Performance Review Form Employee (Review Year)
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1 Performance Review Form Employee (Review Year) Employee Name: Date: Job Title: Job Code: Division/Department: Manager Name (Reports to): Review Type: Self- assessment Annual Interim / Off- cycle Probationary Transfer Performance reviews are a key component of employee development. This evaluation is intended to be a fair and balanced assessment of the employee's performance since the last review. Meaningful two-way feedback provides the employee and the manager with an understanding of how past performance combined with a review of expectations creates an environment for career growth and continuous improvement. Goals & Key Responsibilities This section provides employees and managers with the ability to rate and comment on current year performance goals and/or key job responsibilities. All five goals & key responsibilities must be rated in order for this section to provide an accurate score & Often Exceeds 5 Consistently Exceeds Page 1
2 Average Page 2
3 Core Competencies & Often Exceeds 5 Consistently Exceeds Personal Accountability Commitment to Quality Takes pride in work, strives for excellence. Takes responsibility for performance and fixes mistakes. Continually looks to improve the quality/quantity of work. Safety Consciousness Contributes to a safe working environment; performs duties in a clean and safe manner. Brings safety concerns to appropriate parties; takes initiative to resolve when possible. Attendance and Punctuality Fulfills work and time requirements. Keeps unscheduled absences to a minimum. Plans for coverage of responsibilities where appropriate. Reliability/Dependability Meets task deadlines and work commitments. Fulfills work obligations in a timely and satisfactory manner. Takes responsibility for personal actions and performance. Appearance Dresses appropriately. Avoids wearing strong fragrances or other strong odors (e.g., from smoking). Keeps workplace neat, clean and organized. Professionalism Self-Awareness Demonstrates continuous professionalism, respect, and workplace civility. Mindful of actions; topic, tone, volume, and body language. Avoids gossip. Working with Others Approachable, inclusive, and respectful. Exhibits teamwork, takes initiative to help. Courteous and cooperative. Respects diversity and appreciates differences. Relationship to Supervisor Responds and acts cooperatively; works to maintain positive relationships with supervisor/manager. Accepts responsibility for own actions. Gives and Receives Feedback Provides constructive feedback to colleagues. Mindful of both verbal and body language when giving feedback. Receptive to feedback from others; accepts feedback without defensiveness. Role Modeling Conducts self in fair and trustworthy manner. Upholds professional and ethical standards. Demonstrates departmental and organizational values, including Integrity, Compassion, Accountability, Respect, and Excellence. Page 3
4 Core Competencies & Often Exceeds 5 Consistently Exceeds Functional Expertise Job Knowledge Clearly demonstrates functional expertise as it relates to the job. Strives for excellence. Asks relevant questions when uncertain. Shares information and knowledge with others. Learning Agility Keeps abreast of new developments and enhancements to systems, procedures and products. Values learning; seeks out new learning and development opportunities. Completes learning assignments in a timely manner. Problem Solving & Decision Making Uses good judgment when evaluating a problem. Analyzes risks and identifies consequences. Makes appropriate decisions in a timely manner. Uses problem solving strategies to work through roadblocks and deliver timely results in a manner that is consistent with organizational values. Policy Awareness Understands and adhere to departmental and organizational standards, policies, and procedures, as appropriate. Asks relevant questions when uncertain. Continuously works to maintain standards. Use of Resources Works to reduce waste by identifying ways to be more efficient with time, money, or processes. Where appropriate is aware of equipment and supply costs; understands appropriate use of resources. Demonstrates a sense of organizational stewardship. Service Excellence Treatment Towards Others Listens carefully, expresses compassion and empathy where appropriate. Mindful of the perspective and needs of others (e.g. colleagues, patients, students, families and others). Service Orientation Embraces organization and department mission. Works to understand goals and objectives of the unit or the department. Communication Communicates ideas and messages clearly and concisely. Actively listens, seeks to understand others. Answers questions clearly and asks clarifying questions when needed. Keeps others informed when deadlines are challenged. Productivity Works to deliver an expected volume of work; seeks operating efficiencies without sacrificing quality. Works to stay organized. Uses technology as needed/where appropriate. Responds to Change Adapts to changing priorities. Handles unexpected situations and does so in a calm and positive manner. Where appropriate, questions and recommends alternatives to new processes and procedures. Page 4
5 Performance Goal Planning The purpose of this section is to create Performance Goals for the next performance review cycle. These new performance goals will be rated during the next annual performance review cycle. The creation of 3-5 performance goals is highly recommended. Goal #1 Goal #2 Goal #3 Goal #4 Goal #5 Page 4
6 Summary Section Section Section Weight Goals & Key Responsibilities 50% Core Competencies 50% Overall Performance Review Score Section Score Weighted Score and Often Exceeds Consistently Exceeds Final Comments Manager Writing Review: Final Comments Employee Being Reviewed: Manager Signature: Date: Print Name: Employee Signature: Date: Page 5
7 Print Name: Page 6
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