"Fire Department Employee Performance Evaluation Form"

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Fire Department Employee Performance Evaluation
Name:
Position:
Supervisor:
Company:
Chief or others to be present:
Date of this
Date of last
Next scheduled
Evaluation
/
/
Evaluation
/
/
Evaluation
/
/
Reason for Evaluation:
Annual
Probation
Policy Infraction
Missed critical participation requirement
Instructions: Evaluate the employee's work performance as it pertains to the job requirements. Circle the letter
that best describes the employee's performance since the last evaluation. Add comments to support the
evaluation. Critical job participation requirements must be met to receive a satisfactory evaluation unless the
supervisor agrees that the employee’s explanation is acceptable.
CRITICAL JOB PARTICIPATION REQUIREMENTS:
S - Satisfactory
U - Unsatisfactory
Factors
Evaluation
Comments
EMERGENCY CALLS
______________________________________________
Attends 25% or more of the
______________________________________________
paged emergency calls.
S
______________________________________________
______________________________________________
(reviewed quarterly)
U
DRILLS
______________________________________________
Attends or makes up twenty (20)
______________________________________________
or more drills annually including
S
______________________________________________
all mandatory drills.
______________________________________________
U
(reviewed quarterly)
COMPANY MEETINGS
______________________________________________
Attends 9 or more (75%) of their
______________________________________________
designated company meetings
S
______________________________________________
annually.
______________________________________________
(reviewed quarterly)
U
Fire Department Employee Performance Evaluation
Name:
Position:
Supervisor:
Company:
Chief or others to be present:
Date of this
Date of last
Next scheduled
Evaluation
/
/
Evaluation
/
/
Evaluation
/
/
Reason for Evaluation:
Annual
Probation
Policy Infraction
Missed critical participation requirement
Instructions: Evaluate the employee's work performance as it pertains to the job requirements. Circle the letter
that best describes the employee's performance since the last evaluation. Add comments to support the
evaluation. Critical job participation requirements must be met to receive a satisfactory evaluation unless the
supervisor agrees that the employee’s explanation is acceptable.
CRITICAL JOB PARTICIPATION REQUIREMENTS:
S - Satisfactory
U - Unsatisfactory
Factors
Evaluation
Comments
EMERGENCY CALLS
______________________________________________
Attends 25% or more of the
______________________________________________
paged emergency calls.
S
______________________________________________
______________________________________________
(reviewed quarterly)
U
DRILLS
______________________________________________
Attends or makes up twenty (20)
______________________________________________
or more drills annually including
S
______________________________________________
all mandatory drills.
______________________________________________
U
(reviewed quarterly)
COMPANY MEETINGS
______________________________________________
Attends 9 or more (75%) of their
______________________________________________
designated company meetings
S
______________________________________________
annually.
______________________________________________
(reviewed quarterly)
U
JOB PERFORMANCE:
S - Satisfactory
U - Unsatisfactory
Factors
Evaluation
Comments
PUBLIC RELATIONS
______________________________________________
Attends community service
______________________________________________
events, does station tours or
S
______________________________________________
other public service.
______________________________________________
U
TASK ASSIGNMENTS
______________________________________________
Can be relied upon to complete
______________________________________________
tasks correctly and on time.
S
______________________________________________
(equipment checks, special
______________________________________________
projects etc.)
U
TASK PERFORMANCE
______________________________________________
Able and willing to perform job
______________________________________________
functions at the appropriate level.
S
______________________________________________
______________________________________________
U
ATTENTION TO POLICY
_______________________________________________
Follows S.O.Gs, safety
_______________________________________________
regulations etc. Meets minimum
S
_______________________________________________
requirements for membership.
_______________________________________________
U
INTERPERSONAL SKILLS
_______________________________________________
Willingness and ability to
_______________________________________________
communicate, cooperate, and
S
_______________________________________________
work with co-workers and
_______________________________________________
supervisors.
U
Accomplishments
Future Plan For Areas That Need Improvement
Recommendations for Career Development - Schooling, Seminars etc....
Employee's overall performance:
Satisfactory
Probation for next 12 months.
Unsatisfactory.
A second unsatisfactory within 12 months is cause for dismissal.
Follow up necessary every 3 months.
Comments
Follow Up Required: _______ YES _______ NO
Follow Up Date:
______ / ______ / ______
Employee Signature:
Supervisor Signature:
________________________
________________________
Fire Chief: ________________________________
Battalion Chief: ____________________________
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