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- Sample Form -

Hourly Performance Appraisal This is an example form used by one of our


customers. If you would like us to send you
the editable Word document, please
contact info@halogensoftware.com

Appraisal Score Overall Score: /3.0

JC003 - LIS Coordinator


Name: Job Title:

Department: Supervisor

Evaluation Date:

I. 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

Performance Measures Score: /3.0


Performance
Competency Assessment Comments: 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.

Attendance:
Regular & punctual attendance at or below the 4 point
threshold. Individual is at workstation when scheduled and
remains for the duration of shift.

 
- Sample Form -
Hourly Performance Appraisal This is an example form used by one of our
customers. If you would like us to send you
the editable Word document, please
contact info@halogensoftware.com

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.
 
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.

Productivity:
Properly uses materials & equipment to effectively and
efficiently complete varying workload in a timely fashion.

Problem Solving:
Demonstrates the ability to gather information, to critically
evaluate options, seeking alternative perspectives to identify
root causes & develop solutions.

Development Plan:

II. 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
everyday.
- Sample Form -
Hourly Performance Appraisal This is an example form used by one of our
customers. If you would like us to send you
the editable Word document, please
contact info@halogensoftware.com

Indicate the extent to which the employee displays these values.


Performance Assessment:
EE - Exceeds Expectations
ME - Meets Expectations
NI - Needs Improvement to Meet Expectations

Values Score: /3.0


Performance
Competency Assessment Comments: 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.

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.

 
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.

 
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.

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.
- Sample Form -
Hourly Performance Appraisal This is an example form used by one of our
customers. If you would like us to send you
the editable Word document, please
contact info@halogensoftware.com

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.

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

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.

III. Overall Comments – Employee

IV. Overall Comments – Manager