MILESTONE, INC.

Group Supervisor Evaluation

Day Training Settings

Name Date Eval. Type: 90 Day Annual

Date of Hire___/___/___
Check One
TIME USAGE Yes No
1. Takes only paid time off. ______
2. On time to work and leaves on time. ______
3. Only takes breaks as scheduled. ______
For “no” answers, the following is
expected for improvement ______
______
______/ Rec. Add. Trng., Perf. Still Needs Improv.
/ Needs Additional Training
/ Performance is Satisfactory
/ Performance Exceeds Expectations
1. Talks with individuals politely and with enthusiasm during all activities.
2. Looks for possible injuries, seizures, changes in behavior that may mean a health problem, reports immediately, ensuring medical attention, and documents.
3. Assists individuals in using all adaptive equipment including gait belts and walkers safely. Uses lifts safely, if applicable.
4. Makes sure all individuals are clean, well groomed, and neat at all times(face and hands clean).
5. Does Eating Programs (and documents) or feeds individuals making sure person and area are neat and clean during meal, talking to individuals, and making mealtime pleasant.
6. Follows menus and diets correctly.
7. Does group activities as planned, making sure all individuals are involved and are
enjoying activity. Uses praise and encouragement for participation.
8. Conducts individual programs consistently and documents immediately. Praises
successful performance or attempts.
9. Follows BDP’s for all individuals as written and documents immediately. Correctly uses reinforcements.
10. Follows supervisor’s instructions and is courteous to supervisor and co-workers.
11. Toilets or changes individuals as needed and documents. Remains with individuals who
need help.
12. Cleans up area at the end of the day, encouraging individual participation.
13. Completes monthly report, lesson plans, summaries, and job market reviews on time.
14. Protects individuals from abuse or neglect at all times and immediately reports any
concerns.
15. Ensures individual choice in all outings, encouraging participation and trying new
activities.
16. Follows all procedures on outings including driving in a safe manner at all times and obeying all traffic laws.
17. Ensures individual safety at all times. Completes disaster drills as required. Knows whereabouts of individuals at all times.
25. Understands and promotes Milestone mission statement as evidenced by quality of work (allowing and encouraging individuals to function as independently as possible at all times).
26. Remains at work area leaving only with prior approval of supervisor.
27. Maintains equipment and activity items/supplies in a clean and organized manner and properly stored. Gets replacements and repairs done as needed.
28. Follows all policies and procedures regarding medication administration, if applicable.
29. Teaches skills in and assists with budgeting as needed, recognizing individual choice/control over how money is budgeted/ spent. Accurately completes financial documentation.
30. Assists and supports individuals in use of community programs including those related to health and living skills.
31. Assists and supports individuals in participation in volunteering in the community.
32. Assists and supports individuals in maintaining a circle of friends both within the agency and in the community.

For checks in “Needs Additional Training”, the following will be done:

For checks in “Rec’d Additional Training, But Performance Still Needs Improvement”, the following will be done.

Attendance or Training issues will be addressed as follows:

Additional comments/Supervisor Employee Comments (continue on back if needed)

Supervisor(s) Date

Employee Date

Next Level Supervisor Date

Pe.2DSP3/03