Non-EXEMPT EMPLOYEE PERFORMANCE EVALUATION
2015
Employee:__
Position:_
Supervisor:_
Dept / Division
Period Covered: 09/01/2014 - PRESENT
Date:_
Supervisor will distribute
Part IV: Employee Input document to employee being evaluated.
Performance Standards
Exceeds Expectations: Performance is consistently and significantly above job expectations and
requirements. Demonstrates the willingness to assume additional responsibilities.
Meets Expectations: Performance regularly accomplishes what is expected. Performance demonstrates the
required skills and knowledge for the position and sometimes exceeds expectations
Needs Attention: Performance meets only the minimum requirements, which could be improved through
development, experience, and/or application. Performance is below accepted levels for the time in the
position, and needs improvement.
No Basis or N/A: Opportunity to observe employee’s ability to meet standard not sufficiently observed
during review period or described criteria does not apply to employee’s position.
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Part I: Supervisor Ratings
Rate the employee within each category below, by placing a numerical rating under the appropriate column. Each
rating is weighted using a point system. At the end, you will add each column in order to score the review.
KEY: Exceeds 3 pts.; Learning/Meets 2 pt.; Needs Attention 1pts.
Exceeds
Expectations
Technical Skills (requisite knowledge to perform job
requirements)
Productivity (produces appropriate quantity of error free work)
Organizational Skills (organizes work flow, maintains/improves
files and information to allow quick retrieval; where applicable,
cleans up after work orders or projects; maintains organized
vehicle; files all work orders in a timely manner with office and
signs in/out vehicles daily; multi-tasking)
Prioritization (performs tasks in order of importance)
Follow Through (attends to tasks from inception to final
resolution)
Accountability (accepts personal responsibility for assigned
work, tools and equipment)
Problem Solving (manages daily problems independently and
efficiently)
Flexibility (supports new ideas and easily adapts as changes are
initiated)
Cooperation (team skills, works well with others and to achieve
growth/improvement of department)
Positive Attitude (helps to create an effective work environment;
embraces teamwork with other department members)
Pro-active (offers ideas to improve and minimize problems;
seeks better alternatives for performing assigned tasks)
Confidentiality (discusses sensitive matters only when
appropriate; where applicable, returns work keys and secures
work area at end of duty day; follows applicable policies on
protecting data)
Attendance (consistency of attendance, leave usage, punctuality)
Tact and Diplomacy (relates well to customers and colleagues
alike)
Safety (follows safety guidelines and safe work practices; reports
work hazards)
Appearance (adheres to dress and appearance guidelines)
TOTAL POINTS FOR EACH COLUMN:
OVERALL PERFORMANCE RATING:
Mark with an X, the appropriate column, based on the points
below:
Exceeds Expectations 40–48points;
Meets Expectations 25-39 points;
Needs Attention
0-24 points
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Meets
Expectations
Needs
Attention
Part II: Goals for Upcoming Year
Areas of Opportunity – things to adjust to improve your effectiveness and performance.
1.
2.
3.
Areas of Focus - focusing on these expectations will help to improve your effectiveness and
performance.
1.
2.
3.
Strengths – continue to exhibit these strengths that are encouraged and appreciated.
1.
2.
3.
Part III. Supervisor Comments (attach additional sheets if necessary):
Discussion of Review with Employee and Signatures
This review has been discussed with me:
Employee Signature: _____________________________
Date: ___/____/2015
**I also acknowledge I have attached the Employee Comments (Section IV)
Supervisor Signature: _____________________________
Distribution: Original to Human Resources Copy to Employee
For HR Use Only: Evaluation Received in HR: ____/_____/2015
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By: __________
Initials
Date: ___/____/2015
Employee Name:_
Department:
Period Covered: 9/1/2014 through Present
Part IV. Non-Exempt Employee Input Form
This part of the evaluation provides an opportunity for the employee to present information to the
supervisor. Supervisor will distribute this part to the employee and the employee will return the
completed Part IV prior to the review meeting and attach to the review.
A.
Do you have any specific suggestions to improve your own or your department’s service to
the Stetson community?
B.
Describe the coaching, training, or other developmental activities that would improve your
performance or increase your job satisfaction.
C.
List any Stetson service activities outside your work responsibilities (e.g., committees, task
forces, special projects, events, etc…)
Each individual evaluated is encouraged to add any comments to this review (attach additional sheets if
necessary):
________________________________________
Employee’s Signature
____/____/2015
Date
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