Performance Evaluation Record

Southern Stone County Fire Protection District

4TH quarter eligibility? Yes No

Part 1 –Personnel Identification

Name:

Last First Middle Initial

Part II – Performance

Evaluation in this part compares the individual’s actual performance to standards.

Needs to improve Meets Far Exceeds

to meet standards Standards Standards

DATE TITLE OF SUPERVISOR SIGNATURE OF SUPERVISOR

PART III Skills, Knowledge, and Abilities

1. Knowledge of principles and practices in own area of work.

Lacks the basic knowledge Has a good basic knowledge; Has enough depth

to function effectively can perform the primary duties knowledge to cope

present job. of the job. With every facet of the

job, regardless of the

assignment.

______

2. Understanding of the work related to, but outside of, own specialty or technical area.

Lacks the knowledge of Has understanding of the Has in depth knowledge

activities outside of own relationship of his/her work about activities related to his

immediate area of work. to that of others when work and makes effective use

appropriate. of that knowledge in coordinating

with others.

1. Applying Knowledge to Practical Situations.

Judgment is not always Judgment is technically sound Effective in evaluating

technically sound; frequently and recommendations or decisions complex problems.

is unable to reach timely are timely and reflect proper and developing technically

decisions on the course of consideration of alternatives. sound solutions; decisions or

action to take or recommend. recommendations are always

workable as presented.

______

2. Adheres to Dress Code of the Fire District

Does not dress professionally; Meets dress code; seldom Always looks professional;

uniform is not laundered is out of uniform adheres to dress code

or meets Fire District dress at all times.

code.

3. Planning and Organizing Work.

Slow to complete assignments; Completes ongoing Consistently maintains an

has difficulty meeting assignments within exceptional high standard

deadlines or accomplishing acceptable time limits. of work.

work within acceptable time

limits.

______

6. Writing Skills.

Does not express thoughts Written work is acceptable An excellent writer who

well in writing; work often understandable and suitable express thoughts clearly

requires rewrite because it for the intended recipient concisely and effectively

is incomplete; contains faulty only minimum re-write is

grammar or unacceptable required.

tone.

______

7. Skills in Oral Communication.

Is not an effective speaker in Can hold his own in Makes a good oral

group discussions or does not discussions; makes own presentation; speaks

communicate readily in face position clear; evaluates effectively and convincingly;

to-face situations questions and responds respects the ideas of others

when challenged. and can turn them to his

advantage.

8. Accepting Responsibility.

Often avoids taking a position Accepts responsibility for Will stand up and be counted;

or unwilling to support own assigned tasks and for his/ accepts responsibility even

decisions; or, consistently her role in decisions or for unpleasant tasks and

offers excuses when results recommendations. takes full responsibility for

are unfavorable. actions.

______

9. Meeting Changing Demands of the Work Situation.

Resists changes in routine Accepts procedural changes Adjusts quickly to changes;

procedures; is often flustered willingly; an innovator when can devise procedures when

by change in work load or by conditions demand new the solution is not “in the

the pressure of deadlines. approaches; can cope with book”; meets varying work-

normal job pressures. Load demands, even under

heavy job pressure.

______

SUPERVISOR’S ______

1. Delegates Authority.

Remains too much involved Delegates authority for work Delegates authority fully

In the details of work; or, and follows up to ensure work commensurate with the

delegates routine matters, is accomplished. capabilities of staff; follows

doesn’t follow up to ensure up to ensure accomplishment.

accomplishment.

______

2. Making Administrative Decisions.

Has difficulty making minor Administrative decisions Does not procrastinate;

administrative decisions in prompt and workable. is decisive in his/her actions.

a timely manner. Always acts in best interest of

the Fire District.

______

3. Developing teamwork.

Unable to develop work force Obtains the cooperation and Adept at achieving

into a team working for a support of the staff and is able unit goals through

common goal. to avoid damaging dissension combined team effort

within the group. of the staff.

______

4. Developing Subordinates

Fails to recognize the Provides adequate orientation; Identifies both short and long

need to develop the identifies need to overcome range organizational needs

skills of employees. current deficiencies; and arranges and provides the training to

for employees to get the training meet those needs on a timely

needed. basis.

______

5. Using Resources – Manpower, Money and Material.

Planning is governed solely Shows concern for cost/benefit Makes best use of resources at all

by the availability of people benefit effects when requesting times; adjusts resources to meet

and funds; does not consider and making use of allotted emergency or changing needs

whether best use is being resources.

made of resources.

PART IV Personnel Development

1. What District or outside training has the employee completed during the year?

2. What training do you recommend during the next year?

1. I understand that my signature indicates only that I have had the opportunity to review the completed form and my supervisor has discussed my evaluation with me. My signature does not take the place of or otherwise prevent my requesting a review or appealing my evaluation if I believe such action is warranted.

Date Personnel Signature

Revised 11/08/17