"Performance Review Assessment" - Mississippi

Performance Review Assessment is a legal document that was released by the Mississippi State Personnel Board - a government authority operating within Mississippi.

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MISSISSIPPI STATE PERSONNEL BOARD
PERFORMANCE REVIEW ASSESSMENT
REVISION DATE: JUNE 1, 2020
MANAGEMENT
NON-MANAGEMENT
PROBATIONARY
A. DEMOGRAPHIC/SIGNATURES
SECTION 1. EMPLOYEE DEMOGRAPHICS
ACE ID:
NUMBER OF PEOPLE SUPERVISED:
EMPLOYEE NAME:
JOB TITLE:
PIN:
AGENCY:
COUNTY:
SUPERVISOR NAME:
REASON FOR ASSESSMENT:
PERSONNEL ACTION
PERFORMANCE EVALUATION
SIGNATURE CONFIRMS EMPLOYEE ACKNOWLEDGEMENT OF JOB DUTIES AND PERFORMANCE EXPECTATIONS
ASSESSMENT START DATE:
ASSESSMENT END DATE:
DATE:
SUPERVISOR SIGNATURE:
FIRST LEVEL REVIEWER
DATE:
SIGNATURE:
EMPLOYEE SIGNATURE:
DATE:
SECTION 2. MIDPOINT REVIEW ACKNOWLEDGEMENT
SUPERVISOR COMMENTS
SUPERVISOR SIGNATURE:
DATE:
EMPLOYEE SIGNATURE:
DATE:
SECTION 3. FINAL ASSESSMENT RATING
2.0 - 2.9 SUCCESSFUL
3.0 OUTSTANDING
1.0. - 1.9 IMPROVEMENT NEEDED
SUPERVISOR SIGNATURE:
DATE:
FIRST LEVEL REVIEWER
DATE:
SIGNATURE:
EMPLOYEE SIGNATURE:
DATE:
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MISSISSIPPI STATE PERSONNEL BOARD
PERFORMANCE REVIEW ASSESSMENT
REVISION DATE: JUNE 1, 2020
MANAGEMENT
NON-MANAGEMENT
PROBATIONARY
A. DEMOGRAPHIC/SIGNATURES
SECTION 1. EMPLOYEE DEMOGRAPHICS
ACE ID:
NUMBER OF PEOPLE SUPERVISED:
EMPLOYEE NAME:
JOB TITLE:
PIN:
AGENCY:
COUNTY:
SUPERVISOR NAME:
REASON FOR ASSESSMENT:
PERSONNEL ACTION
PERFORMANCE EVALUATION
SIGNATURE CONFIRMS EMPLOYEE ACKNOWLEDGEMENT OF JOB DUTIES AND PERFORMANCE EXPECTATIONS
ASSESSMENT START DATE:
ASSESSMENT END DATE:
DATE:
SUPERVISOR SIGNATURE:
FIRST LEVEL REVIEWER
DATE:
SIGNATURE:
EMPLOYEE SIGNATURE:
DATE:
SECTION 2. MIDPOINT REVIEW ACKNOWLEDGEMENT
SUPERVISOR COMMENTS
SUPERVISOR SIGNATURE:
DATE:
EMPLOYEE SIGNATURE:
DATE:
SECTION 3. FINAL ASSESSMENT RATING
2.0 - 2.9 SUCCESSFUL
3.0 OUTSTANDING
1.0. - 1.9 IMPROVEMENT NEEDED
SUPERVISOR SIGNATURE:
DATE:
FIRST LEVEL REVIEWER
DATE:
SIGNATURE:
EMPLOYEE SIGNATURE:
DATE:
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B. PERFORMANCE ASSESSMENT
IMPROVEMENT
ASSESSMENT RATING SYSTEM
SUCCESSFUL
OUTSTANDING
NEEDED
2.0 OR 2.5
1.0 OR 1.5
3.0
PERFORMANCE FACTORS:
# 1. JOB KNOWLEDGE / TECHNICAL ABILITY
ACQUIRES AND APPLIES KNOWLEDGE AND SKILLS TO EFFECTIVELY PERFORM ALL PARTS OF THE JOB.
TASKS / DUTIES TO BE RATED:
0.0
ENTER RATING FOR FACTOR #1 HERE ---------->
SUPERVISOR COMMENTS:
EMPLOYEE COMMENTS:
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B. PERFORMANCE ASSESSMENT (CONTINUED)
IMPROVEMENT
ASSESSMENT RATING SYSTEM
SUCCESSFUL
OUTSTANDING
NEEDED
1.0 OR 1.5
2.0 OR 2.5
3.0
PERFORMANCE FACTORS (CONTINUED):
# 2. USE OF REQUIRED SYSTEMS/PROGRAMS/EQUIPMENT OR TOOLS
DEMONSTRATES THE ABILITY TO EFFECTIVELY AND ACCURATELY USE REQUIRED PROGRAMS, EQUIPMENT OR TOOLS.
SYSTEMS/PROGRAMS/EQUIPMENT/INSTRUMENTS TO BE RATED:
ENTER RATING FOR FACTOR #2 HERE --------->
0.0
2.5
SUPERVISOR COMMENTS:
EMPLOYEE COMMENTS:
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B. PERFORMANCE ASSESSMENT (CONTINUED)
IMPROVEMENT
ASSESSMENT RATING SYSTEM
SUCCESSFUL
OUTSTANDING
NEEDED
1.0 OR 1.5
2.0 OR 2.5
3.0
PERFORMANCE FACTORS (CONTINUED):
#3. PROBLEM SOLVING/DECISION MAKING
EXHIBITS SOUND AND ACCURATE JUDGEMENT IN IDENTIFYING AND ADDRESSING ISSUES THAT ARISE IN THE COURSE OF WORK.
TASKS / DUTIES TO BE RATED:
ENTER RATING FOR FACTOR #3 HERE --------->
0.0
3.0
SUPERVISOR COMMENTS:
EMPLOYEE COMMENTS:
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B. PERFORMANCE ASSESSMENT (CONTINUED)
IMPROVEMENT
ASSESSMENT RATING SYSTEM
SUCCESSFUL
OUTSTANDING
NEEDED
2.0 OR 2.5
1.0 OR 1.5
3.0
PERFORMANCE FACTORS (CONTINUED):
# 4. PROJECT / PEOPLE MANAGEMENT AND DELEGATION
PLANS, ORGANIZES, EXECUTES, MONITORS, AND CLOSES WORK EFFECTIVELY TO SUCCESSFULLY COMPLETE
GOALS AND OBJECTIVES.
APPLIES ONLY TO MANAGERS OF PEOPLE OR PROGRAMS
TASKS / DUTIES TO BE RATED:
ENTER "0" IF NON-MANAGEMENT
ENTER RATING FOR FACTOR #4 HERE -------->
2.5
0.0
(ZERO WILL NOT BE AVERAGED)
SUPERVISOR COMMENTS:
EMPLOYEE COMMENTS:
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