SAMPLE PERFORMANCE EVALUATION SUPERVISOR/DEPARTMENT HEAD
TYPE OF EVALUATION End of Probationary Period Annual Evaluation Remedial/Developmental Employee: Employment Date:
EVALUATION PERIOD: From: To:
Title: Length of Time in Current Position:
Name and Title of Person Making Performance Evaluation:
Evaluations: (EE) Exceeds Expectations (DN) Does not meet expectations (ME) Meets Expecations (NA) Not applicable (MS) Meets Some Expectations Note: If evaluation is rated (MS) or (DN) comment section must be completed. 1. QUANTITY OF WORK Completes necessary amount of work required in position Finishes work on time Finds or requests more work when assignments are completed
EE ME MS DN NA
Meets performance goals set by Supervisor Comments:
2.
QUALITY OF WORK Work is done neatly and in an orderly fashion Produces thorough and accurate work with a minimum need to verify
EE
ME
MS
DN
NA
SAMPLE
Follows instructions, performs Assigned tasks, meets schedules
Comments:
3.
COMMUNICATIONS/ INTERPERSONAL RELATIONS Facilitates good communications between co-workers and supervisor Interacts with co-workers and customers in a courteous and helpful manner Responds to requests and telephone calls promptly Listens carefully to suggestions and information from supervisor Comments:
EE
ME
MS
DN
NA
4.
COOPERATION Seeks and volunteers information and advice from co-workers Willingly supports and accepts City policy and procedural changes Adapts to new methods or tasks in a cooperative manner Volunteers assistance and support to other departments, customers, managers, and co-workers Comments:
EE
ME
MS
DN
NA
SAMPLE
5.
INITATIVE/WORK HABITS Attempts to find solutions to problems encountered Seeks guidance when necessary Plans and organizes work and established priorities Works well under pressure Comments:
EE
ME
MS
DN
NA
6.
JOB KNOWLEDGE Keeps current on changes in job related Equipment and/or technology Applies job knowledge and skills to Effectively perform current assignment Keeps current on changes in City procedures and information Comments:
EE
ME
MS
DN
NA
7.
SAFETY Maintains safe use of equipment Demonstrates compliance with rules/ regulations regarding equipment and use Comments:
EE
ME
MS
DN
NA
SAMPLE
8.
DECISION MAKING Recognizes and addresses problems promptly Gathers facts and information carefully before making decisions
EE
ME
MS
DN
NA
Seeks advice as necessary from supervisor, co-workers, and outside sources Learns from past decisions Makes decisions in a timely manner Comments:
9.
MANAGEMENT OF EMPLOYEES Leads by example; displays leadership skills Evaluates employees in a timely manner Establishes and clearly communicates performance objectives Plans and organizes workload in a manner that makes best use of resources
EE
ME
MS
DN
NA
Develops procedures to improve efficiency within area of responsibility Initiates action to improve subordinate performance Creates a positive work environment, contributes to team productivity and team problem solving situations Comments:
SAMPLE
Supervisor/Department Head’s Overall Evaluation
EE ME MS DN
PASS
FAIL
________________________________ Signature of person completing form
____________________ Date
OBJECTIVES FOR COMING YEAR 1. 2. . 3. . 4. . RESULTS FROM PRIOR YEAR 1. . 2. . 3. . 4. . EMPLOYEE COMMENTS
ACKNOWLEDGMENT
SAMPLE I confirm the receipt and discussion of this evaluation, which took place with __________________________________ in attendance. My signature acknowledges neither acceptance or disagreement but only the receipt and discussion. If I fail to present either acceptance or disagreement in writing to _________________________________ on ______________________ then I realize that my ability to disagree is forfeited and that I have accepted this evaluation as received and discussed.
________________________________________ Employee Signature
______________ Date
________________________________________ Witness Signature
______________ Date