Handwritten Performance Review Form

Effective evaluation of job performance is an ongoing process. Annually, associate and supervisor review and discuss performance against overall expectations. This form
should be used for associates who do not have regular computer/email access (e.g. most community associates, except people leaders and sales).

INSTRUCTIONS
Associates, rate yourself and provide supporting comments for each section. Then, give the form to your supervisor. Supervisors, rate your associate and provide
supporting comments for each section. Discuss ratings and feedback with the associate. Associate must sign and date to confirm performance discussion occurred.
Supervisors, file the completed and signed review in the associate’s local personnel file. DO NOT SUBMIT TO SERVICENOW.

For complete step-by-step instructions and year-end review tools, see the 2020 Year-End Review Guidebook.

Parts of This Performance Review Form

Part I – Performance of Role Responsibilities & Requirements

Discuss performance against the responsibilities and requirements of the role.

Part II – Brookdale Cornerstones

Cornerstones are the foundation of all that we do at Brookdale. These are the values that we look to all associates to demonstrate in their roles on a daily basis. Consider
whether, and how, these cornerstones were demonstrated over the last 12 months. Share examples of strengths and opportunities.

Part III – Brookdale Competencies & Development

Use the Brookdale competency model to identify 2-3 competencies of skill and 2-3 competencies of less skill. Consider development ideas for lower skill competencies.
Remember to use competencies that apply to the position (Individual Contributor or People Leader). It may be helpful to refer to the Brookdale Competency Model in
the 2020 Year-End Review Guidebook.

Part IV – Overall Performance Rating

Consider both what was achieved and how it was achieved when determining overall performance rating.
 Community/
Associate Name: Agency/Function:

Employee ID: Supervisor/Rater:

PART I: PERFORMANCE OF ROLE RESPONSIBILITIES & REQUIREMENTS

Discuss performance against the responsibilities and requirements of the role. Then, select a rating.

Associate Comments Supervisor Comments

Exceeded Exceeded

Met Met

Partially Met Partially Met

Did Not Meet Did Not Meet

 PART II: BROOKDALE CORNERSTONES

Cornerstones are the foundation of all that we do at Brookdale. These are the values that we look to all associates to demonstrate in their roles on a daily basis. Consider
whether, and how, these cornerstones were demonstrated over the last 12 months. Share examples of strengths and opportunities.

Passion
Seeks out challenges  Identifies and solves problems  Drives for results with enthusiasm  Celebrates wins

Associate Comments Supervisor Comments

Consistently Consistently
Demonstrated Demonstrated

Sometimes Sometimes
Demonstrated Demonstrated

Rarely Rarely
Demonstrated Demonstrated

Courage
Tackles tough assignments with a positive mindset  Addresses difficult issues in a constructive manner  Provides direct and actionable feedback  Takes appropriate risks to improve the
organization
Associate Comments Supervisor Comments

Consistently Consistently
Demonstrated Demonstrated

Sometimes Sometimes
Demonstrated Demonstrated
 Rarely Rarely
Demonstrated Demonstrated

Partnership
Working collaboratively with others to achieve individual, team, department, and organizational goals  Applies expertise to support team, department, and organization  Partners with
others to get work done  Breaks down barriers or silos to achieve results
Associate Comments Supervisor Comments

Consistently Consistently
Demonstrated Demonstrated

Sometimes Sometimes
Demonstrated Demonstrated

Rarely Rarely
Demonstrated Demonstrated

Trust
Listens to understand, partner, and solve  Follows through on commitments  Shows consistency between words and actions  Gains trust and support of others
Associate Comments Supervisor Comments
 Consistently Consistently
Demonstrated Demonstrated

Sometimes Sometimes
Demonstrated Demonstrated

Rarely Rarely
Demonstrated Demonstrated
 PART III: BROOKDALE COMPETENCIES & DEVELOPMENT

Use the Brookdale competency model to identify 2-3 competencies of skill and 2-3 competencies of less skill. Consider development ideas for lower skill competencies.
Remember to use competencies that apply to the position (Individual Contributor or People Leader). It may be helpful to refer to the Brookdale Competency Model in the
2020 Year-End Review Guidebook.

Associate Comments Supervisor Comments

 PART IV: OVERALL RATING

Consider both what was achieved and how it was achieved when determining an overall rating.

Associate Comments Supervisor Comments

Associate consistently Associate consistently

exceeded overall exceeded overall
performance performance
expectations. expectations.

Associate consistently Associate consistently

met, and may have met, and may have
sometimes exceeded, sometimes exceeded,
overall performance overall performance
expectations. expectations.

Associate sometimes Associate sometimes

met, and sometimes did met, and sometimes
not meet, overall did not meet, overall
performance performance
expectations. expectations.

Associate did not meet Associate did not meet

overall performance overall performance
expectations. expectations.

Associate must sign and date below to confirm supervisor discussed the completed performance review.

Associate Signature: ________________________________________________________________ Date: _______________________________________________