Annual Staff Performance Evaluation Form - Athens State University - Alabama

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ANNUAL STAFF PERFORMANCE EVALUATION
(Non-Faculty Positions)
Employee Name: _______________________________________________________
Job Title: ____________________________________________________________________
Department/Office: ___________________________________________________________
Period of Evaluation:
From ____________________To _____________________
Employment Date: _____________________________________________________
Status (check one):
Probationary
Continuing Service
Temporary
Other
PART I - INSTRUCTIONS
Listed below are six performance factors, six self-management factors, and five supervisory
factors (for supervisors only) that are important in the performance of the staff member’s job.
Performance factors and self-management factors must be utilized for all staff members. The
supervisor factors should be utilized only for staff members with supervisory responsibilities.
NOTE:
A selection of Unacceptable (1), Needs Improvement (2) or Superior (5) requires
comments.
Distribution Instructions:
1. Return the original form to the Office of Human Resources
2. Maintain one copy for departmental records (Optional).
3. Give one copy to the employee.
Marking Instructions:
The supervisor should indicate the staff member’s performance
by circling or checking the appropriate level of performance.
The following evaluation scale guide is being provided to assist the evaluator in assigning the
most appropriate measurement of the staff member’s performance factors, self-management
factors, and supervisory"factors0"
1 - Unacceptable - Consistently fails to meet job requirements; performance clearly below
minimum standards and requirements.
Immediate improvement required to maintain
employment. (Requires comments)
2 - Needs Improvement – Occasionally fails to meet job requirements; performance must
improve to meet expectations of position. (Requires comments)
3 - Meets expectations – Able to perform all job duties satisfactorily. Normal guidance and
supervision are required.
4 - Exceeds expectations – Frequently exceeds job requirements; all or most planned objectives
were achieved above the established standards and accomplishments were made in unexpected
areas as well.
5 - Superior – Consistently exceeds job requirements; this is the highest level of performance
that can be attained. (Requires comments)
ANNUAL STAFF PERFORMANCE EVALUATION
(Non-Faculty Positions)
Employee Name: _______________________________________________________
Job Title: ____________________________________________________________________
Department/Office: ___________________________________________________________
Period of Evaluation:
From ____________________To _____________________
Employment Date: _____________________________________________________
Status (check one):
Probationary
Continuing Service
Temporary
Other
PART I - INSTRUCTIONS
Listed below are six performance factors, six self-management factors, and five supervisory
factors (for supervisors only) that are important in the performance of the staff member’s job.
Performance factors and self-management factors must be utilized for all staff members. The
supervisor factors should be utilized only for staff members with supervisory responsibilities.
NOTE:
A selection of Unacceptable (1), Needs Improvement (2) or Superior (5) requires
comments.
Distribution Instructions:
1. Return the original form to the Office of Human Resources
2. Maintain one copy for departmental records (Optional).
3. Give one copy to the employee.
Marking Instructions:
The supervisor should indicate the staff member’s performance
by circling or checking the appropriate level of performance.
The following evaluation scale guide is being provided to assist the evaluator in assigning the
most appropriate measurement of the staff member’s performance factors, self-management
factors, and supervisory"factors0"
1 - Unacceptable - Consistently fails to meet job requirements; performance clearly below
minimum standards and requirements.
Immediate improvement required to maintain
employment. (Requires comments)
2 - Needs Improvement – Occasionally fails to meet job requirements; performance must
improve to meet expectations of position. (Requires comments)
3 - Meets expectations – Able to perform all job duties satisfactorily. Normal guidance and
supervision are required.
4 - Exceeds expectations – Frequently exceeds job requirements; all or most planned objectives
were achieved above the established standards and accomplishments were made in unexpected
areas as well.
5 - Superior – Consistently exceeds job requirements; this is the highest level of performance
that can be attained. (Requires comments)
PART II - PERFORMANCE FACTORS
1.
Knowledge, Skills, Abilities – (Consider how the staff member understands work assignments, exhibits
the required level of
knowledge and/or skills to perform the job, and uses appropriate techniques,
materials and equipment).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________"
"
Planning and Organization – (Consider how the staff member plans and organizes his/her work load,
2.
maintains an effective work schedule, and coordinates with others).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________"
3.
Quality of Work – (Consider how the staff member completes assignments and meets quality standards,
including but not limited to accuracy, neatness, thoroughness and adherence to applicable standards and
safety rules).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________"
"
Quantity of Work – (Consider the employee’s production results, ability to manage several responsibilities
60
simultaneously, and timeliness in meeting deadlines).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments__________________________________________________________________________________
_____________________________________________________________________________________________"
Cooperation – (Consider to what extent the employee displays a positive, cooperative attitude toward
70
work assignments, co-workers, students, faculty, staff in other departments, and other customers, both
internal and external).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments__________________________________________________________________________________
__________________________________________________________________________________________"
"
Communication – (Consider job related effectiveness in dealing with others, how clearly the staff member
80
expresses ideas , both orally and in writing, and how well he/she listens and responds appropriately. As a
result, the mission of the QEP – “Building Success Through Writing” will be enhanced and supported).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments__________________________________________________________________________________
__________________________________________________________________________________________"
PART III – SELF-MANAGEMENT FACTORS
1.
Work Habits – (Displays appropriate and consistent attendance, punctuality, dependability, availability,
accessibility, and adherence to University policies, procedures, or practices; uses resources efficiently).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________"
"
2.
Teamwork – (Promotes and demonstrates trust, mutual respect, and cooperative working relationships;
supports the University’s vision, mission, goals and objectives; supports and contributes to the attainment
of unit goals and objectives; assists others; shares information as appropriate; supports open and honest
communication;
encourages
and
recognizes
the
contribution
of
others;
places
success
of
organization/unit/team above self-interests; contributes to unit cohesion).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments__________________________________________________________________________________
_____________________________________________________________________________________________
Customer Service – (Communicates courteously and effectively to customers; listens carefully and with
3.
interest; assumes responsibility; asks questions in a caring and concerned manner; apologizes without
blaming; responds in a timely manner; follows through to ensure problem is solved).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments _________________________________________________________________________________
____________________________________________________________________________________________
4.
Initiative/Innovation – (Plans ahead, initiates continuous improvement; uses creative and/or innovative
thinking and problem solving).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________
5.
Adaptability – (Adapts to change, accepts constructive feedback and suggestions; receptive to new ideas;
listens to others).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
_____________________________________________________________________________________________"
"
6.
Judgment – (Reasons logically; effectively analyzes problems and identifies solutions, determines
appropriate action; and exhibits timely and decisive action).
Unacceptable…………………………………….Superior
1
2
3
4
5
Comments___________________________________________________________________________________
____________________________________________________________________________________________
PART IV –
This section is optional, but is provided for the supervisor to list essential duties and
responsibilities that are relevant to this particular position. Attach additional sheets if necessary.
Essential Duties & Responsibilities
Rating
Unacceptable…………………….………Superior
1)
1
2
3
4
5
2)
1
2
3
4
5
3)
1
2
3
4
5
4)
1
2
3
4
5
5)
1
2
3
4
5
6)
1
2
3
4
5
7)
1
2
3
4
5
8)
1
2
3
4
5
9)
1
2
3
4
5
10)
1
2
3
4
5
PART V – SUPERVISORY FACTORS
Use the supervisor’s insert for all staff members who have supervisory responsibilities. Non-supervisory staff
DO NOT NEED Part V.
PART VI –
This performance evaluation is based on my observation and knowledge of both the employee and
the job responsibilities.
Reviewing Supervisor: _____________________________
Date: ____________________
PART VII – TO THE STAFF MEMBER:
I have been advised of my performance ratings. I have discussed the contents of this review with my supervisor.
My signature does not necessarily imply agreement. My comments are as follows (optional) (attach additional
sheets if necessary):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Employee Signature: _____________________________
Date: _______________________________
Job Description Reviewed (employee initial):_______________
PART V - SUPERVISORY FACTORS (This section is only for employees with supervisory
responsibilities). This page is not required to be submitted unless it is applicable to this
employee.
1. Leadership – (Consider how well the supervisor demonstrates effective supervisory abilities, sets goals and
priorities, gains respect and cooperation, inspires and motivates subordinates, models good work habits and
behaviors, directs subordinates toward common goals, promotes cooperation between departments and
supports administrative decisions).
Unacceptable…………………………………….Superior
N/A
1
2
3
4
5
Comments: _______________________________________________________________________________
__________________________________________________________________________________________
2. Delegation/Coordination – (Consider how well the supervisor demonstrates the ability to direct others in
accomplishing work, effectively selects and motivates staff, gives clear instructions, defines work assignments,
appropriately distributes workload, oversees the work of subordinates, and coordinates with subordinates and
other staff).
Unacceptable…………………………………….Superior
N/A
1
2
3
4
5
Comments: ______________________________________________________________________________________
_________________________________________________________________________________________________
3. Planning and Organizing – (Consider how well the supervisor plans and organizes work for self and others;
coordinates with others, establishes appropriate priorities, anticipates future needs, allocates time and
resources, and carries out assignments effectively).
Unacceptable…………………………………….Superior
N/A
1
2
3
4
5
Comments:_______________________________________________________________________________________
_________________________________________________________________________________________________
4. Quality Management – (Consider how well the supervisor performs day-to-day administrative tasks, uses
quality management tools and techniques when appropriate, achieves desired results, manages time, effectively
administers policies and implements procedures, maintains appropriate contact with supervisor and other staff
and stakeholders, and effectively and efficiently utilizes time, funds, staff, and/or equipment).
Unacceptable…………………………………….Superior
N/A
1
2
3
4
5
Comments: ______________________________________________________________________________________
_________________________________________________________________________________________________
5. Supervision of Staff – (Consider how well the staff member serves as a role model, provides guidance and
opportunities to their staff for their development and advancement, encourages teamwork and team
participation, resolves work-related employee problems, assists subordinates in accomplishing their work-
related objectives, communicates in a clear, concise, accurate, and timely manner with subordinates, and makes
useful suggestions).
Unacceptable…………………………………….Superior
N/A
1
2
3
4
5
Comments:______________________________________________________________________________________
_________________________________________________________________________________________________

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