Leadership Performance Review
NOTE: Do a file, save as, to save this form for your use and to insure that your entries are
saved.
Name:
Appraiser’s Name:
Employee Title:
Department:
Employee Number:
Appraisal Period From:
To:
Part I. Competency Evaluation – How This Employee Achieved Results
Ratings for competencies evaluate the degree to which employees used their skills and knowledge in
achieving results. While comments are only mandatory for competencies evaluated as Does Not Meet
Expectations or Exceeds Expectations, managers are encouraged to substantiate all ratings by
commenting on each competency.
Core Competencies
Assess all employees on each of the competencies listed in this section by placing the appropriate
rating (N, M, or E) in the “Rating” column.
N: Does Not Meet Expectations
Competency
M: Meets Expectations
Comments
Strategic Leadership
Able to inspire, influence, and enable
others to achieve a specific mission.
Drive for results/initiative. Helps others
understand the LGSTX Values.
Business & Organization
Knowledge
Having a solid knowledge of LGSTX’s
businesses and organization. Ability to
identify and learn new information.
Decision Making
Acts on and makes timely decisions
with business direction. Delegates
decision-making authority to level with
capability and information closest to
the internal or external customer.
Customer Focus
Ability to anticipate and meet
internal/external customer needs in
timely manner. Ensures customer
satisfaction through process of
monitoring, developing, improving, and
delivering excellence in products and
service.
Professional Demeanor
Presents a professional image at work
and within the community. Is
approachable and able to relate with
people at all levels in the organization.
Is highly visible and available at
1
E: Exceeds Expectations
Rating
important functions and during high
volume work periods.
Valuing People
Competence can be seen by how well
self and others are developed.
Effectively manages human capital.
Provides timely feedback, both positive
and negative. Demonstrates
care/concern for employees.
Teamwork
Builds winning teams. Works effectively
with others to accomplish goals/resolve
problems.
Communications
Is viewed as a good communicator.
Plans and anticipates information
requirements for effective management
of area.
Accountability
Makes aggressive commitments and is
willing to be judged against them.
Trustworthy with unyielding integrity.
Demands high level of accountability
within all areas of responsibility.
Vision / Direction Setting
Ability to provide clear sense of
direction for organization/department.
Secures relevant information. Identifies
key issues and sets priorities.
Drive for Results / Resource
Management
Identifies new ways to improve quality,
productivity and customer service.
Maximizes talents and abilities. Uses
available resources efficiently (e.g.,
time, materials, people).
Building Trust
Ability to demonstrate honesty, keep
commitments, and hold people
accountable. Treats people with dignity
and respect. Is highly
visible/approachable. Viewed as a
competent leader.
Safety
Focuses on safety when managing
operations and projects.
Develops/implements safety standards
when unique projects are required.
Overall Evaluation of Competencies
Please assign an overall rating for the competencies described above by placing an “X” in the appropriate box.
You may assign only one rating.
Does Not Meet Expectations
Meets Expectations
2
Exceeds Expectations
Part II. Summary of Results Achieved for Review Period:
Describe specific goals and results achieved during the year.
1. Describe Goal:
2. Timeline:
3. Results:
1. Describe Goal:
2. Timeline:
3. Results:
1. Describe Goal:
2. Timeline:
3. Results:
Overall Comments on Goal Attainment
Part III. Goals for Next Review Period:
Describe specific goals and results in which you hope to have the employee achieve next year.
1. Describe Goal:
2. Timeline:
3. Expected Results:
1. Describe Goal:
2. Timeline:
3. Expected Results:
1. Describe Goal:
2. Timeline:
3. Expected Results:
Employee Comments
The employee can provide any additional comments that he/she believes are important for describing
the employee’s performance and contributions, including any factors that may have positively or
adversely impacted performance.
3
Part IV. Pay Rate
Current Pay Rate
Percent Increase
$_______________
_______________%
New Pay Rate
Effective Date
$_______________
_______________
Part V. Signatures
The employee should sign below to acknowledge having received this appraisal and having the
opportunity to discuss its contents with the appraiser. Signing does not indicate agreement with the
contents of this appraisal, and the employee may comment as appropriate.
_________________________________
Appraiser’s Name (print name)
______________________________
_________________________________
Date_____________________
Employee’s Signature
Appraiser’s Signature
_________________________________
Title
___________________________
Date
4