Base Level Evaluation Report Checklist
Part I - Administrative
Does the rating period coincide with the Support Form?
Is the rating period correct ?
Is the rating period at least 120 days?
Has the appropriate Reason for Submission been checked (e.g., Annual [include early, if applicable], or Special?)
Part II - Authentication
Has the report been signed by the Senior Rater (if required), Intermediate Rater (if applicable), Rater, and Ratee?
Part III - Awards
Was the award nomination and approval indicated only on an extra copy of page 1 of the evaluation?
Part IV - Duty Description
Are comments confined to the space provided (cannot exceed)?
Are counseling dates recorded?
Part Va - DA Values (Comments are encouraged - not mandatory)
Are comments in bullet form?
Are comments limited to no more than two lines per bullet?
Are comments double-spaced between bullets?
Are only positive comments listed (non-derogatory)?
Part Vb - Responsibilities (Rater)
Has rater assigned a rating to each responsibility?
Are comments written for any responsibility to be rated (required for responsibilities rated other than success; encouraged for those rated success)?
Are comments in bullet format?
Are comments limited to no more than two lines per bullet?
Are comments double-spaced between bullets?
If the ratee is a supervisor, are Responsibility #5, Supervision and Leadership, and responsibility #6, EEO and Affirmative Action, rated? Are there bullet comments?
Are comments confined to the space provided (cannot exceed)?
Intermediate Rater (if applicable)
Has the Intermediate Rater signed and dated Part II?
If the Intermediate Rater disagreed with the Rater and they could not work it out, has the Intermediate Rater given both views to the Senior Rater (preferably in writing)?
Part VI - Overall Performance (Senior Rater if used, Rater if no senior rater used))
Does the Overall Performance Rating agree with the rater's Responsibilities rating in part Va?
Are comments provided--both on Ratee's performance and potential?
If the Ratee is a Supervisor, and was rated above SUCCESSFUL LEVEL 3, was he/she rated EXCELLENCE in either or both of Responsibilities #5 and #6?
Are comments in bullet form?
Are comments limited to no more than two lines per bullet?
Are comments double-spaced between bullets?
Are comments confined to the space provided (cannot exceed)?
If the Senior Rater disagrees with the Rater and resolution through discussion/negotiation has not resulted in agreement, has he/she either directed or made the
necessary changes?
DA Form 7223-1, Counseling Checklist/Record
Were copies attached to the appraisal?
Is the counseling checklist/record for the correct rating period?
Did the Ratee, Rater, Intermediate Rater (if appropriate), and Senior Rater (if required) initial
and date the form?
Was at least a midpoint review completed, documented on the Checklist/Record,
and initialed and dated at least by the Ratee and Rater?
Were main points of any counseling (e.g., initial and midpoint) annotated on the
Checklist/Record?
If major changes were made to the support form during the rating period, did the Senior Rater (if used) also review and approve the modifications?
Was the performance plan in effect for at least 120 days?
If the plan was in effect for less than 120 days, was it due to administrative
oversight? Is a statement of concurrence included, signed by the rater, ratee, and
senior rater?
Has a copy of the performance appraisal been provided to the ratee?
Have 2 copies of the appraisal been received?
Responsibility Ratings
Excellence: Consistently exceeds level described by standards and
documented expectations; frequently produces more and/or better than expected.
Success: Usually performs at the level described by the standards and
documented expectations. Quality/quantity of accomplishments are generally
at expected levels. Strengths clearly outweigh the weaknesses.
Needs Improvement: Sometimes performs at level described by standards and
documented expectations. However, fails enough so that weaknesses slightly
outweigh strengths.
Fails: Frequently fails to perform at levels described by standards and
documented expectations. Rarely achieves expected results. Weaknesses
clearly outweigh strengths.
Overall Ratings
Successful Level 1: Ratee with no supervisory duties is rated EXCELLENCE in at least 3 of the 4 Responsibilities and SUCCESS on the remainder. Ratee with supervisory duties is rated EXCELLENCE in 5 of the 6 Responsibilities--one must be either Supervision/Leadership or EEO/AA (both may be)-- and SUCCESS in the remainder.
Successful Level 2: Ratee with no supervisory duties is rated EXCELLENCE in either 1 or 2 of the Responsibilties and SUCCESS in the other nonsupervisory Responsibility. Ratee with supervisory duties is rated EXCELLENCE in either 2 or 3 Responsibilities--one must be either Supervision/Leadership or EEO/AA (both may be)--and SUCCESS in the remainder.
Successful Level 3: Ratee with no supervisory duties is rated no lower than SUCCESS in responsibility. Ratee with supervisory duties is rated no lower than SUCESS on any supervisory or nonsupervisory responsibility must include ratings on both Supervision/Leadership and EEO/AA.
Fair: Ratee is rated NEEDS IMPROVEMENT in 1 or more Responsibilities and NOT RATED FAILS IN ANY.
Unsuccessful: Ratee is rated FAILS in 1 or more Responsibilities--regardless of ratings assigned remaining Responsibilities.
