"EMPLOYEE PERFORMANCE EVALUATION"
EMPLOYEE PERFORMANCE EVALUATION Employee Name: Position: Department: Site: Planning Year: Date Completed: Supervisor Name: Supervisor Position: Place an "X" in one of the following that describes the reason for this particular performance evaluation. Prior to the end of the three-month probationary period for all new employees, or when it is sufficiently clear that new employee is not likely to be satisfactory for the job. Termination of Employment Annual: 12 months from last evaluation Other, specify: PERFORMANCE REVIEW APPRAISER: Consider the following five columns as a scale. The extreme right as outstanding, the extreme left as unusually poor. Based on your opinions, place an "X" in the box under the paragraph that best describes each quality of the individual. In each comment section, make a brief statement about why certain conclusions were made. Evaluate only the qualities you have observed. Use additional blank sheets for opinion if required. Interpersonal Unable to work or Often unable to work or In most cases, gets Rarely has problems in Gets along well with others, Effectiveness deal with others. deal with others. along well with working with others. without exception. others. Consider demonstrated ability to work with others, both inside and outside the organization Comment: Technical Knowledge & Lacks knowledge to Has a marginally sufficient Has a sound level of Has a grasp of skills and Demonstrates a complete Skills perform work level of knowledge and skill and knowledge knowledge which clearly mastery of the required skill properly. skill for the job. for the job. exceed that required for and knowledge in own the job. specialty. The employee has sufficient skill and knowledge to work to their scope of practice or job qualifications. Comment: C:\Docstoc\Working\pdf\57fa1588-2562-41d3-98f5-2a8767ccbf63.doc Page 1 of 5 EMPLOYEE PERFORMANCE EVALUATION Quality of Work Work typically Work varies in quality. Work is usually Displays good Work is always of very high unsatisfactory and Often is below standard. satisfactory and productivity. Instructions quality and exceeds below standard. meets most standard followed accurately. standards and expectations. instruction. Consider thoroughness and quality of work in relation to established standards and supervisors instructions. Comment: Planning & Organization Completes tasks in Adjusts tasks to reflect Identifies impacts of Is highly effective in using Is highly flexible at the order they were shifting organizational shifting organizational systems that enhance identifying the need to shift received. Does not priorities when receives needs on personal personal effectiveness. personal priorities based on set priorities. instruction to do so. priorities and Meets deadlines, except organizational needs. identifies required in unusual circumstances. shifts in tasks and responsibilities. Consider demonstrated ability to anticipate conditions, plan ahead, establish priorities and meet deadlines. Comment: Teamwork A loner who is either Prefers to work alone, Typically functions Is a better than average An outstanding team person unable or unwilling to although, if forced, can effectively as a team player. who always makes a clear work with others. perform satisfactorily in a member of the work and significant contribution group. group. to the overall strength of the work group. Consider the extent to which the employee functions as an effective member of the work group in situations where teamwork is a requirement of the job. Comment: C:\Docstoc\Working\pdf\57fa1588-2562-41d3-98f5-2a8767ccbf63.doc Page 2 of 5 EMPLOYEE PERFORMANCE EVALUATION Interpersonal Does not share Shares required Identifies needs of Proactively identifies the Proactively identifies the Communication required information information only when others for information needs of others for needs of others for with others in a requested to do so. and usually selects information and selects information and develops timely manner. an appropriate and appropriate vehicle to mechanisms and processes vehicle for communicate the to solicit feedback. communicating that information on a timely information. basis. Consider demonstrated ability to clearly and effectively communicate ideas and information. Comment: Attendance/Punctuality Employee was Employee was sometimes Employee has Employee is punctual, and Employee was never frequently absent absent and/or late - more satisfactory record - submits time off requests absent/and or late. and/or late placing a often than would be some lates and/or well in advance. serious additional expected. absences. burden on co- workers. Consider the extent to which the employee was absent and/or late during the appraisal period. Comment: Skill Acquisition/ Has not made efforts Efforts to acquire new Progress in the Considerable A significant degree of Upgrading to acquire necessary skills or to upgrade acquisition and/or skill/knowledge acquistion skill/knowledge and/or new skills or existing skills have been upgrading of skill and current skills exceed upgrading has occurred, knowledge. made. levels has occurred immediate requirements. and employee looked upon and skill base is as an expert. expanding. Consider the extent to which the employee willingly and enthusiastically adds to his or her skill or knowledge base. Comment: C:\Docstoc\Working\pdf\57fa1588-2562-41d3-98f5-2a8767ccbf63.doc Page 3 of 5 EMPLOYEE PERFORMANCE EVALUATION Decision Making Is hesitant do make Will make decisions only Will make decisions Considers relevant factors Proactively identifies decision on own. when forced. that take relevant when making decisions. required information when Relies on others. factors into making decisions and takes consideration, active steps to gather however not all information. required factors are identified. Considers relevant facts when making a decision. Consults others as appropriate. Comment: Leadership Does not May provide leadership to Provides leadership Provides leadership to Provides leadership to large demonstrate ability to small ad hoc teams. to project and/or work large project and/or work project and/or work teams. lead others. teams. teams. Monitors and Provides both individual and measures performance to team coaching to develop ensure goals are being high performance and met. enhanced team relationships. Provides effective leadership to others on team. Demonstrates effective goal setting and coaching approaches. Effectively manages team needs and priorities. Comment: (Use for RN & CCC): Problem Solving Does not identify Will work to resolve Identifies issues that Proactively identifies Proactively identifies issues issues that may issues that have been may impact ability to issues that may impact that may impact the impact goals. identified by others. achieve team or ability to achieve team or achievement of goals. individual goals. individual goals. Works with appropriate individuals to address these issues. Takes the steps necessary to identify and analyze the cause of problems, and develops effective/innovative solutions in collaboration with others, as appropriate. Comment: C:\Docstoc\Working\pdf\57fa1588-2562-41d3-98f5-2a8767ccbf63.doc Page 4 of 5 EMPLOYEE PERFORMANCE EVALUATION Specific action to be taken by By Whom: By When: supervisor and/or employee to improve weakness. Additional Supervisor Comments: Supervisor's Signature: Date: Employee Comments: Employee’s Signature: Date: Move to Next Increment: Yes No Supervisor's Signature: C:\Docstoc\Working\pdf\57fa1588-2562-41d3-98f5-2a8767ccbf63.doc Page 5 of 5