Classified_Staff_Performance_Appraisal_Form
Document Sample
University of Texas Health Science Center at Houston
Classified Staff Performance Appraisal Form
Employee Name Evaluation Period
Employee ID Review Date
Position Department
Supervisor Name Business Unit
Performance Rating Scale
Rating Definitions
Performance far exceeded expectations due to exceptionally high quality of work performed in all essential areas of
responsibility, resulting in an overall quality of work that was superior; and either 1) included the completion of a major goal or
5 Exceptional project, or 2) made an exceptional or unique contribution in support of unit, department, or University objectives. This rating is
achievable by any employee though given infrequently.
Exceeds Performance consistently exceeded expectations in all essential areas of responsibility, and the quality of work overall was
4 excellent. Annual goals were met.
Expectations
Performance consistently met expectations in all essential areas of responsibility, at times possibly exceeding expectations,
3 Meets Expectations and the quality of work overall was very good. The most critical annual goals were met.
Improvement Performance did not consistently meet expectations – performance failed to meet expectations in one or more essential areas
2
Needed of responsibility, and/or one or more of the most critical goals were not met.
Performance was consistently below expectations in most essential areas of responsibility, and/or reasonable progress toward
1 Unsatisfactory critical goals was not made. Significant improvement is needed in one or more important areas. A plan to correct performance,
including timelines, must be outlined and monitored to measure progress.
N/A N/A The employee has been in the position less than six months or out on leave of absence for 75% of the performance period.
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Section I – Performance Goals & Objectives
List each of the employee’s performance goals established for the performance period below. Using the scale above, select the appropriate
Instructions level of attainment and enter the rating in the Goal Rating field. Enter key accomplishments and the justification for the rating in the
Accomplishments & Comments field.
Performance Goals Results & Comments Rating
1.
2.
3.
4.
5.
6.
7.
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Section II – Performance Standards
Rate the employee on each of the skills and competencies below using the rating scale above. For ratings of Exceptional (5) or Unsatisfactory
Instructions (1), use the comments field to enter the justification. Add other comments as appropriate.
Performance Standard Comments Rating
Accountability, Dependability, Responsibility
Accepts accountability for own actions and performs assignments in a timely manner. Makes effective
use of resources. Meets deadlines and standards for quality and quantity of work. Takes responsibility
for the results of decisions made.
Personal Integrity
Builds trust. Model of principled, ethical, and values-orientated behavior.
Interpersonal Skills, Communication, Flexibility
Interacts with others in open, objective ways which show respect and interest. Listens attentively to the
ideas and concerns of others and gives them genuine consideration. Communicates orally and in writing
in clear, succinct, and understandable ways. Passes information on to others as appropriate. Focuses
on issues and not personalities. Is sensitive to impact on others. Willingly alters plans and personal work
style to fit circumstances.
Decision-Making, Problem-Solving, Judgment
Identifies problems and opportunities. Gathers and organizes facts. Makes effective decisions using
sound judgment.
Organizational and Planning Skills
Sets goals, establishes priorities, utilizes available resources, and organizes work to meet deadlines,
schedules, or commitments through effective planning and prioritizing. Makes effective use of time.
Teamwork
Demonstrates willingness to assist colleagues with various projects/tasks (assigned projects as well as
unassigned where help is needed).
Initiative and Resourcefulness
Offers suggestions. Anticipates needs. Seeks additional tasks as time permits. Contributes, develops,
and/or carries out new ideas or methods.
Attendance and Punctuality
Reports to work on time. Gives prompt notice of absence due to illness. Adheres to department policies
regarding leave requests. Adheres to all applicable university and departmental policies.
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Professional Self-Improvement
Keeps abreast of current developments in field. Attends internal and external classes, workshops,
seminars, and training programs. Participates and maintains memberships in professional organizations
if applicable. Seeks assignments to support professional growth.
Safety and Compliance
Completes all mandatory basic safety and compliance training by required deadlines. Completes EHS
safety training required by job function, e.g. completes required training if they will have exposure on the
job to biological, chemicals or radiation hazards. Adheres to safety rules, and compliance/HOOP
standards and policies.
Customer, Client, Patient Relations
Maintains good customer relations. Returns calls promptly. Works with customers in problem
resolution. Provides timely follow-up with clients. Acts in a courteous and professional manner.
Supervision
Responds well to supervision, coaching and feedback.
Job Specific Functional/Technical Skills
Please list and rate job specific functional/technical skills required for this position.
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Section IV – Summary of Overall Performance
Instructions
To be completed by employee’s manager.
Overall Rating
Exceptional Exceeds Expectations Meets Expectations Improvement Needed Unsatisfactory
5 4 3 2 1
Summary of Overall Performance
Employee Strengths
Employee Development Opportunities
Employee Comments
The space below is reserved for the employee’s comments concerning this performance review.
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University of Texas Health Science Center at Houston
Performance Plan
Employee Name Performance Period
Position Supervisor
Key Responsibilities
Instructions
Enter the employee’s key responsibilities for the new performance period.
1.
2.
3.
4.
5.
Performance Goals
Instructions
Enter the employee’s performance goals below along with the criteria that will be used to measure success.
Goal Action Plan Metrics
What will you do to achieve this goal? Measures for success, Target Dates or Milestones
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Development Goals
Instructions
Enter the employee’s goals to help the employee grow and increase their skills and capabilities.
Goal Action Plan Metrics
What will you do to achieve this goal? Measures for success, Target Dates or Milestones
Signatures
We certify by our signatures below that this performance evaluation and this performance plan have been discussed and agreement finalized. The goals in the
performance plan above support and align with the strategic plan of The University of Texas Health Science Center at Houston and the operating plan of our
school/business unit. The goals above are to be achieved by the employee during the new evaluation period.
Employee Date
Manager/Supervisor Date
Senior Manager/Supervisor Date
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