Performance Assessment
Employee Name / Title / DatePlease check the appropriate box as indicated.
SA=Strongly Agree A=Agree IP=Improvement Possible D=Disagree SD=Strongly Disagree
Communication / SA / A / IP / D / SD
Speaks clearly and concisely.
Is an effective listener.
Communicates effectively in writing.
Employee Self-Evaluation:
Supervisor Comments/Action Plan:
Interpersonal Relations / SA / A / IP / D / SD
Understands the importance of on-the-job relationships; facilitates relationships that add to his/her individual job success and to the success of others.
Exhibits tact, sensitivity, and discretion.
Is proactive and responsive with colleagues and co-workers.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Teamwork / SA / A / IP / D / SD
Can be counted on to help others inside and outside the department to accomplish institutional goals.
Shares information and collaborates with other team members which enables the entire group to be effective; volunteers assistance.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Customer Service
/ SA / A / IP / D / SDIs attentive and responsive to customers’ needs and requests. / / / / /
Is consistently courteous and respectful to customers. / / / / /
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Job Knowledge
/ SA / A / IP / D / SDDemonstrates understanding of daily job requirements, equipment operation, systems navigation.
Keeps up to date with technical advances in the field.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Quality of task performance
/ SA / A / IP / D / SDAccuracy, clarity, consistency and thoroughness of work.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Productivity
/ SA / A / IP / D / SDCompletes amount of work required and paces self to meet demands of assignments. / / / /
Work assignments are effectively planned and organized to meet deadlines. / / / /
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Initiative
/ SA / A / IP / D / SDIs self-motivated and requires little prompting from supervisor.
Anticipates needed action; suggests better ways of doing things.
Identifies, prevents and/or recommends solutions to problems.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Reliability / SA / A / IP / D / SD
Is dependable and follows through on commitments in a timely manner, meeting daily, weekly, and monthly deadlines.
Can be relied upon to see tasks through to completion and to ensure that tasks are performed comprehensively.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Departmental/Institutional Knowledge
/ SA / A / IP / D / SDUnderstands and acts on pertinent departmental and program policies and procedures.
Understands and acts on pertinent district policies and procedures.
Employee Self-Appraisal:
Supervisor Comments/Action Plan:
Overall Rating
q Meets expectations
q Does not meet expectations, performance improvement plan to be completed.
Overall Comments:
Development/Training Plan
Describe the additional training or development activities an employee should take to keep skill levels current, prepare for the future, meet changing job requirements, or overcome identified weaknesses or skill deficits that have had an impact on performance.
Personal Career Goal
Describe the development work an employee will undertake based on personal career objectives. This may include preparing for a career change or striving toward a new challenge or promotion.
Employee: I understand that my signature does not necessarily indicate agreement and that I have the right to attach to this evaluation my comments that I will submit within five (5) working days.
Employee: ______Date: ______
Supervisor: ______Date: ______
Director/Dean (if applicable): ______Date: ______
Vice President: ______Date: ______
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