"Performance Appraisal Form"

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Performance Appraisal
Employee Name____________________________________________
Title_________________________________
Department________________________________________________
Employee Payroll #_____________________
Reason for Review
Annual
Peer Appraisal
Unsatisfactory Performance
Merit
End of Introductory Period
Other________________________
Date Employee began present position_____/___/_____
Date of last appraisal_____/___/______
Scheduled appraisal date_____/___/______
Instructions: Carefully evaluate employee’s work performance in relation to the essential functions of the job. Check Rating box that indicates the employee’s
performance. Indicate N/A if not applicable. Assign points for each Rating within the Scale and write that number in the corresponding Points box. Points will be
totaled
and averaged for an overall performance score.
Definitions of Performance Ratings
O-Outstanding. Performance is exceptional in all areas and
I-Improvement Needed. Performance is deficient in certain
is recognizable as being far superior to others.
areas. Improvement is necessary.
V-Very Good. Results clearly exceed most position
U-Unsatisfactory. Results are generally unacceptable and
Requirements. Performance is high quality and is achieved on
require immediate improvement. No merit increase should be
a consistent basis.
Granted to individuals with this rating.
G-Good. Competent and dependable level of performance.
N/A-Not Applicable or too soon to rate.
Meets performance standards of the job.
General Factors
Rating
Scale
Supportive Details/Comments
O ¨
1.
Quality- The extent to which an employee’s
100-90
Points
____________________________________
O
V ¨
work is accurate, thorough and neat.
89-80
V
G ¨
79-70
____________________________________
G
I ¨
69-60
I
U ¨
Below 60
____________________________________
U
O ¨
2.
Productivity- The extent to which an
100-90
Points
____________________________________
V ¨
employee produces a significant volume
89-80
G ¨
of work efficiently in a specified period
79-70
____________________________________
¨
of time.
I
69-60
U ¨
Below 60
____________________________________
O ¨
3.
Job Knowledge- The extent to which
100-90
Points
____________________________________
V ¨
an employee possesses the practical/technical
89-80
G ¨
knowledge required on the job.
79-70
____________________________________
¨
I
69-60
U ¨
Below 60
____________________________________
O ¨
4.
Reliability- The extent to which an
100-90
Points
____________________________________
V ¨
employee can be relied upon regarding
89-80
G ¨
task completion and follow-up.
79-70
____________________________________
¨
I
69-60
U ¨
Below 60
____________________________________
O ¨
5.
Attendance- The extent to which an
100-90
Points
____________________________________
V ¨
employee is punctual, observes prescribed
89-80
G ¨
work break/meal periods and has an
79-70
____________________________________
I ¨
acceptable overall attendance record.
69-60
U ¨
Below 60
____________________________________
O ¨
6.
Independence- The extent to which and
100-90
Points
____________________________________
V ¨
employee performs work with little or
89-80
G ¨
no supervision.
79-70
____________________________________
I ¨
69-60
U ¨
Below 60
____________________________________
Performance Appraisal
Employee Name____________________________________________
Title_________________________________
Department________________________________________________
Employee Payroll #_____________________
Reason for Review
Annual
Peer Appraisal
Unsatisfactory Performance
Merit
End of Introductory Period
Other________________________
Date Employee began present position_____/___/_____
Date of last appraisal_____/___/______
Scheduled appraisal date_____/___/______
Instructions: Carefully evaluate employee’s work performance in relation to the essential functions of the job. Check Rating box that indicates the employee’s
performance. Indicate N/A if not applicable. Assign points for each Rating within the Scale and write that number in the corresponding Points box. Points will be
totaled
and averaged for an overall performance score.
Definitions of Performance Ratings
O-Outstanding. Performance is exceptional in all areas and
I-Improvement Needed. Performance is deficient in certain
is recognizable as being far superior to others.
areas. Improvement is necessary.
V-Very Good. Results clearly exceed most position
U-Unsatisfactory. Results are generally unacceptable and
Requirements. Performance is high quality and is achieved on
require immediate improvement. No merit increase should be
a consistent basis.
Granted to individuals with this rating.
G-Good. Competent and dependable level of performance.
N/A-Not Applicable or too soon to rate.
Meets performance standards of the job.
General Factors
Rating
Scale
Supportive Details/Comments
O ¨
1.
Quality- The extent to which an employee’s
100-90
Points
____________________________________
O
V ¨
work is accurate, thorough and neat.
89-80
V
G ¨
79-70
____________________________________
G
I ¨
69-60
I
U ¨
Below 60
____________________________________
U
O ¨
2.
Productivity- The extent to which an
100-90
Points
____________________________________
V ¨
employee produces a significant volume
89-80
G ¨
of work efficiently in a specified period
79-70
____________________________________
¨
of time.
I
69-60
U ¨
Below 60
____________________________________
O ¨
3.
Job Knowledge- The extent to which
100-90
Points
____________________________________
V ¨
an employee possesses the practical/technical
89-80
G ¨
knowledge required on the job.
79-70
____________________________________
¨
I
69-60
U ¨
Below 60
____________________________________
O ¨
4.
Reliability- The extent to which an
100-90
Points
____________________________________
V ¨
employee can be relied upon regarding
89-80
G ¨
task completion and follow-up.
79-70
____________________________________
¨
I
69-60
U ¨
Below 60
____________________________________
O ¨
5.
Attendance- The extent to which an
100-90
Points
____________________________________
V ¨
employee is punctual, observes prescribed
89-80
G ¨
work break/meal periods and has an
79-70
____________________________________
I ¨
acceptable overall attendance record.
69-60
U ¨
Below 60
____________________________________
O ¨
6.
Independence- The extent to which and
100-90
Points
____________________________________
V ¨
employee performs work with little or
89-80
G ¨
no supervision.
79-70
____________________________________
I ¨
69-60
U ¨
Below 60
____________________________________
General Factors
Rating
Scale
Supportive Details/Comments
O ¨
7.
Creativity – The extent to which an
100-90
Points
____________________________________
V ¨
employee proposes ideas, finds new
89-80
G ¨
and better ways of doing things.
79-70
____________________________________
I ¨
69-60
U ¨
Below 60
____________________________________
O ¨
8.
Initiative- The extent to which an employee
100-90
Points
____________________________________
V ¨
seeks out new assignments and assumes
89-80
G ¨
additional duties when necessary.
79-70
____________________________________
¨
I
69-60
U ¨
Below 60
____________________________________
O ¨
9.
Adherence to Policy- The extent to which an
100-90
Points
____________________________________
V ¨
employee follows safety and conduct rules,
89-80
G ¨
other regulations and adheres to company
79-70
____________________________________
¨
policies.
I
69-60
U ¨
Below 60
____________________________________
O ¨
10. Interpersonal Relationships- The extent to which an
100-90
Points
____________________________________
V ¨
employee is willing and demonstrates the ability to cooperate,
89-80
G ¨
work and communicate with coworkers, supervisors,
79-70
____________________________________
¨
subordinates I and/or outside contacts.
I
69-60
U ¨
Below 60
____________________________________
O ¨
11. Judgement- The extent to which an employee
100-90
Points
____________________________________
V ¨
demonstrates proper judgment and decision-
89-80
G ¨
making skills when necessary.
79-70
____________________________________
I ¨
O
69-60
U ¨
V
Below 60
____________________________________
G
I
¨ ¨ ¨ ¨ Outstanding
Rate employee’s overall performance in comparison to position duties and responsibilities
U
100-90
¨ ¨ ¨ ¨ Very Good
89-80
¨ ¨ ¨ ¨ Good
79-70
÷ ÷ ÷ ÷ Number of Factors Rated
¨ ¨ ¨ ¨ Improvement Needed
Total Points
=
Overall Rating
69-60
¨ ¨ ¨ ¨ Unsatisfactory
Below 60
Complete all of the following sections
1.
_____________________________________________________
Accomplishments or new abilities demonstrated since last review
_____________________________________________________________________________________________________
2.
_________________________________________________________________________
Specific areas of needed improvement
_____________________________________________________________________________________________________
3.
Recommendations for professional development (seminars, training, schooling, etc.)____________________________________________
_____________________________________________________________________________________________________
4.
_______________________________________
__________________________
Absences: Number of incidents
Number of days
Employee’s Comments*_________________________________________________________________________________
_____________________________________________________________________________________________________
*
If necessary, additional sheets may be attached
Discussed with individual on ________________________Employee’s Signature_________________________________________________
*I acknowledge that this Performance Appraisal was discussed with me
Follow-up requested/desired
Yes
No
Follow-up Date____________________
Evaluator’s Signature____________________________________________________________________ Date________________________
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