STAFF
Employee Performance Review
Employee Name
Position Title
Department or Project Name
Performance Review Period:
From:
Jul
To:
Supervisor:
2014
Tel. #:
Jun
2015
E-mail:
PERFORMANCE STANDARDS
For each performance area described below, rate the performance as either:
1 Exceptional –Performance demonstrates superior performance and effectiveness in carrying out assigned responsibilities.
2 Exceeds Expectations – Performance exceeds requirements of position. Results achieved are often beyond expectation.
3 Meets Expectations – Fully Satisfactory and dependable level of performance. Results are what are expected of competent
employees.
4 Needs Improvement – Performance is below normal expectations. Performance periodically falls short of acceptable standards.
5 Unsatisfactory – Consistently performs below adequate level. Failing to meet requirements and needs immediate improvement.
****You must provide supporting rationale (specific examples and comments) for each area of performance.****
SUMMARY OF OVERALL PERFORMANCE
AREAS TO BE EVALUATED
Quality of Work – Ability to provide neat, accurate and thorough quality work at an appropriate level based on understanding
gained through experience, education and training. Adheres to policies, procedures and remains current with work related
developments.
Specific examples and comments (REQUIRED)
Please Select a Rating
Quantity/Timeliness of Work – Ability to produce required volume of work in a timely manner.
Specific examples and comments (REQUIRED)
Please Select a Rating
Initiative – Ability to begin and complete assignments without specific directions; recognize problems and apply or suggest viable
solutions. Ability to make sound and accurate decisions.
Please Select a Rating
Specific examples and comments (REQUIRED)
Adaptability/Versatility – Willingness to learn new tasks and adapt to change; establish priorities and handle various tasks
simultaneously; perform job under pressure or in critical situations.
Specific examples and comments (REQUIRED)
Please Select a Rating
Cooperation/Relations – Ability and willingness to cooperate with associates, supervisors and subordinates to accomplish job
requirements and meet the customers’ needs to ensure the success of the division. Interactions with others foster a positive and
productive work environment.
Specific examples and comments (REQUIRED)
Please Select a Rating
Communication Skills – Ability to effectively convey ideas, thoughts and information clearly and concisely to others in oral and/or
written form.
Please Select a Rating
Specific examples and comments (REQUIRED)
Confidentiality – Ability to handle sensitive information in a confidential manner. Maintains high level of discretion in regards to
departmental information.
Please Select a Rating
Specific examples and comments (AS APPLICABLE)
Attendance – Employee demonstrates that they can be relied upon to complete their job with respect to punctuality, attendance,
breaks, reliefs and willingness to work when needed.
Specific examples and comments (AS APPLICABLE)
Please Select a Rating
Rev. 05/2012
2
Health and Safety Standards – Ability to follow safety policies and procedures. Maintains acceptable health and personal hygiene
as related to the individual work environment.
Specific examples and comments (AS APPLICABLE)
Please Select a Rating
Goals and Action Plan – This section is an overall evaluation of accomplishing the goals and action plans established for the
current review period.
Specific examples and comments (REQUIRED)
Please Select a Rating
THIS SECTION IS FOR SUPERVISORY EMPLOYEES ONLY
Supervision/Leadership Skills – Ability to plan, organize and control work activities in a professional manner; train, motivate and
maintain morale; evaluate performance and communicate at all levels.
Specific examples and comments (REQUIRED)
Please Select a Rating
GOALS AND ACTION PLAN FOR NEXT REVIEW PERIOD
GOAL 1
ACTION PLAN
PROJECTED COMPLETION DATE
GOAL 2
Please Select One
ACTION PLAN
PROJECTED COMPLETION DATE
Rev. 05/2012
Please Select One
3
GOAL 3
ACTION PLAN
PROJECTED COMPLETION DATE
GOAL 4
Please Select One
ACTION PLAN
PROJECTED COMPLETION DATE
Please Select One
EMPLOYEE COMMENTS
This section may be used to provide feedback to your supervisor on what can be done to assist you in performing your job. For
example, you could address training or equipment needs, safety issues, improvements to policies and/or procedures, etc.
EMPLOYEE COMMENTS (Optional)
SIGNATURES
Date
Employee’s Signature
This performance evaluation has been completed to assist you in your job performance and development. Your signature does not
necessarily imply that you agree with the comments or rating, but that your supervisor has reviewed the document with you.
Supervisor’s Signature
Date:
Director’s Signature
Date:
Next Higher Level
Reviewer’s Signature
Date:
Human Resources
Date:
Final Rating Score 0.00
Rev. 05/2012
4