District-Level Non-Instructional Professional Technical Evaluation Form
Employee’s Name
Department
Job Assignment/Title
Self-Evaluation
2014-2015 REV.
Employee ID
School Year
Interim Evaluation (Optional)
Final Evaluation/Summary
Domain 1: Environment and Efficacy
1a. Promoting a Positive Work Environment - The highly effective employee promotes a positive work environment, demonstrates knowledge, and applies best
practices in assigned areas of responsibility. The employee promotes a culture of inclusivity and acceptance and understands the impact culture has on the work
environment. The employee inspires confidence, trust, and generates commitment to the vision and mission of the District.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating - Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
1b. Managing the Work Environment - The highly effective employee manages resources in ways that maximize their use as appropriate to his or her area of
responsibility. The employee productively and efficiently manages the volume of work assigned to his or her area of responsibility and builds individual accountability.
The employee promotes a safe, efficient, legal, and effective work environment.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
1c. Developing a Shared Efficacy - The highly effective employee promotes a vision for the assigned area of responsibility that aligns with and supports the District’s
vision. Interactions with colleagues demonstrate ownership in and align with the vision and goals of the District. The employee exhibits the knowledge, skills, and
dispositions to develop, articulate, and implement a shared vision.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
Domain 2: Commitment, Collegiality, and Initiative
2a. Supporting the Mission and Goals of the District - The highly effective employee works in a collegial manner with all stakeholders. Interactions with others
promote and support the mission and goals of the District.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
2b. Demonstrating Consideration for Others – The highly effective employee considers the position and perspectives of others when planning, organizing, and making
decisions. The employee modifies collaboration and communication methods as appropriate to the task and/or audience.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
1
CJ/JR PD
District-Level Non-Instructional Professional Technical Evaluation Form
2014-2015 REV.
2c. Building and Maintaining Positive Relationships – The highly effective employee builds positive relationships to ensure that key stakeholders work effectively with
each other to achieve sustainable and transformative results. The employee sustains transparent relationships with stakeholders and collaborates with stakeholders
to create and maintain quality service within the organization.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
2d. Serving as a Change Agent – The highly effective employee systematically considers more effective ways of doing things and is reflective and resilient in the role of
change agenda. The employee leads the change process based upon situational awareness and pacing of various change initiatives.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
Domain 3: Decision-Making and Support Strategies
3a. Demonstrating Use of Decision-Making Strategies - The highly effective employee plans effectively, using critical thinking and problem solving techniques that
support system improvement. The employee collects and analyzes data from multiple sources to improve and modify decision-making processes.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐ Not Applicable
☐ Not Applicable
☐ Not Applicable
3b. Building Capacity & Providing Differentiated Support to Stakeholders – The highly effective employee provides stakeholders with feedback and support in a
reasonable timeframe and courteous manner; communicates and collaborates with stakeholders to provide a differentiated/coordinated support system.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐ Not Applicable
☐ Not Applicable
☐ Not Applicable
3c. Demonstrating Expertise - The highly effective employee demonstrates the expertise, knowledge, and qualifications needed to provide quality support to schools.
The employee serves as a resource to stakeholders as appropriate to his or her area of responsibility.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐ Not Applicable
☐ Not Applicable
☐ Not Applicable
3d. Supporting Stakeholder Improvement – The highly effective employee assists stakeholders in improving data use processes and calls on District stakeholders with
special expertise to assist with data analysis/use as appropriate.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating - Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐ Not Applicable
☐ Not Applicable
☐ Not Applicable
3e. Responding to Stakeholder Needs – The highly effective employee provides schools with direct services and support needed to build capacity at the school level.
The employee responds to school needs with differentiated support strategies.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐ Not Applicable
☐ Not Applicable
☐ Not Applicable
2
CJ/JR PD
District-Level Non-Instructional Professional Technical Evaluation Form
2014-2015 REV.
Domain 4: Continuous Improvement, Professional Responsibility, and Ethical Conduct
4a. Seeking Continuous Professional Improvement – The highly effective employee designs and implements a professional growth plan for himself or herself and all
direct reports, as appropriate to his or her level of responsibility. The employee serves as a resource and/or mentor to others in his or her area of expertise.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
4b. Adhering to District Policies, Procedures, and Guidelines - The highly effective employee adheres to all District guidelines, policies, and procedures. The employee
actively seeks new research, regulations, practices, etc. relevant to his or her area of responsibility to improve professional practice and align support strategies to
District strategic goals.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
4c. Communicating with Stakeholders – The highly effective employee actively listens and clearly expresses ideas orally and in writing for a variety of audiences. The
employee initiates and models collaborative communication skills with stakeholders.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
4d. Demonstrating Professional Responsibility – The highly effective employee presents a positive image of the schools and the District and supports the mission and
strategic goals of the District even when difficult actions are required.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
☐U ☐NI ☐Effective ☐Highly Effective
4e. Demonstrating Professional and Ethical Behavior – The highly effective employee models the principles of professional, moral, and ethical standards of conduct in
all interactions. The employee demonstrates ethical behavior and acts with integrity, fairness, and honesty.
Self-Evaluation
Supervisor’s Rating - Interim
Supervisor’s Rating – Final
☐U/NI
☐Effective/Highly Effective
☐U/NI
☐Effective/Highly Effective
☐U/NI
☐Effective/Highly Effective
Supervisor’s Rating – Interim (Optional)
☐U
3
☐NI
☐Effective ☐Highly Effective
Supervisor’s Rating - Final /Overall
☐U
☐NI
☐Effective
☐Highly Effective
CJ/JR PD
District-Level Non-Instructional Professional Technical Evaluation Form
Planning Date
Interim Review Date
Administrator Signature
Administrator Signature
Administrator Signature
Employee Signature
Comments (Optional):
Employee Signature
Employee Signature
4
(OPTIONAL)
2014-2015 REV.
Summary Review Date
CJ/JR PD
District-Level Non-Instructional Professional Technical Evaluation Form
2014-2015 REV.
OPTIONAL for 2014-2015
Name
District-Level Non-Instructional Professional Technical
Goal Form
Department
Position
Planning Date
Interim Review Date (optional)
Summary/Final Review Date
Employee Signature
Employee Signature
Employee Signature
Supervisor Signature
Supervisor Signature
Goal (Department Goal or Individual Professional Growth Goal)
Goal:
Supervisor Signature
Alignment to District Strategic Plan:
(Identify the component of the Strategic Plan
that aligns with your goal – link to plan
below)
http://www.polkfl.net/districtinfo/departments/learning/aae/docume
nts/StrategicPlan_v11_9_13.pdf
Strategies/Actions: The highly effective employee’s selected strategies are purposefully implemented and modified as needed throughout the
year to increase the positive outcome of the goal. The employee uses related data and progress toward the goal is consistently monitored. The
goal is pursued throughout the year and/or until completion.
Strategy/Action to Achieve Goal
Indicators of Accomplishment/Achievement
Timeline
Supervisor’s Comments:
5
CJ/JR PD