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STAFF PERFORMANCE APPRAISAL FORM


Name:_______________________________________Job Title:__________________________________

Department:______________________________________Period Covered:____________________________

The primary purpose of a performance evaluation is to STIMULATE COMMUNICATION and help the supervisor and
employee discuss the level of performance associated with the employee's job duties and responsibilities, leading to an
improved understanding of performance requirements. It is important that the supervisor make constructive comments
aimed at helping the employee and that both parties discuss the rating and have a shared understanding of the standards
used by the supervisor, his or her expectations, and the objectives and needs of the employee. In order to succeed, the
performance review must include a full discussion of all items on the performance evaluation form.

Appraisal should be based on the job description for the position the employee holds. Comments included after each
evaluation item should be references to the performance level of the job duties/or responsibilities or work assignments
included in the job description.

(1) (2) (3) (4)


Unsatisfactory Needs Improvement Meets Expectations Above Expectations

TASK ACCOMPLISHMENTS

1. Rate the quality of this person's work. For example, does it fulfill requirements, and is it acceptable to those it serves?
1 _______ 2 _______ 3 _______ 4 ______

2. Rate the quantity of this person's work. For example, can the person work on more than one task concurrently, and is
the work completed within reasonable time?
1 _______ 2 _______ 3 _______ 4 _______

3. Rate the thoroughness of this person's completed work. For example, is the work comprehensive in scope and
complete in detail?
1 _______ 2 _______ 3 _______ 4 _______

4. Rate the accuracy of the completed work. For example, does this person produce work that is relatively free from
error?
1 _______ 2 _______ 3 _______ 4 _______

5. Rate this person's overall job knowledge. For example, to what extent does this person display a complete mastery of
all phases of the job?
1 _______ 2 _______ 3 _______ 4 _______

6. Rate this person's written communication skills. For example, how well does the person communicate through written
messages, reports, etc?
1 _______ 2 _______ 3 _______ 4 _______

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7. Rate this person's use of judgement. For example, how effectively does the person arrive at sound conclusions, and
how precise is the person in determining when action is needed and what action to take?
1 _______ 2 _______ 3 _______ 4 _______

Comments:
_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

SUPPORTIVE CHARACTERISTICS:

1. Rate this person's initiative. For example, is the person a self-starter in pursuing activities which lead to successful
attainment of objectives?
1 _______ 2 _______ 3 _______ 4 _______

2. Rate this person's reliability. For example, can the person generally be depended upon in day-to-day activities and in
matters of a highly important or confidential nature?
1 _______ 2 _______ 3 _______ 4 _______

3. Rate this person's enthusiasm and cooperation. For example, is the person eager to accomplish tasks and does this
person contributes to the climate of collaboration and team work among co-workers?
1 _______ 2 _______ 3 _______ 4 _______

4. Rate this person's oral communication skills. For example, how effectively does the person comment, question, and
provide information in task-related discussions?
1 _______ 2 _______ 3 _______ 4 ________

5. Rate this person's perseverance. For example, how successful is the person in following a task through to completion
in spite of setbacks or discouragement?
1 _______ 2 _______ 3 ________ 4 ________

Comments:
_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

ONLY TO BE COMPLETED FOR THOSE WHOSE JOB DESCRIPTION INCLUDES


SUPERVISORY RESPONSIBILITIES

SUPERVISORY CHARACTERISTICS:

1. Rate this person as a leader. For example, how successful is the person in guiding people so that they work together
toward a common objective?
1 _______ 2 _______ 3 _______ 4 _______

2. Rate this person's ability to communicate as a supervisor. For example, does the person disseminate general and
specific information regarding goals, tasks, personnel and administrative details in a timely fashion?
1 _______ 2 _______ 3 _______ 4 _______

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3. Rate this person's flexibility. For example, how successfully can the person alter activities to meet the demands of new
situations?
1 _______ 2 _______ 3 _______ 4 _______

4. Rate this person's ability to provide structure. For example, how successful is the person in arranging the total activity
into logical, practical assignments?
1 _______ 2 _______ 3 _______ 4 _______

5. Rate this person's concern for subordinates. For example, does the person create a climate of growth, development, and
support for employees?
1 _______ 2 _______ 3 _______ 4 _______

6. Rate this person's economy. For example, are costs adequately controlled by utilizing personnel, material, and machine
resources efficiently?
1 _______ 2 _______ 3 _______ 4 _______

7. Rate this person's ability to monitor progress. For example, to what extent does this person see that plans and
instructions are effectively carried out?
1 _______ 2 _______ 3 _______ 4 _______

IN SUMMARY, WHAT IS YOUR ESTIMATE OF THIS EMPLOYEE'S ALL AROUND PERFORMANCE

1 _______ 2 _______ 3 _______ 4 _______

SUMMARY COMMENTS:
_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

______________________________________________________ _______________________________
SUPERVISOR'S SIGNATURE DATE

EMPLOYEE COMMENT:
_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

This evaluation has been discussed with me by my immediate supervisor.

______________________________________________________ _______________________________
EMPLOYEE SIGNATURE DATE

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