Hourly employee evaluation form

JC003 - LIS Coordinator

Appraisal Score Overall Score: /3.0

Name: Job Title:

Department: Supervisor:

Evaluation Date: 

1. Business Deliverables

There are six key performance measures to be evaluated in the job this year. Performance measures should be linked to
current business strategy and focus on significant business challenges or opportunities. At year-end, the employee and
supervisor/coach should discuss specific accomplishments or developmental needs in support of each key performance
category.

Assessment of Performance Measures

Performance Assessment:

EE - Exceeds Expectations

ME - Meets Expectations

NI - Needs Improvement to Meet Expectations

Employee Evaluation Sample Forms Package – Employee goal setting appraisal form
Performance Measures Score:/3.0

Competency Performance Assessment Score /3.0

EE ME NI

Safety: Demonstrates a commitment to safety by following safety rules & 

guidelines; follows good housekeeping practices, takes proper care of equipment.
Meets requirements of 100% participation in safety training & 100% safety actions   
completed.

Comments 

Attendance: Regular & punctual attendance at or below the 4-point threshold.

   
Individual is at workstation when scheduled and remains for the duration of shift.

Comments 

Initiative & Energy: Takes advantage of training opportunities and progresses 

through work stations at an acceptable rate. Initiates actions without needing
direction; Demonstrates a sense of urgency; Corrects errors; Requests assistance   
in a timely manner; Handles unexpected situations calmly & efficiently to minimize
problems.

Comments 

Quality: Considers accuracy & the appearance of work, committed to producing a

quality product and to continuous improvement efforts. Recognizes & learns from

mistakes, taking appropriate action to reduce errors. Understands the role that   
quality plays in customer satisfaction.

Comments 

Productivity: Properly uses materials & equipment to effectively and efficiently

   
complete varying workload in a timely fashion.

Comments 

Problem Solving: Demonstrates the ability to gather information, to critically 

evaluate options, seeking alternative perspectives to identify root causes &   
develop solutions.

Comments 

Development Plan

Employee Evaluation Sample Forms Package – Employee goal setting appraisal form
2. Guiding Principles – How We Win

• Attract, Train & Retain exceptionally passionate and results-oriented people.

• Provide a safe work environment.
• Embrace a culture of Diversity, Integrity & Respect.
• Empower our people to win by improving results everyday.
• Contribute to our communities & proactively support environmental initiatives.
• Strive to earn loyal customers and maintain long-term relationships.
• Exceed customer expectations by reducing variations & delivering high-quality products on time every day.

Indicate the extent to which the employee displays these values.

Performance Assessment:
EE - Exceeds Expectations
ME - Meets Expectations

Values Score:/3.0

Competency Performance Assessment Score /3.0

EE ME NI

Accountable/Dependable: Takes responsibility for decisions, actions & results; 

delivers on commitments to stakeholders. Acts in the best interest of stakeholders;
places success of the organization ahead of personal gain. Proactive in decisions   
and actions.

Comments 

Teamwork: Builds trust by respecting the ideas & contributions of everyone; 

works well with others. Coaches & encourages others on a regular basis;
contributes to positive morale & spirit within the team; and embraces diverse &   
global cultures & ideas.

Comments 

Engaging: Demonstrates enthusiasm & passion for our business; willing to take 
risks & question status quo; creates excitement & inspires others to deliver by
motivating, positively influencing & recognizing others and making work fun;   
Decisive.

Comments 

Commitment to Excellence: Meets commitments using available resources.

Sets clear & measurable goals; stays focused on business priorities; willing to

make tough decisions & live with consequences; displays persistence & tenacity
to overcome obstacles. Seeks simple solutions to complex problems, considering   
varied alternatives before selecting solution; effectively uses internal/external
network.

Comments 

Employee Evaluation Sample Forms Package – Employee goal setting appraisal form
Curious: Generates new & creative ideas; fosters environment where questions, 
ideas & feedback are valued and acted upon; Attentive & respectful when listening
and responding to others. Develops self, learning from failures as well as   
successes. Accessible & approachable.

Comments 

Integrity: Demonstrates a commitment by adhering to its stated values, policies & 

procedures. Does the right thing, conducts business in an ethical manner in   
accordance with our conduct guidelines.

Comments 

Innovative: Anticipates internal & external customer needs & understands the 
customer perspective; pursues creative & unique solutions; is inspired to achieve   
more than imagined.

Comments 

Communication: Organizes & expresses ideas and information clearly, using 

appropriate and efficient methods of conveying the information. Communicates   
accurately & honestly in an open, candid and respectful manner.

Comments 

3. Overall Comments – Employee

4. Overall Comments – Manager

ABC 

Employee Evaluation Sample Forms Package – Employee goal setting appraisal form
Employee Evaluation Sample Forms Package – Employee goal setting appraisal form