Employee Self-Assessment FormUpdated 02/2017

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Employee Name / Date
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Job Title / Unit
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Supervisor
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As part of the performance review process, please complete the following self-assessment form and submit it to your supervisor by your department’s designated deadline. It will not become part of your personnel file unless you initial under the Initial section.

Use this self-assessment with your supervisor to facilitate discussion regarding your previous year’s performance and accomplishments, and communicate any career or development goals or needs you may have.

List your goals from the last review period and how you assess and feel about your performance. In addition, please describe one accomplishment for which you are the most proud.
Goals / Performance
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Accomplishment of Pride / Comments
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Competencies
The Institute’s seven core competencies for all employees are below with full definitions at the end of this guide.For the following questions, please discuss your strengths as it relates to these competencies and any areas of focus for growth and development.
  • Decision making
  • Effective communications
  • Interpersonal relationship
  • Job knowledge
  • Producing results
  • Service excellence
  • Honesty and integrity

Comment upon any challenges or barriers that may have prevented you from achieving your goals or effectively completing projects. How can thesechallenges be overcome in the future?
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Are there specific areas for professional/career development you would like to discuss with your supervisor? Please include ideas for training, skill improvement, development goals, and/or career guidance.
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Has the scope of your job responsibility changed in the past year? If so, please details the specific changes that have occurred.
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How can your supervisor be most helpful to you next year?
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Are there any additional topics you would like to discuss with your supervisor during your review meeting?
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Initial
Initial here if you would like this form included in your personnel file.

Employee Name, Printed / Initial / Date
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REFERENCE

Competencies

Decision Making
Able to analyze situations fully and accurately and reach productive decisions. Consults appropriate parties when necessary and identifies the key concerns and/or issues that need to be addressed in order to make the best decision possible.
Effective Communications
Able to express ideas in a clear, concise, and effective manner, whether speaking or in writing. Uses correct grammar and sentence structure in communications. Is a good listener, even when differing viewpoints are expressed. Openly shares information and keeps all relevant parties updated.
Interpersonal Relationships
Builds and maintains effective working relationships with others- both internal and outside the organization. Takes a positive and productive approach to resolving any conflicts which may arise. Exemplifies commitment to the USG core value of respect- treating everyone with fairness, compassion, and dignity.
Job Knowledge
Demonstrates the professional, administrative, supervisory, and/or technical knowledge required to perform the job successfully. Continuously strives to further improve job knowledge. Serves as a reliable resource for other employees regarding areas of expertise.
Producing Results
Assignments/projects are consistently completed in a timely manner with the desired level of quality and quantity. Follows up on the outcome of work efforts to ensure desired results.
Service Excellence
Makes excellent customer service a top priority and constantly seeks to improve customer service. Is responsive to changes in what customers want and need. Delivers on promises made to customers and follows up appropriately.

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