Employee Name (Last, First, MI): Sample, Joe__________________ Employee ID:_____W0000000000______________ State of Kansas
Performance Review Form
Identification Information (please print)
Employee Name (Last, First, MI):
Sample, Joe
Employee ID: W0000000000
Job Title:
Supervisor
01/01/2014
Person Completing Review:
Manager, Jane
Agency Name: Kansas State University
Position Number:
Date of this Review:
W0000000
12/20/14
To 12/31/2014
(Month/Day/Year) Timeframe Being Evaluated (Month/Day/Year)
Overall Performance Rating:
Unsatisfactory (U)
Needs Improvement (NI)
X Meets Expectations (M)
Exceeds Expectations (EE)
Exceptional (E)
Review Type:
Probationary
Recommend permanent status
Extend probationary status
Not recommended for permanent status
X Annual
Special
Unclassified
Task Objectives
Rating
1. Provide a detailed report of account expenditures and balances for
all accounts by the 10th of the month.
ME
2. Provide a detailed physical inventory of office equipment by
MM/DD/YY.
EE = 100% complete with high level of detail and no errors.
ME =100% complete.
NI = < 90% complete.
U = < 70% complete.
NI
Examples of Task
Performance
Reports were consistently
received by the 10th of the
month.
Inventory was 80%
complete on due date.
3.
Competencies/Behaviors
On the Job Suggestion/Example
Rating
Behavioral
Examples/Comments
Problem Solving/Decision Making
Attitude/Accountability
Productivity
Teamwork
Customer Service
Communication
When communicating with coworkers, your supervisor, and
customers, be aware of your
tone of voice, choice of words
and remain nonaggressive in
your communication and how
you deliver information. Remain
professional and use courtesy in
all conversations in the
workplace.
ME
There were no instances
of Joe using harsh tones
with the supervisor. Your
continued efforts in this
area are appreciated.
DA 244 (Rev 4/15) Employee Name (Last, First, MI): Sample, Joe__________________ Employee ID:_____W0000000000______________ Job Knowledge/Professional
Development
Leadership (includes Staff
Development)
It is expected, as a supervisor, that ME
you follow K.A.R 1‐7‐10(2): A performance review shall be completed and a rating assigned at least annually for all of the employees that you supervise. All reviews for your subordinates were completed on schedule. Essential Requirements
*Dependability: Recognizes responsibilities to the agency and applies effective work habits and attitudes to meet work
requirements. Attends work regularly and on time, plans appropriately for absences and assumes personal accountability
for work.
Meets Expectations:
X
Unsatisfactory:
*K-State Values: Align actions with high standards of conduct, accept responsibility for behavior and exhibit personal
integrity at all times. Acts as a role model for other employees and does the right thing, even when no one is watching.
Demonstrates personal integrity and ethical behavior, displays good stewardship of public resources and adapts to
changes in processes, procedures and responsibilities.
Meets Expectations:
X
Unsatisfactory:
*Essential Requirements: An Unsatisfactory rating in Dependability or K-State Values will result in an Overall Performance
Rating of Unsatisfactory
Summary Discussion Points
Areas of Strength(s):
Areas for Development:
Other Evaluation Comments:
DA 244 (Rev 4/15) Employee Name (Last, First, MI): Sample, Joe__________________ Employee ID:_____W0000000000______________ Performance Review Form Signatures
Performance Planning Discussion:
Employee’s Signature*:
Date:
01/10/2014
Manager’s Signature (completed by):
Date:
01/10/2014
Employee’s Signature*:
Date:
05/01/2014
Manager’s Signature (completed by):
Date:
05/01/2014
Manager’s Signature (completed by):
Date:
12/18/2014
Reviewer’s Signature (reviewed by):
Date:
12/19/2014
_______Date:
12/20/2014
Mid-Review Discussion:
End of Review Performance Discussion
Employee’s Signature*:
*Note: Signature does not imply agreement with the content of the review. It only indicates the employee’s awareness of the information contained
herein. A permanent employee, within seven calendar days after being informed of his/her rating, may appeal to Human Resources, 103 Edwards
Hall.
Employee Comments:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Annual Position Description Review
1. _X_ I have reviewed my position description, and it accurately reflects the job responsibilities of the positon.
2. ___ I have reviewed my position description, and it does not accurately reflect the job responsibilities of the
position. If 2 is checked, a new PER-1 needs to be submitted to Compensation and Organizational
Effectiveness.
DA 244 (Rev 4/15) Employee Name (Last, First, MI): Sample, Joe__________________ Employee ID:_____W0000000000______________ Definitions
Problem Solving/Decision Making
Consistently gives reasonable consideration to all issues that arise, gathers and analyzes information accurately, seeks
appropriate input, makes quality and timely decisions, and communicates those decisions to all affected parties.
Attitude/Accountability
Maintains a positive attitude. Accepts challenges due to changing conditions and situations in work responsibilities. Can
work independently. Accepts personal responsibility for work, actions, and attitudes. Accepts constructive
criticism/suggestions. Handles conflict in a constructive manner. Consistently works scheduled duty hours and maintains
recommended leave balances. Effectively represents the work unit.
Productivity
Consistently applies available resources towards program delivery in an efficient and cost effective manner, providing high
quality levels of service. Strives to assure program meets overall best interests of the agency. Practices cost effective
stewardship of all public resources.
Teamwork
Cooperates with co-workers, treating them with respect, and integrity, voluntarily provides support to team members,
ensures all team members have the relevant and needed information, genuinely values others’ input and expertise and is
willing to learn from others, adds value to team meetings
Customer Service
Treats clients and customers with respect and compassion, demonstrates understanding of client’s point of view, delivers
on commitment, provides friendly, cheerful service, distributes helpful information to clients, and maintains confidentiality
Communication
Demonstrates high quality and effective interpersonal communication skills with subordinates, peers, and supervisors
through clear, concise written and oral communications. Maintains healthy working relationships. Appreciates the diversity
of others. Displays an appropriate balance between personal effort and team effort.
Job Knowledge/Professional Development
Is technically and professionally skilled in all position responsibilities and requirements. Maintains currency in all
professional aspects of program responsibility. Seeks new skills, sets high professional goals and
standards. Demonstrates knowledge of procedures and policies.
Leadership (includes Staff Development)
Utilizes employee skills effectively and productively in meeting program goals. Develops goals, objectives and deadlines.
Promotes appropriate staff development activities. Recognizes problems, seeks appropriate input, and develops solutions
to resolve personnel problems or improve procedures. Motivates staff and gains support and action from others while
maintaining professional relationships. Creates and maintains a positive goal-oriented environment. Provides training,
supervision and feedback to employees and students. Consistently challenges past practices in order to identify and
implement more effective and efficient practices. Assures that follow up is provided.
Overall Ratings
Exceptional (E): Performance far exceeded expectations. An employee performing at this level should be performing at a
significantly higher level than those who Exceed Expectations. Only a small percentage of employees will achieve this level
of performance.
Exceeds Expectations (EE): Performance consistently exceeded expectations. An employee performing at this level
should truly be performing above and beyond what was agreed to as their objectives and other performance criteria (i.e.
employee took on additional duties beyond what was agreed upon or completed the duties significantly better than was
expected).
Meets Expectations (M): Performance consistently meets expectations. An employee who completes all of the objectives
and competencies identified at the beginning of the review period is performing at this level. The majority of employees will
perform at this level.
Needs Improvement (NI): Performance did not meet expectations. An employee who performing at this level is
inconsistent in performance. Continual improvement is required to fully meet expectations.
Unsatisfactory (U): Performance consistently below expectations. Immediate improvement is required.
DA 244 (Rev 4/15)