Employee
Self-Assessment
Name
Department/Unit
Job Role
Period for Self-Assessment
Date Self-Assessment Submitted to
Supervisor
Directions
In the spaces below, provide information and examples of your significant accomplishments during the review
period. Include all status/outcomes related to goals and objectives that were set for the review period.
Please also comment on your actions and accomplishments as they connect to the Ithaca College Core
Competency areas identified below. This information is an opportunity to self-assess your performance and
accomplishments to facilitate an effective conversation and overall review process. This information should be
submitted to your supervisor before your performance review conversation.
Please provide examples, feedback and a rating for each feedback area. Rating scale: 1 = Unsatisfactory,
2 = Improvement Needed, 3 = Meets Expectations, 4 = Exceeds Expectations, 5 = Outstanding.
Feedback Areas
Comments/Examples
Job-Specific Skills and Knowledge
Understands the job requirements and possesses
the required skills, experience and specific content
knowledge necessary to accomplish results.
Quality of Work
Completes assigned work accurately, effectively and
efficiently. Work performed is consistent, thorough
and completed in a timely manner.
Competencies
Open and Adaptable
Approachable and accessible, welcomes and
actively seeks feedback, embraces new ideas,
adapts plans and actions readily and easily, and
takes initiative.
Collaborative
Cultivates relationships and maintains effective
partnerships that leverage expertise and strengthen
individual and institutional performance and
accomplish organizational goals.
Communication
Facilitates open communication, demonstrates
effective listening skills, and constructively provides
and receives feedback, takes appropriate action to
address and resolve conflict.
Revised 3/15/16
1
Rating
Employee
Self-Assessment
Leadership
Displays and fosters integrity and honesty through
the promotion of mutual trust and respect,
acknowledges the contribution of others, and
creates an environment where everyone feels
valued.
Organizational Engagement and Service
Understands the value of his/her role as part of the
educational experience of our students and actively
participates as a member of the campus
community.
Diversity and Inclusion
Demonstrates a commitment to diversity principles
and fosters an inclusive workplace where individual
differences are valued and leveraged to achieve
organizational goals.
Significant Accomplishments/Results
Achieved
Individual identified goals aligned with their unit
and the College’s strategic direction, and achieves
results. Takes action in the accomplishment of
tasks, assignments and goals.
Areas for Growth, Development,
Improvement
Identify areas for professional and personal growth
and development as well as any areas for
improvement.
Revised 3/15/16
2