form

This form should be completed at the end of a PIP review period (e.g., 30, 60, or 90 days) to:

• Summarize performance against established objectives
• Document the manager’s assessment
• Determine the final outcome (completion, extension, or termination)
• Record employee and manager acknowledgment

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Form Sections

1. Employee Information
   • Name, Job Title, Location/Brand, Manager/Supervisor
   • PIP Start and End Dates
2. Objectives Review
   • List of original performance objectives
   • Summary of progress and whether each objective was met
3. Manager Summary
   • Highlights of improvements
   • Any remaining gaps or challenges
4. Outcome and Decision
   • ☐ Successful Completion – All expectations met
   • ☐ Extension of PIP – Additional time needed
   • ☐ Termination of Employment – Insufficient improvement
5. Acknowledgment
   • Signatures from both employee and manager confirming review and understanding

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Submission & Documentation Process

1. Complete the Form
   • Fill out all required fields and review with the employee.
2. Submit via Zendesk
   • Upload the signed form to Zendesk for HR and Manager approval.
3. Meet with Employee
   • Discuss the outcome and next steps in a final review meeting.
4. Upload to Paychex
   • Upload the signed form to the employee’s profile in the Paychex Client Service Website under “Documents.”

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Important Notes

• This form is confidential and part of the employee’s permanent record.
• The outcome should be based on documented progress and objective evaluation.
• Ensure alignment with HR before finalizing decisions.