Jl. Bukit Panorama No.

6 Graha Candi Golf - Semarang

Jl. Raya Semarang - Demak KM 19 Kel. Dukun Kec. Karangtengah - Demak
Jl. Tahunan-Batealit Ds. Bawu Kec. Batealit - Jepara
Central Java - Indonesia
Telp +62 291 595544 / 4298477 ; +62 24 76420879

PERFORMANCE EVALUATION SHEET

Employee's Data 1st Evaluator (Direct Supervisor) : Grade :

Name 2nd Evaluator (Work Colleague) : 5 = Very good
Position 3rd Evaluator (Direct Subordinate) : 3 = Sufficient
Department Evaluation Period : 3 months 1 = Lacking
Working Period Date of Evaluation : Oct 2019

Weight 1st Evaluator (50%) 2nd Evaluator (30%) 3rd Evaluator (20%) Ttd Penilai 1 Ttd Penilai 2
Evaluation Criteria G GxB G GxB G GxB
1 Work Quality 25 5 125 5 125 5 125
2 Dutifulness 25 5 125 5 125 5 125
3 Team work 25 5 125 5 125 5 125
4 Initiative 25 5 125 5 125 5 125 Final Grade :
TOTAL 100 Sub Total 1 500 Sub Total 1 500 Sub Total 2 500 Exceptional = 421 - 500
Attendance and Discipline (filled by HRD) Score : [Sub Total 1 x50%] + [Sub Total 2 x 30%]+[Sub Total 1 x20%] Excellent = 341 - 420
Score = 250 150 100 = 500 Good = 261 - 340
Overdue Sick leave Permit
Average = < 261
1 x ……… days 3 x .…… days 5 x .…… days Final Grade: Score -- Attandance deduction Insufficient = below 12

Absence Warning letter Memoranda Exceptional 500

15 x ……… days (- 30)/letter (- 50)/memoranda
0 0 0

Disetujui Oleh , Diketahui Oleh,

Diana Albab Nor Aryo Prabowo

HR Factory Spv Factory Manager HR & Legal head
Jl. Bukit Panorama No. 6 Graha Candi Golf - Semarang
Jl. Raya Semarang - Demak KM 19 Kel. Dukun Kec. Karangtengah - Demak
Jl. Tahunan-Batealit Ds. Bawu Kec. Batealit - Jepara
Central Java - Indonesia
Telp +62 291 595544 / 4298477 ; +62 24 76420879

FORM PENILAIAN KINERJA TAHUNAN

Karyawan Staff / Leader

IDENTITAS PEKERJA Penilai 1 (Atasan Langsung) : Grade :

Nama Penilai 2 (Depart Head) : 5 = Sangat baik
Bagian Penilai 3 (Factory Manager) : 4 = Baik
Dept. Periode Penilaian : 3 = Cukup Final Grade :
Masa kerja Tanggal Penilaian : 2 = Kurang A = 421 - 500
B = 341 - 420
Bobot Penilai 1 (50%) Penilai 1 (30%) Penilai 2 (20%) C = 261 - 340
KRITERIA PENILAIAN G GxB G GxB G GxB D = < 261
1 Kualitas Kerja 25 5 125 5 125 5 125
2 Kepatuhan 25 5 125 5 125 5 125
3 Kerjasama / Team Work 25 5 125 5 125 5 125 Ttd Penilai 1 Ttd Penilai 2
4 Inisiatif 25 5 125 5 125 5 125
JUMLAH 100 Sub Total 1 500 Sub Total 1 500 Sub Total 2 500
PENILAIAN ABSENSI & DISIPLIN (Diisi oleh HRD) Score : [Sub Total 1 x50%] + [Sub Total 2 x 30%]+[Sub Total 1 x20%]
Datang Lambat / Lupa Score = 250 150 100 = 500
Catat Sakit Ijin

1 x ……… hari 3 x .…… hari 5 x .…… hari Final Grade / NILAI AKHIR : Score -- Potongan Absensi Catatan :

Mangkir Surat Teguran Surat Peringatan A 450 Pekerja yang mendapat Surat Peringatan
15 x ……… hari (- 30)/kali (- 50)/kali tidak berhak mendapat Final Grade "B"
1 2x 1x

Disetujui Oleh , Diketahui Oleh,

Diana Albab Nor Aryo Prabowo

HR Factory Spv Factory Manager HR & Legal head