Janus Youth Programs, Inc.
EMPLOYEE PERFORMANCE EVALUATION
AND DEVELOPMENT REVIEW
(not for supervisors or directors)
Introductory
Date:
Regular
______
Name:
Program:
Period covered
by this review: From
Position:
to
.
Purpose of this Evaluation and Development Review
This form serves as a guideline for employees and supervisors to jointly review and plan goals,
performance standards and commitments. Direct and open communication about all aspects of the
employee's current job performance against specific goals, tasks and projects is essential to make
this discussion valuable to both the agency and the employee. This form is intended for use by
employees and their respective supervisors and managers. Each will retain a copy. A copy will also
be kept in the employee’s personnel file.
Levels of Performance
There are three possible levels of performance: 1) the employee meets or exceeds job expectations.
2) The employee needs continued improvement in performance, but is not currently below the
minimum expectations; and 3): The employee is currently below minimum expectations for the
position in one or more areas and must show immediate and continuous improvement in order to
continue employment.
Performance Evaluation
Part I is the EVALUATION section; its focus is the performance of the employee during the time
period covered by this appraisal. Performance is evaluated on job responsibilities as indicated in the
employee’s job description. Strengths, assets, and growth areas (or areas needing improvement)
and any areas of performance that have been below minimum expectations during the evaluation
period (if applicable) should be discussed as part of the evaluation meeting with the employee. Areas
requiring improvement or that are below minimum performance standards should be noted in the
appropriate boxes. Improvements noted should be included wherever applicable.
Development Planning
Part II is the Staff Development Plan; its focus is on present and future professional development of
the employee, and includes identifying specific goals for the next evaluation period related to the
employee’s ongoing knowledge and skill development.
Any area below minimum, if applicable, is not an area of growth, but rather an area of required
change. These areas are addressed in Part I, and require a work improvement plan. The future
refers to goals for performance in the coming review period. If there are any job functions below
minimum in Part I, or that require improvement, the first goal becomes successful completion of the
required work plan.
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Evaluation form
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Part I: Evaluation of Performance: Nonexempt
Basic Day to Day Job Functions
Satisfactory
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Punctuality
Dependability
Attendance
Use of Leave*
Unsatisfactory
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*Do not include any leave which has a protected status such as
family medical leave, military leave, jury duty.
Training Requirements completed (including annual updates)
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Orientation I
Orientation II
Orientation III
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Orientation IV
First Aid
Food Handlers
TB Clearance
NPI # Obtained
Bloodborne Pathogens/Universal Precautions
Mandatory Reporting
Behavior Management Training
Environmental Emergencies (Earthquake, etc)
Other: - (Identify)
_____________________
_____________________
_____________________
_____________________
NOTE:
(Note: Not all of these are required for every position)
Yes
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No
N/A
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NPI # required for staff at Annex I, Annex II, Buckman House, Cordero House and Imani House

Job Responsibilities
reviewed the employee’s job description (copy attached). We have
Reviewed essential functions, duties and responsibilities and discussed the employee’s strengths and assets, growth areas,
and any areas below minimum performance standards.
fully meets or exceeds job performance standards in all areas of the job description.
Recognized strengths and/or contributions:
Continuous improvement is needed in the following areas.
not currently meeting job performance standards in one or more areas described
on the attached work plan.
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Part II: Employee Development Plan
Supervisor and Employee identify at least 3 specific goals for the next evaluation period related to the
employee’s ongoing knowledge and professional development.
1.
2.
3.
Please mark the box applicable: (“introductory” and/or “regular” status does not apply to temporary workers)
1. Introductory Employee:
Employee has successfully completed the introductory period of employment and
is now considered a regular status employee.
Employee’s introductory period is extended for up to a maximum of ____ days to demonstrate the
ability to meet minimum performance expectations in all areas of the job description. See work plan
attached.
2. Regular Employee:
Employee currently meets or exceeds job performance expectations in all areas of responsibility.
Employee is being placed on a work plan. A follow up review will be completed within
the next _______days to determine the employee’s progress in meeting performance expectations in the
problem areas that have been identified. This is not a guarantee of employment for the next
days; in
accordance with current personnel practices, employees of Janus Youth Programs are “at will” and are
employed without any commitments as to duration of employment. This means that you may resign or
that the organization may terminate the employment relationship at any time for whatever reason the
employee or the organization consider appropriate.
Employee is being placed on probation for _____days. A follow up review will be completed within
the next _______days to determine the employee’s progress in meeting job performance expectations. .
This is not a guarantee of employment throughout the probationary period. In accordance with current
personnel practices, employees of Janus Youth Programs are “at will” and are employed without any
commitments as to duration of employment. This means that you may resign or that the organization
may terminate the employment relationship at any time for whatever reason the employee or the
organization consider appropriate.
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Employee Signature*
Date
Supervisor Signature
Date
__________________________________
Program Director Signature
Date
*Employee’s signature indicates that the written evaluation was reviewed with her/him by the supervisor. It
does not necessarily indicate agreement with the content. The employee has the right to attach additional
written information within seven days of the review with the supervisor.
Cc: Personnel file
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