Form DWR877 "Employee Exit Interview Report (Confidential)" - California

What Is Form DWR877?

This is a legal form that was released by the California Department of Water Resources - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the California Department of Water Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DWR877 by clicking the link below or browse more documents and templates provided by the California Department of Water Resources.

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Download Form DWR877 "Employee Exit Interview Report (Confidential)" - California

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State of California
DEPARTMENT OF WATER RESOURCES
California Natural Resources Agency
EMPLOYEE EXIT INTERVIEW REPORT
(CONFIDENTIAL)
Personal Information
Name (optional):
Classification:
Division:
Organizational Unit:
Length of Service:
Civil Services Status:
Work Phone:
Home:
Email:
Separation Date:
Type of Separation:
*Selecting ‘yes’ authorizes OWE to share your name with the
I choose to waive my anonymity. *
Yes
No
hiring authority. Selecting ‘no’ means that OWE will not share
your name with anyone.
1. If transferring to another department, please list: (State Dept.)
2. If you are leaving for other employment, where are you going?
Public Agency
Private Company
Self-Employment/Consultant
Employer name
3. If you are leaving for employment outside DWR, will you be:
Performing comparable work:
Yes
No.
Making a career change:
Yes
No
4. Primary reason(s) for leaving (check all boxes that apply):
Personal
Professional
More Personal Time
Change in Working Conditions
Family Circumstances (Child care/Maternity/Eldercare)
Quality of Management/Supervision
Transportation Problems
Career Change
Parking
Career Advancement
Moving
Part-Time Employment
Health/Medical (self-resignations only)
Self-employment
Education/Returning to School
Better Opportunity to Advance
Conflict with Supervisor
Broader range of Duties
Conflict with Co-workers
Better Training/Development Opportunities
Incompatible Work Schedule
Adverse Action
Other:
Other:
5. What did you like most about working for DWR, your division or organization unit?
6. What did you like least about working for DWR, your division or organization unit?
7. What could DWR, your division or organization unit have done to retain your services?
8. Would you consider working for DWR, your division or organization unit again?
Yes
No
DWR 877 (Rev. 7/19)
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State of California
DEPARTMENT OF WATER RESOURCES
California Natural Resources Agency
EMPLOYEE EXIT INTERVIEW REPORT
(CONFIDENTIAL)
Personal Information
Name (optional):
Classification:
Division:
Organizational Unit:
Length of Service:
Civil Services Status:
Work Phone:
Home:
Email:
Separation Date:
Type of Separation:
*Selecting ‘yes’ authorizes OWE to share your name with the
I choose to waive my anonymity. *
Yes
No
hiring authority. Selecting ‘no’ means that OWE will not share
your name with anyone.
1. If transferring to another department, please list: (State Dept.)
2. If you are leaving for other employment, where are you going?
Public Agency
Private Company
Self-Employment/Consultant
Employer name
3. If you are leaving for employment outside DWR, will you be:
Performing comparable work:
Yes
No.
Making a career change:
Yes
No
4. Primary reason(s) for leaving (check all boxes that apply):
Personal
Professional
More Personal Time
Change in Working Conditions
Family Circumstances (Child care/Maternity/Eldercare)
Quality of Management/Supervision
Transportation Problems
Career Change
Parking
Career Advancement
Moving
Part-Time Employment
Health/Medical (self-resignations only)
Self-employment
Education/Returning to School
Better Opportunity to Advance
Conflict with Supervisor
Broader range of Duties
Conflict with Co-workers
Better Training/Development Opportunities
Incompatible Work Schedule
Adverse Action
Other:
Other:
5. What did you like most about working for DWR, your division or organization unit?
6. What did you like least about working for DWR, your division or organization unit?
7. What could DWR, your division or organization unit have done to retain your services?
8. Would you consider working for DWR, your division or organization unit again?
Yes
No
DWR 877 (Rev. 7/19)
Page 1 of 2
State of California
DEPARTMENT OF WATER RESOURCES
California Natural Resources Agency
How would you rate the communication in relation
Excellent
Good
Fair
Poor
to your job?
Within your division/management
With other divisions/units
With your supervisor
Among your co-workers
With the public/customers
How would you rate your working conditions?
Excellent
Good
Fair
Poor
Work space/furniture
Office/building facility conditions
Workload
Excellent
Good
Fair
Poor
How would you rate your Supervisor and Manager
on the following:
Sup
Mgr
Sup
Mgr
Sup
Mgr
Sup
Mgr
Provided timely and effective performance
evaluations
Provided clear directions
Administered and followed policies and procedures
Demonstrated fair and equitable treatment
Encouraged and listened to suggestions
Set clear expectations and standards
Resolved complaints and problems appropriately
Acknowledged and recognized employee
performance
Developed cooperation and team work
Planned and scheduled work assignments
effectively
Provided opportunities for training/development
Provided opportunities for advancement
Office of Workforce Equality and Demographic Information:
Gender:
Female
Male
Age Group:
Disability:
Are you aware of DWR procedures and resources available
Race/Ethnic Group:
to remedy allegations of discrimination?
Yes
No
Discrimination experienced at DWR:
Any other comments or information regarding OWE (attach a separate paper or email if needed):
INTERVIEWED BY
INTERVIEW DATE
DWR 877 (Rev. 7/19)
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