Employee Name
Supervisor / Manager
Job Title
Type of review
[ ] Annual [ ] 6 month [ ] Other
Employee signature
Department
Period covered by the review
Review date
Date

Specify objectives from the previous review period and consider to what extent they were achieved or fulfilled. 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
Comments
Objective #2
Comments
Objective #3
Comments

Use this section to describe employee performance in specific work areas. Provide comments as needed. Questions to consider when providing your comments.
1.
How did you perform on these factors in the past review period?
2.
Are there any of these factors on which you performed exceptionally well?
3.
Are there factors on which you might have performed better, or would like to improve upon in the future?
Job Knowledge
 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
Comments
Decision Making / Judgment
 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
Comments

Personal / Personnel Development
 Takes initiative / ownership
 Seeks out personal development opportunities
 Provides feedback and coaching
 Motivates, challenges and develops employees
 Takes mentoring role
 Accepts mistakes
 Defines roles and responsibilities
Comments
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
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

Problem Solving
 Breaks down problems into smaller 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
Work environment / Safety
 Promotes mutual respect
 Keeps workplace safe and clean
 Supports safety program
Comments

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: