![]() |
![]() |
||||||||||||
|
| |||||||||||||
Title: |
Performance Rating Dispute Process |
Effective Date: |
January 12, 2009 |
Revision History: |
September 5, 2007; January 1, 2002; August 5, 2008 |
Authority: |
G.S. 143B-10, 126 |
The purpose of this directive is to establish department policy and procedures for reviewing and resolving employee disputes concerning job performance ratings in accordance with the requirements and guidelines established by the State Personnel Commission.
APPROVED |
|
Lanier M. Cansler, Secretary | |
Department of Health and Human Services |
Attachments
Attachment 1
North Carolina Department of Health and Human Services
PERFORMANCE RATING DISPUTE PROCESS
COMPLAINT FILING FORM
Check ONE only: ___ Step 1 Complaint ___ Step 2 Complaint (see 15 below) |
1. Name (First, Middle, Last): _______________________________________________________________________ |
|||
3. Sex: _______ |
4. Race:________ |
5. Date of Birth:______ |
6. Personnel No.:_________________________ |
6. Business Telephone: ______-______-____________ |
|||
7. Work Address (include zip code): __________________________________________________________________ |
|||
8. Classification and Salary Grade: ___________________________________________________________________ |
|||
9. Division/Facility/School: _____________________________________________________________________________ |
|||
10. Period covered by work cycle: From (month/year) __________ |
To (month/year) __________ |
||
11. Statement of issues and facts on which complaint is based. Be specific. Attach additional sheet if necessary. |
|||
_______________________________________________________________________________
|
|||
_______________________________________________________________________________
|
|||
12. Statement of relief desired (attach additional sheet if necessary): ________________________________ |
|||
_______________________________________________________________________________
|
|||
13. Attach copy of the following: |
|||
a. Your completed work plan for the cycle, including interim review and overall performance summary rating. b. The written notice that generated this complaint. If a Step 2 complaint, include copy of the Step 1 decision letter. c. Other documents you consider relevant to this complaint, including a list of such documents. |
|||
14. Step 2 Only: (check one only): |
|||
___ I want to appear before the Performance Review Board and speak on my behalf. ___ I want the Board to consider my complaint through a review of documents only. |
|||
15. Employee's Signature: _____________________________ |
Date: _____________ |
||
The Following to be Completed by Unit Human Resource Manager |
|
1. Received by (Name and Title): |
2. Date Received: |
_________________________________________ |
___________________ |
3. Complaint is timely filed: ___ Yes ___ No, If No, give reason(s): __________________ |
|
DHHS Filing Form PRD-1 (Rev. 1/09)
Attachment 2
North Carolina Department of Health and Human Services
PERFORMANCE RATING DISPUTE PROCESS
MANAGEMENT RESPONSE FORM
(Submit to Director of Division of Human Resources within
10 days of receipt of Step 2 Complaint; attach complaint filing form)
1. Employee Name:_________________________________________________________________________ |
|||
2. Personnel No.: _______________________________________________ |
|||
3. Division/Facility/School: ________________________________________________________________________ |
|||
4. Response to employee's statement of issues and facts on which complaint is based. Be specific. Attach additional sheet(s) if necessary. |
|||
_______________________________________________________________________________
|
|||
_______________________________________________________________________________
|
|||
_______________________________________________________________________________
|
|||
_______________________________________________________________________________
|
|||
_______________________________________________________________________________
|
|||
5. Attach to this form copies of any relevant documents you wish the Board to consider, in addition to those submitted by the employee. Include a list of such documents. |
|||
6. If employee will appear before the Board, enter the name of management representative: |
|||
Name: ________________________________________________________________________ Title: __________________________________________________________________________ Work Location: __________________________________________________________________ Business Telephone Number: ( _________ )______________________ |
|||
7. Agency Director's Signature: __________________________________________________________ |
|||
8. Date: ___________________________ |
|||
DHHS Response Form PRD-2 (Rev. 1/09)
|
For questions or clarification on any of the information contained in these manuals, please contact the DHHS Office of the General
Counsel.
|