Employee Name
Job Title
Department
Supervisor / Manager
Period covered by the review
Type of review
Review date
[ ] Annual [ ] 6 month [ ] Other
Signature of reviewing manager
Signature of 2nd level review manager
Employee signature
Date
Review Summaries
This section summarizes employee performance in specific work areas.
Summary: Employee Objectives for Past Review Period
Overall average score:
Summary: Employee Performance in Key Areas
Overall average score:
Employee Objectives for Past Review Period
Specify objectives from the previous review period and consider to what extent they were
achieved or fulfilled. In the space provided, mark the appropriate rating. Use comments to
explain any change to objectives that occurred during the year and/or to identify all factors that
caused the goal to be met or not met.
Objective #1
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Comments
Objective #2
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Comments
Objective #3
Comments
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Employee Performance in Key Areas
Use this section to describe employee performance in specific work areas. In the space provided,
mark the appropriate rating. Provide comments as needed.
Job Knowledge
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Understands job duties and responsibilities
Has necessary job skills and knowledge
Has necessary technical skills
Understands and is able to operate
equipment
Understands County mission and values
Keeps job knowledge current
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance

Comments
Decision Making / Judgment
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Recognizes problems and responds
Systematically gathers information
Sorts through complex issues
Seeks input from others
Makes timely decisions
Addresses root cause of issues
Can make difficult decisions
Uses consensus when possible
Communications decisions to others
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Comments
Personal / Personnel Development
 Takes initiative / ownership
 Seeks out personal development
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opportunities
Provides feedback and coaching
Motivates, challenges and develops
employees
Takes mentoring role
Accepts mistakes
Defines roles and responsibilities
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Comments
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Interpersonal Skills
 Has good listening skills
 Networks and builds strong relationships
 Is flexible and open minded
 Negotiates effectively
 Seeks out performance feedback
 Accepts constructive criticism
Comments
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Communication
 Communicates both verbally and in writing
 Creates accurate and punctual reports
 Delivers effective presentations
 Shares information and ideas with others
 Has good listening skills
Comments
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Problem Solving
 Breaks down problems into smaller
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
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components
Understand underlying issues
Can simplify and process complex issues
Understands the difference between critical
details and unimportant facts
Comments
Teamwork
 Contributes to team projects
 Exchanges ideas, opinions
 Helps prevent, resolve conflicts
 Works well with other departments
 Develops positive working relationships
 Is flexible and open minded
Comments
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Work environment / Safety
 Promotes mutual respect
 Keeps workplace safe and clean
 Supports safety program
Rating
[ ] 1 Unsatisfactory Performance
[ ] 2 Improvement Desired
[ ] 3 Meets Expectations
[ ] 4 Exceeds Expectations
[ ] 5 Exceptional Performance
Comments
Employee Objectives for Upcoming Review Period
Use the following section to record major accountabilities and goals for the next review period.
In the space provided, specify the objectives and describe how to measure whether they are
achieved.
Objective #1
Measurement of objective achievement:
Timeframe:
Objective #2
Measurement of objective achievement:
Timeframe:
Objective #3
Measurement of objective achievement:
Timeframe: