Fill and Sign the Staff Performance Appraisal

Staff Performance Appraisal Confidential Name of Staff Member: __________________________ Job Title: __________________________ Department/Office: __________________________ Name of Supervisor: __________________________ Appraisal Period: __________________________ Date of Appraisal: __________________________ Sections I is to be completed by the staff member. I. Major Responsibilities: List the major responsibilities of the staff member’s position in approximate order of importance. After you complete this section, forward this form to your supervisor. _______________________________________________________________ _______________________________________________________________ Sections II, III, and IV are to be completed by the supervisor. II. Supervisor’s Review of Responsibilities: Review the above list of major responsibilities and note your concurrent or comment on any additions, deletions, or changes in priority that you feel are appropriate. _______________________________________________________________ _______________________________________________________________ III. Performance Factor Ratings: Using the following definitions, check the box that most closely describes the staff member’s performance for each of the required performance factors. If a performance factor does not apply, please leave blank. 1. Exceptional: Contributions and excellent work are widely recognized. Performance consistently exceeds all defined expectations, producing important and impactful results through superior planning, executing, and creativity. 2. Highly Effective: Most performance objectives exceed expectations. Projects and objectives are completed in a manner that expands the scope and impact of the assignment and increases the impact on the business. The employee is viewed as having made notable contributions to the department. 3. Effective: Performance is competent and effective along established expectations, initiative, resourcefulness and good judgment are consistently exercised. Employee makes a solid, reliable and meaningful contribution to the department. 4. Improvement Required: Performance falls below expectations on one or two job requirements and responsibilities. A performance improvement plan should be created. 5. Unsatisfactory: Performance falls below expectations on several critical job requirements and responsibilities. Without significant improvement reassignment or separation are indicated. A performance improvement plan must be in place. Performance Exceptional Highly Effective Improvement Unsatisfactory Factor Effective Quality of Work Consider accuracy, thoroughness, effectiveness. Flexibility Consider performance under pressure and handling of multiple assignments. Initiative Consider the extent to which the employee sets own constructive work practice and recommends and creates own procedures. Dependability Consider the extent to which the employee completes assignments on time and carries out instructions. Interpersonal Relations Consider the extent to which the employee is cooperative, considerate, and tactful in dealing with supervisors, subordinates, and others. Performance Exceptional Highly Effective Improvement Unsatisfactory Factor Effective Safety Compliance The degree to which employee complies with or oversees the compliance with Company safety rules. Organization To what extent are projects well conceived, analyzed, and carried out systematically? Communication Abilities Are the individual’s thoughts expressed clearly and concisely? Facing Issues How well does the individual come to grips with unpleasant issues and seek to solve them by constructive action at his or her own level? Utilization of Resources The degree to which the individual has utilized funds staff or equipment economically and effectively. IV. Supervisor: sign and give form to staff member _____________________ Date: _____________________ (Signature of Supervisor) _____________________ (Printed Name of Supervisor) V. Staff member sign and return form to your supervisor within 48 hours of it receipt. _____________________ Date: _____________________ (Signature of Staff Member) _____________________ (Printed Name of Staff Member) _____________________ Date: _____________________ (Signature of Reviewer) _____________________ (Printed Name of Reviewer) Return Form to Supervisor