Title Page

  • Department

  • Employee Name

  • Date and Time of Review

  • Manager / Supervisor

Details of Need

  • Current Performance: • What is currently happening with performance? What is the employee doing or not doing? [include specific behaviors, results, etc.])

  • Expected Performance: • What should be happening with performance to meet standards/expectations?

  • Gap: • Identify the difference between current performance & expected performance

Additional Information

  • Is the employee aware of what is expected?

  • What are the goals and expectations (standards)?

  • Is the employee aware of their own performance?

  • Provide feedback

  • Is the employee being held accountable for performing to these expectations?

  • Indicate the consequences of not meeting the standards.

  • Is the employee knowledgable, skilled and has the abilities to perform as expected?

  • What specific skills and competencies will be developed to close the performance gap?

  • Is the employee motivated?

  • Identify how the employee can be motivated

  • List uncontrollable internal or external environmental factors influencing the employee’s performance


  • Recommendations

  • Employee (Full Name and Signature)

  • Manager (Full Name and Signature)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.