Performance Assessment
Employee Name
Title
Please check the appropriate box as indicated.
SA=Strongly Agree A=Agree IP=Improvement Possible D=Disagree
Communication
Speaks clearly and concisely.
Is an effective listener.
Communicates effectively in writing.
Employee Self-Evaluation:
Date
SD=Strongly Disagree
SA A IP D SD
Supervisor Comments/Action Plan:
Interpersonal Relations
Understands the importance of on-the-job relationships; facilitates
relationships that add to his/her individual job success and to the success of
others.
Exhibits tact, sensitivity, and discretion.
Is proactive and responsive with colleagues and co-workers.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Teamwork
Can be counted on to help others inside and outside the department to
accomplish institutional goals.
Shares information and collaborates with other team members which enables
the entire group to be effective; volunteers assistance.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Customer Service
Is attentive and responsive to customers’ needs and requests.
Is consistently courteous and respectful to customers.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
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Job Knowledge
Demonstrates understanding of daily job requirements, equipment operation,
systems navigation.
Keeps up to date with technical advances in the field.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Quality of task performance
Accuracy, clarity, consistency and thoroughness of work.
SA A IP D SD
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Productivity
Completes amount of work required and paces self to meet demands of
assignments.
Work assignments are effectively planned and organized to meet deadlines.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Initiative
Is self-motivated and requires little prompting from supervisor.
Anticipates needed action; suggests better ways of doing things.
Identifies, prevents and/or recommends solutions to problems.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Reliability
Is dependable and follows through on commitments in a timely manner,
meeting daily, weekly, and monthly deadlines.
Can be relied upon to see tasks through to completion and to ensure that
tasks are performed comprehensively.
Employee Self-Appraisal:
SA A IP D SD
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Supervisor Comments/Action Plan:
Departmental/Institutional Knowledge
Understands and acts on pertinent departmental and program policies and
procedures.
Understands and acts on pertinent district policies and procedures.
Employee Self-Appraisal:
SA A IP D SD
Supervisor Comments/Action Plan:
Overall Rating


Meets expectations
Does not meet expectations, performance improvement plan to be completed.
Overall Comments:
Development/Training Plan
Describe the additional training or development activities an employee should take to keep skill
levels current, prepare for the future, meet changing job requirements, or overcome identified
weaknesses or skill deficits that have had an impact on performance.
Personal Career Goal
NOTE: Employees who have completed the one year probationary period are eligible to participate
in the Career Incentive Program. Describe the development work an employee will undertake
based on personal career objectives. This may include preparing for a career change or striving
toward a new challenge or promotion.
Employee: I understand that my signature does not necessarily indicate agreement and that I have
the right to attach to this evaluation my comments that I will submit within five (5) working days.
Employee: ____________________________________________
Date: ___________
Supervisor: ____________________________________________
Date: ___________
Director/Dean (if applicable): __________________________
Date: ___________
Vice President: _________________________________________
Date: ___________
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