STATE OF MAINE
BUREAU OF HUMAN RESOURCES
3 MONTH PROBATION REPORT

EMPLOYEE NAME:	     	SSN:	     	NH/PROM DATE:	     	

AGENCY:	
      	
CLASSIFICATION:	
     	
3-MO PROB DATE:	
     	

Maine Law and Civil Service Rules require that probationary employees, whether on initial or promotional probation, be reviewed at the end of the third month of employment.  In order to accomplish that requirement, human resource representatives and program supervisors are being provided this report, which is based upon the criteria established for the Performance Management System.  Raters and reviewers should discuss the following competencies with each probationary employee.  A more detailed explanation of each competency/criteria may be found on Form PER 119.

AFTER THREE MONTHS OF EMPLOYMENT, HAS THIS PROBATIONARY EMPLOYEE’S PERFORMANCE BEEN SATISFACTORY?  Please answer “YES” or “NO” and add any appropriate explanations (e.g., action necessary for improvement) for the following categories and questions.

CORE COMPETENCIES	Yes	No		TERMS & CONDITIONS	Yes	No	
INITIATIVE:				WORKS WHEN SCHEDULED:			
ADAPTABILITY:				REQUESTS/USES TIME APPROPRIATELY:			
PLANNING/ORGANIZING WORK:				USES SAFETY CLOTHING/EQUIPMENT:			
DECISION MAKING:				OBSERVES HEALTH/SAFETY/SANITATION  POLICIES			
CUSTOMER SERVICE:				FOLLOWS ALL OTHER RULES/POLICIES:			
TEAMWORK:							
INTERPERSONAL RELATIONS:				MANAGERS/SUPERVISORS ONLY	Yes	No	
				DELEGATION/FOLLOW-UP			
JOB KNOWLEDGE & SKILL	Yes	No		STAFFING:			
JOB KNOWLEDGE:				COACHING/COUNSELING:			
ORAL COMMUNICATION:				EMPLOYEE DEVELOPMENT:			
WRITTEN COMMUNICATION:				QUALITY FOCUS:			
If you have answered “NO” to any of the above explain, in detail, the nature of the problem and corrective action necessary to meet probationary standards.  (Use attached additional sheet if necessary)		PLANNING/ORGANIZING:			
					
     

	

Has this employee received a written job description for the position?	YES  	NO  

EXPLAIN:       

Has this employee been advised of performance expectations for the position?	YES  	NO  

EXPLAIN:       

Has this employee received supervisory orientation?	YES  	NO  

EXPLAIN:       

Has this employee been scheduled for New Employee Orientation? (Required by law)	YES  	NO  

EXPLAIN:       

Has this employee made reasonable progress toward achieving full performance expectations established on	YES  	NO  
Section 3 of the Performance Management Form (PER 119)?

EXPLAIN:       

Has this employee made reasonable progress toward achieving full performance standards?	YES  	NO  

EXPLAIN:       

Has the employee been advised of any job-related performance problem(s) in writing? (Recommended)	YES  	NO  

EXPLAIN:       

At this mid-way point of probation, is the employee in jeopardy of failing to meet established performance	YES  	NO  
standards and not attaining permanent status?

EXPLAIN:       

EMPLOYEE SIGNATURE & DATE: ___________________________________ RATER SIGNATURE & DATE: _______________________________

REVIEWER SIGNATURE & DATE: ____________________________________