Revised 5/2012
FNP
Performance Evaluation
Nutrition Program Assistant and Associate
Name
Evaluator
Title
From
To
To
(Dates of performance evaluation period)
OBJECTIVES
Performance evaluations enable employees and supervisors to work together to achieve performance expectations in key
areas, promote both the organization’s development and personal development, and foster commitment and mutual
understanding of the mission, vision, and values of the organization. Key objectives include:
Serve as an important communication tool for expectations and providing feedback on performance between employees
and supervisors. Actively involve employees in the process, establish performance evaluation as an important aspect of
meeting organizational goals.
Increase mutual understanding of job expectations and results. Provide information to plan for personal improvement and
professional growth.
Enhance individual productivity for meeting organizational goals.
Provide a fair and objective basis for making personnel decisions, including salary determination, promotion, transfer and
separation.
RATINGS
U
Unsatisfactory - significantly fails to meet the expectations for the criterion. Improvement in performance on
specific recommendations is mandatory. Unsatisfactory rating will result in disciplinary action up to and
including termination (see progressive discipline policy).
NI
Needs improvement - does not meet the expectations of the criterion. Specific areas of improvement are easily
identified. Failure to improve may result in an unsatisfactory rating on future evaluations and may result in
further disciplinary action (see progressive discipline policy).
ME
Meets Expectations – meets the expectations of the criterion and requires minimal supervision.
E
Exceeds expectations - exceeds the expectations for the criterion. Work is high quality and employee requires
minimal supervision.
S
Superior - consistently provides superior level work. Demonstrates self-motivation to achieve goals and
objectives for self, clients, and colleagues.
Page 1 of 5
CRITERIA AND PERFORMANCE MATRIX
For each criterion, indicate the level of performance you believe this person has demonstrated during the evaluation
period. Use the matrix and rating descriptions as a guide for identifying performance ratings for each criterion.
1. Teaching and Engaging Audiences
Unsatisfactory
Teaching time averages
2 hours or less per day
worked.
Needs Improvement
Fails to teach on
average 3 hours per
day worked.
Meets
Teaches on average 3
hours per day worked.
Exceeds
Teaches on average 4
hours per day worked.
Superior
Teaches on average
more than 4 hours per
day worked.
Needs Improvement
Has 1 SMNED in place
each week and no
corresponding
materials.
Meets
Has 1 SMNED in place
each week with
corresponding
materials.
Needs Improvement
Assists with Food
Power events but
schedules less than 1.5
events per year.
Meets
Schedules an average
of 1.5 Food Power
events per year (3
events/2 years). Assists
with Food Power
events.
Exceeds
Superior
N/A
N/A.
Needs Improvement
Teaches at least 3
target audiences, but
does not include both
youth and adult.
Meets
Teaches 3 of the target
audience groups and
has them preapproved
by the Regional
Coordinator. Teaches
both youth and adults.
Exceeds
Reaches 3 or more
target audiences,
including youth and
adult. Adds at least one
new site annually to
teaching schedule.
Rating and Comments:
2. Display Boards
Unsatisfactory
Does not use the
SMNED displays for
indirect teaching.
Exceeds
N/A
Superior
N/A
Rating and Comments:
3. Food Power
Unsatisfactory
Never assists with Food
Power events. Schedules
less than 1.5 events per
year.
Rating and Comments:
4. Target Audience
Unsatisfactory
Does not teach youth
and adult.
Superior
Reaches 4 or more
target audiences,
including youth and
adults. Adds two or
more sites annually to
teaching schedule.
Rating and Comments:
Page 2 of 5
5. Curriculum
Unsatisfactory
Fails to use approved
curriculum.
Needs Improvement
Deviates from approved
curriculum.
Meets
Teaches approved
curriculum and
activities. Ensures
materials are sent home
with participants.
Exceeds
Teaches approved
curriculum and
activities, including
taste-testing at half of
teaching sessions.
Ensures materials are
sent home with
participants.
Superior
Teaches approved
curriculum. Follows up
with participants to
learn how they are
using the materials at
home.
Rating and Comments:
6. Paperwork (i.e. timesheets, schedules, program information forms, evaluations, travel, etc)
Unsatisfactory
Fails to submit
paperwork on time,
Paperwork is not
completed correctly.
Does not complete
electronic calendar.
Needs Improvement
Paperwork is submitted
sporadically. Often is
completed incorrectly.
Electronic calendar not
accurate and up todate.
Meets
Submits paperwork
every two weeks.
Paperwork is
completed accurately.
Uses electronic
calendar. Notifies
Coordinator of any
changes in advance
Exceeds
Superior
N/A
N/A
Meets
Attends regional staff
meetings on a regular
basis and is engaged in
the trainings.
Exceeds
Attends regional staff
meetings on a regular
basis and is engaged in
the trainings. Engages
in providing feedback
on trainings needed.
Superior
Meets
Maintain effective
internal and external
partnerships.
Communicate program
value. Demonstrate
personal
accountability.
Exceeds
Superior
N/A
N/A
Rating and Comments:
7. Professional Development
Unsatisfactory
Does not attend regional
staff meetings on a
regular basis or has
multiple absences on
training days.
Needs Improvement
Attends regional
trainings but is not
engaged in the
discussions or training
activities.
N/A
Rating and Comments:
8. Professional Behavior
Unsatisfactory
Does not maintain
effective internal and
external partnerships.
Does not communicate
program value. Does
not demonstrate
personal accountability.
Needs Improvement
Effective internal and
external partnerships
are inconsistent.
Communicating
program value and
demonstrating personal
accountability is
inconsistent.
Page 3 of 5
Rating and Comments:
9. Program Associate Duties (if applicable)
Unsatisfactory
Does not provide
trainings for other
professionals serving the
low income audience
Needs Improvement
Training is not based
upon needs identified.
Meets
Upon Coordinator’s
approval, provides
training for
professionals serving
the target audience
Exceeds
Upon Coordinator’s
approval, provides
training for
professionals serving
the target audience.
Meets with agency
professionals to
determine future
training needs.
Superior
Is invited to participate
in committees involved
in nutrition education
within the community
Rating and Comments:
Overall Summary
Overall Ratings
U
NI
M
E
S
# of Ratings Total
Evaluators Comments
Areas of strength:
Areas for program improvement and professional growth:
Note: Any criterion that is rated unsatisfactory or needs improvement shall be addressed in this section. It shall include a statement
on specific items that need attention and suggestions for improvement.
Goals for the next appraisal period:
Page 4 of 5
Employee Input
Coaching, training or development activities that would help you pursue improved performance, job
growth and learning:
Overall comments:
A formal performance counseling session was held on
__________________________________
Evaluator Signature
(date)
________________________________
Employee Signature
(date)
*Employees signature acknowledges that the contents of the performance evaluation were made known to the employee during the performance
evaluation session and that his/her signature does not represent agreement or disagreement.
Page 5 of 5