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For RCUH Use Only:

Received by HR Dept: _____________


Reviewed by Director: _______

The Research Corporation of the University of Hawaii


ANNUAL PERFORMANCE EVALUATION (SAMPLE)
EMPLOYEE: MICKEY SMITH
TITLE:

PROJECT COORDINATOR

PROJECT NAME/LOCATION:

RCUH HR - OAHU

This report covers the period from

7/1/2005

to

6/30/2006

Instructions: Fill in the weighting of each competency according to your project's organizational needs and importance (must total 100 points).
Complete your ranking for the individual employee. Multiply the weighting points by the ranking and place score in the 'subtotal' column. Fill in any
comments as necessary. Add together all values in the 'subtotal' column to determine 'total score'. Check the summary rating that corresponds to the
'Total Score'.

Attendance (punctual, reports to work)

10

Communication (speaks and writes effectively)

10
10
5

Unsatisfactory (1)

10

Requires Improvement (2)

Weighting (Total 100)

Scoring Key:
4 = Exceeds Expectations
3 = Meets Expectations
2 = Needs Improvement
1 = Unsatisfactory

Meets Expectations (3)

RANKING
Exceeds Expectations (4)

COMPETENCY:

Sub
Total

Ability to Perform Job (technical ability)

X
X
X

30
30
30

Degree of Support Provided to Project/PI (provides direct


support, contributes to mission and goals of the project)

30

Initiative (Self starter in finding solutions to problems)

20

10

Timeliness of Work (produces work on time, meets


deadlines)

30

20

Quantity of Work (able to produce the quantities per


standard)

60

Knowledge of Work (knows technical parts of the job)

10

Quality of Work (able to produce the qualities per standard)

10

Safety Awareness (contributes to & encourages a safe work


environment)

100

Comments

(Weighting
x Ranking)

20
X

30
X

20
300

TOTAL SCORE

Total Score - Summary Rating:


X

Exceeds Expectations
Meets Expectations (+)
Meets Expectations

350 - 400
300 - 349
250 - 299
RCUH Form D-1, Revised March 2006

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Requires Improvement
Unsatisfactory

150 - 249
100 - 149

EMPLOYEE: MICKEY SMITH


Descriptive Appraisal:
Mr. Smith always tries his best in all situations. He takes initiative & is eager to learn.

(Please use back of form if necessary)

Recommendations Regarding Modifications of Improvement of Employee's Performance:

Mr. Smith needs to be aware of his work environment. With more training, we believe he
will excel.

(Please use back of form if necessary)

Mickey Smith

John Candy

PRINT Name of Employee

PRINT Name of Manager/Supervisor completing evaluation

Employee Signature

Signature of Manager/Supervisor completing evaluation

(This signature is merely an acknowledgment that this


evaluation was reviewed with me by my supervisor.)

Dr. Peter Piper


Principal Investigator Signature

RCUH Human Resources Representative

RCUH Form D-1, Revised March 2006

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