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Formulaire DS-5055 Instructions

Rapport d'évaluation des employés du service extérieur des États-Unis pour les postes FS-02, FS-01 et les employés titulaires du service extérieur supérieur

Formulaires associés

  • Formulaire DS-5055 - Rapport d'évaluation des employés du service extérieur des États-Unis pour les postes FS-02, FS-01 et les employés titulaires du service extérieur supérieur seulement
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U.S. Department of State  
Form DS-5055 must be used for all required (i.e., regular and interim)  
evaluations - for tenured and untenured FS employees, except for those of  
personnel assigned to training (who use DS-7772 (outside academic  
institution) or DS- 651 (language training)). (Note: If preferred, the DS-  
5055 may be used instead of the DS-7768 for voluntary EERs.) Career Civil  
Service employees serving on excursion limited non-career appointments  
also must use this form. No narrative may exceed the space provided for it,  
except in Section X where the employee may use continuation sheets, and  
Section IV where the review panel may also use continuation sheets. EERs  
may not be classified or contain classified information.  
The post or bureau human resources office will submit the completed EER to  
the eOPF in ePerformance. EERs must be submitted within 30 days of the  
end of the rating period. Any delay over 30 days in submission of an EER  
must be notified to HR/PE. Note: Exceptions to the use of ePerformance are  
limited, and the bureau/post HRO must request the exception in advance by  
There are three types of rating periods and report types.  
A. Regular: The annual rating cycle is from April 16 of one year to April 15  
of the next year for all tenured Foreign Service employees and untenured  
specialists. For untenured generalists, the annual rating cycle begins on the  
date of arrival in the assignment.  
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B. Interim: If a change of rater, assignment, or major duties occurs during  
the regular rating period, an interim report must be prepared for periods of  
120 days or more, including for untenured generalists.  
C. Voluntary: Raters should prepare voluntary reports for periods of fewer  
than 120 days only when required to document significant developments  
pertaining to the employee's performance that cannot be adequately  
documented in the next regular evaluation. Voluntary reports are not to be  
used to document performance during a detail or temporary duty  
assignment when the employee will return to his or her regular position and  
be evaluated for the full period.  
The employee must be advised in writing at the beginning of the rating  
period who the rater will be. The rater is usually the employee’s official  
supervisor. (See 3 FAH-1 2813.3 regarding regional personnel.) The  
reviewer is usually the rater’s supervisor or the next highest- ranking official.  
Every effort should be made to ensure that employees have a reviewer. If  
this is not possible, the employee should be informed in writing at the  
beginning of the rating period that there will be no reviewer.  
ENSURING FAIRNESS: Rated employees must be given the opportunity to  
perform their assigned duties and must be evaluated on their performance  
of the established work requirements. Although the DS 5055 no longer  
requires a Work Requirements Statement, rated employees, raters and  
reviewers must establish a detailed Work Requirements Statement within  
the first 45 days of the rating period and a signed copy should be kept by  
the rated employee, rater and reviewer. This information will form the basis  
for the work responsibilities included on the DS 5055. A rater must discuss  
the work responsibilities and what constitutes acceptable performance with  
the rated employee at the beginning of the rating period and provide  
feedback on the employee's performance during this period. In situations  
where employees are not performing at an acceptable level, they must be  
counseled and afforded a reasonable period of time to improve.  
This section contains general employee information (name, position title,  
grade, series, and post or organization) populated from the employee’s  
record in the Global Employment Management System (GEMS). Type of  
Report and Period Covered are completed by the rater. The rater and  
reviewer signatures will automatically populate when each certify the report  
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is complete, in conformance with the instructions, and adequately  
documents performance. Date received in Post/Bureau and Date Received in  
HR/PE will populate when the employee acknowledges receipt of the EER and  
when the review panel chairperson certifies the EER is complete,  
The rater, reviewer, and rated employee must formalize the employee’s  
work responsibilities within 45 days of the beginning of the rating period.  
Completion of Section V in ePerformance will automatically populate the  
respective date block in Section II. The core work responsibilities and goals  
and objectives requirements may be revised during the rating period to  
reflect a major change in the employee's responsibilities as documented in  
the separate Work Requirements Statement (which is no longer part of the  
This section also certifies that the rater reviewed the performance with the  
rated employee at least twice, at regular intervals, during a rating period,  
with at least one discussion recorded on Form DS- 1974, preferably in  
ePerformance. Raters should use these sessions to ensure that the  
employee is apprised of how well he or she is progressing in achieving the  
work responsibilities. Discussions between the rater and the rated employee  
should address specific areas of accomplishment and/or areas in which the  
rated employee should improve. Assessments included in the final EER  
should not surprise the rated employee. If the rated employee believes that  
the dates of performance review discussions or counseling sessions are  
inaccurate, the rated employee should note that in Section VI and/or in  
Section X. Such disagreements should not prevent an employee from  
acknowledging receipt of the EER in Section III. By signing Section III, the  
employee merely acknowledges receipt of the EER, not agreement with its  
The rated employee should electronically sign and date the cover page to  
acknowledge receipt of a copy of the EER. The signature does not indicate  
agreement with the contents of the EER or limit in any way the right of the  
employee to object to it. If the EER is not completed, signed, and returned  
after five calendar days by the rated employee, a copy of the unsigned  
rating is to be submitted by post/bureau to HR/PE for the employee's Official  
Performance Folder (eOPF) with a covering memorandum to explain the  
absence of signature. In cases where the employee has not signed  
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acknowledging receipt of the EER, the review panel should comment on the  
circumstances in a review panel statement attached to the EER.  
Bureau and post review panels review EERs before the reports are submitted  
to HR/PE. They ensure that reports are completed in accordance with  
regulations and these instructions. Review panel functions are:  
(1) Technical - reviewing EERs for inadmissible comments and  
changing or deleting inadmissible material; confirming that regulations and  
instructions are correctly applied and, if not, returning them for correction;  
(2) Advisory returning reports that lack sufficient examples of  
performance to substantiate comments or that appear to lack internal  
consistency. The panel must try to have deficiencies corrected. If the effort  
is unsuccessful, the panel should note the suggested revisions in Section IV  
of the EER and any reasons for their rejection. A continuation sheet may be  
(3) Administrative -- if an evaluation is submitted to HR/PE after the  
due date, the panel should indicate in Section IV C who was responsible for  
the delay.  
Any revision by the rater should be shown to the reviewer and must be  
shown to the rated employee. A revision of the reviewer’s statement must  
be shown to the rated employee. The employee may then revise Section VI  
or supplement the narrative in Section X.  
If the rated employee's description of accomplishments or optional  
statement contains negative or pejorative comments concerning the rater or  
reviewer, or raises significant questions of fact, the panel must provide the  
employee the opportunity to revise these comments. If the employee  
declines to do so, the review panel may invite the rater or reviewer, as  
appropriate, to comment. Any such comments must be shown to the  
employee, who will have the opportunity to make a final statement. These  
supplemental statements must be attached to the evaluation report.  
Although the review panel has the primary responsibility to check for  
negative and pejorative comments, if HR/PE identifies such comments it will  
follow the procedure outlined above.  
If an evaluation is submitted to HR/PE after the due date, the panel should  
indicate in Section IV C who was responsible for the delay. Assistant  
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secretaries, chiefs of mission, and their equivalents may opt not to submit to  
review panels the evaluations they prepare on their deputies. If this  
provision is invoked, the appropriate Bureau or Post official submitting the  
EER should so annotate in the review panel statement section.  
(Completed by rater, reviewer, and rated employee)  
Department of State guidance requires that all employees and their  
raters/reviewers must have a separate detailed Work Requirements  
Statement discussed and signed by the rated employee, rater, and reviewer  
within the first 45 days of the EER cycle or arrival at new position. This  
document is not part of the formal EER but should form the basis for Section  
The rater should complete Section V within 45 days of the beginning of the  
rating period, in collaboration with the rated employee and with the  
concurrence of the reviewing officer.  
Position Description: The rater should briefly explain the rated employee's position  
and where it fits in the formal staffing pattern. The rater should explain the  
employee’s rating and reviewing responsibilities for other employees and the level  
of financial or other Department resources for which the rated employee exercises  
operational responsibility.  
CORE WORK RESPONSIBILITIES: There are two sections  
within this box.  
Part 1: The first sentence is pre-determined and must be included in all  
EERs. The security section is a drop box dependent on the employee’s  
personal grade. There is space for 1-3 lines for the employees’ broad core  
work responsibilities.  
Part 2: Goals/Specific Objectives - This section sets out the broad goals  
and specific objectives, which guide the employee’s performance for the  
rating period. They should be listed in priority order, and reflect a clear  
appreciation for Mission, Bureau, or Department goals. They should be  
realistic and realizable.  
Here the rater should describe any unusual, unexpected, or unpredictable  
circumstances that developed during the rating period and that significantly  
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altered operational conditions that affected the ability of the employee to  
perform his/her job responsibilities and accomplish his/her goals and  
objectives. This does not include situations that existed at the start of the  
rating cycle or could reasonably be expected to occur during the rating cycle.  
Rated employees must describe their most significant individual and  
collaborative accomplishments during the rating period. Employees should  
provide a factual description of outcomes achieved and how these outcomes  
advanced Mission or Department goals. Employees should not self-appraise  
their own performance.  
The rater and reviewer may suggest changes in this section. The rated  
employee may accept or decline such suggestions.  
Section A. Appraisal  
The rater has primary responsibility for assessing the rated employee’s  
accomplishments in the areas of policy leadership, program and project  
management, and interpersonal relations (Informational, Operational, and  
Relational Effectiveness). The rater should document all performance. If  
the employee did not fulfill his/her work responsibilities or did so in a  
manner that did not meet expectations, the rater must cite specific  
examples. If the employee was fully successful, the rater must document  
whether the rated employee has demonstrated the potential to succeed if  
assigned higher-level responsibilities, and what additional skills the  
employee should work on to perform most effectively in future assignments.  
The rater must use specific examples to address the employee’s  
performance and potential in the areas of informational effectiveness,  
operational effectiveness, and relational effectiveness (see Core Precepts for  
further guidance on these three effectiveness elements, and their  
relationship to the six core competency groups). The rater should focus on  
accomplishments and results and comment on how well the employee has  
integrated the six competencies into areas of effectiveness to accomplish  
his/her goals.  
All jobs require equal employment opportunity (EEO) leadership and adherence to  
EEO principles is a mandatory work responsibility. Raters should discuss an  
employee's EEO leadership and commitment to diversity and inclusion, if he or she  
has demonstrated it, or document performance that suggests less than full support  
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for EEO objectives and diversity and inclusion efforts, providing at least one  
example to support either kind of statement.  
All jobs require sound security awareness. Raters must comment on any  
pattern of failure to meet the Department’s core security awareness  
If the rated employee is a supervisor, including supervision of locally  
employed staff, the rater's comments should describe the employee’s  
effectiveness as a supervisor, including developing subordinates, mentoring,  
and concern for morale (including issues of work/life balance), as well as  
efforts to support and/or increase diversity and inclusion within the section.  
Any deficit in performance of required supervisory responsibilities should  
also be documented, such as: failure to comply with performance appraisal  
requirements; lack of equity in the delegation of assignments, counseling,  
recommendations for training and placement, and recognition of  
achievements of subordinates; failure to foster an inclusive environment that  
respects diversity; and failure to establish or maintain effective and  
appropriate management control systems. In particular, supervisors have a  
responsibility to address any misconduct of subordinates and failure to do so  
should be documented in the EER. In discussing performance, work done for  
other agencies or outside the rater’s personal supervision may be cited,  
drawing as appropriate on any evaluations submitted by the beneficiaries of  
the rated employee’s work.  
Section B. Developmental Area  
During the rating period, the rater must periodically provide guidance to the  
employee on any area that requires focused professional attention, including  
any areas where the employee is not performing to the expected level.  
In the EER, the rater must document the area where the employee should  
focus most attention to be fully successful at his/her current level or to  
succeed in higher-level assignments in the future. The area must be linked  
to one of the six core competency groups. The rater must justify the area  
with one or more examples. The rater cannot use this section to cite a need  
for formal or informal training (as opposed to substantive knowledge or  
technical expertise).  
Section C. Summary Appraisal  
For all employees, the rater must say whether the employee’s performance  
was satisfactory or better. In the case of tenured employees, if the  
performance was unsatisfactory, the rater must comply with 3 FAH-1 H-  
2814.3 and all other provisions to which the section refers. For untenured  
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employees, if the performance was unsatisfactory the rater must comply  
with 3 FAM 2246 and all other provisions to which the section refers. A rater  
may not assign an overall unsatisfactory rating unless the employee has  
previously been advised of the areas of performance which are inadequate  
and has been given a reasonable opportunity (normally 30 to 60 days) and  
adequate guidance to remedy these deficiencies. In addition, for untenured  
employees, if the rater assigns an unsatisfactory rating, the EER must be  
forwarded directly to HR/PE. For untenured employees, the rater must also  
indicate whether the employee is recommended for tenure.  
Section VIII. Review Statement  
The reviewer must independently assess the rated employee's preparedness  
for assuming positions of greater responsibility, citing examples of  
performance, and must not rely solely on the views of the rater. The  
reviewer must describe the employee’s relations with his/her rater, and  
document the employee’s record of working collaboratively with peers and of  
supporting the professional development of subordinates. If the reviewer  
disagrees with the evaluation of the employee by the rater, or if relations  
between the rater and employee are strained, the reviewer must make this  
The reviewer shares responsibility for ensuring that the employee is fairly  
rated. The reviewer may comment on the adequacy and candor the rater  
showed in preparing the report.  
Section IX. Performance Pay  
SFS Members Performance Pay: Raters should evaluate SFS employees for  
performance pay. Such pay is based solely on performance during the most  
recent rating period and specifically on established performance pay criteria  
as specified in the Procedural Precepts for Performance Pay Boards. Those  
criteria are:  
(1) The relative value of the member's achievement to the accomplishment  
of the Department's mission;  
(2) The degree of difficulty inherent in successful achievement by the  
(3) The extent to which achievement was characterized by strong executive  
leadership and significant contributions in the formulation of agency policies  
and programming; and  
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(4) Effective supervision and development of subordinates.  
Section X. Optional Statement by the Rated Employee  
Rated employees may address any activities or problems that they believe  
have not been covered adequately. The rated employee should use this  
section to identify a disagreement with the rater in Section II regarding the  
dates of establishment of work responsibilities or performance review  
discussions. If additional space is required, continuation sheets may be  
attached. This space should not be used as a continuation of Section VI’s  
Description of Accomplishments.  
The employee must be provided five calendar days from the date of receipt  
of the final EER to review it and prepare a statement. The employee does  
not have the right to amend this statement at a later date except in  
response to changes made in the rater's or reviewer's sections. If the rated  
employee disagrees that counseling sessions have been held, he or she may  
use this section to explain the disagreement. Neither the rater nor reviewer  
has a right to see the employee's statement. See section on review panel  
responsibilities above for exceptions to this rule.  
3 FAM 2810 and 3 FAH-1 H-2810 - See below for instructions on  
inadmissible comments.  
Decision Criteria for Promotion  
Department of State policy is to provide equal opportunity and fair and  
equitable treatment in employment to all persons without regard to race,  
color, religion, sex, national origin, age, disability, political affiliation, marital  
status, or sexual orientation.  
Additional information can be obtained from 3 FAM 1500 or by contacting  
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Inadmissible comments may not be included in any section of the evaluation  
report, or in other forms of evaluative material. Raters and reviewers, as  
well as review panels, must ensure that employees are not disadvantaged,  
directly or indirectly, for reasons of race, color, religion, sex, age, marital  
status, national origin, disability, reasonable accommodation for disability,  
sexual orientation, or means of entry into the Foreign Service. Stereotypes,  
group assumptions, and sexist or ethnic comments are inadmissible.  
The following subjects are inadmissible in any part:  
(1) Reference to race, color, religion, sex (does not extend to the use of Mr.,  
Mrs., Ms., or first names or personal pronouns), national origin, age,  
disability, reasonable accommodation for disability, and sexual orientation;  
(2) Ranking by former Selection Boards or impending selection out;  
(3) Physical characteristics and personal qualities that do not affect  
performance or potential;  
(4) Marital status or plans, or references to spouse or family;  
(5) Retirement, resignation, or other separation plans;  
(6) Reference to job sharing and telecommuting;  
(7) Grievance, equal employment opportunity, or Merit Systems Protection  
Board proceedings;  
(8) Method of entry into the Service;  
(9) Reference to private U.S. citizens by name;  
(10) Participation or nonparticipation of Foreign Service personnel, in any  
organization which exists for the purpose, in whole or in part, of dealing with  
foreign affairs agencies concerning grievances, human resources policies,  
and practices;  
(11) Ratings for earlier periods prepared by other supervisors;  
(12) Reluctance to work voluntary overtime;  
(13) Leave record, except in the case of unauthorized absences;  
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(14) Letters of reprimand;  
(15) Negative reference to use of the Dissent Channel or direct or indirect  
reference to, or consideration of, judgments in dissent channel messages as  
a basis for an adverse evaluation of performance or potential.  
When the rated employee's expression of dissenting views on policy, outside  
of the dissent channel, raises substantial questions of judgment or  
obstructionism relevant to the employee's performance, it may be the  
subject of comment. However, general comment may not be used to get  
around the proscription of this section. Specific instances must be cited.  
(16) Negative or pejorative discussion of the performance of another  
identifiable employee;  
(17) Specific identification by rating or reviewing officers of disability or  
medical problem (including alcoholism, drug abuse, or rehabilitation efforts);  
Although the details or specific identification of a medical problem are  
inadmissible in the evaluation report, general reference may be made to  
confirmed knowledge of a medical problem to the extent it affects job  
performance. Rated employees may discuss their own health problems in  
specific terms if rating or reviewing officers have made references to such  
problems, or to explain or clarify adverse comments in a report.  
Employees, raters, review panels, and HROs are encouraged to consult  
HR/PE with questions about what may or may not be admissible.  
(18) Reference to academic degrees, titles, or specific institutions of higher  
learning (except that physicians may be referred to as "Dr."); or  
(19) Outside activities that are not relevant to performance or post  
Employee Evaluation Reports are subject to strict confidentiality under section 604  
of the Foreign Service Act of 1980 and the provisions of the Privacy Act, 5 U.S.C.  
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