2/23/23, 1:53 PM Staff Performance Appraisal - SafetyCulture

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Title Page

Date and Time of Review 

Department

Name of Employee

HR Manager / Supervisor

General Information

Employee Number

Post

Date Hired 

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Employment Status

Reference

REFERENCE: Rating Guidelines

[This is an example of how you can use iAuditor to include reference images in your
templates to assist with assessment]

Performance Assessment

Attendance

5 4 3 2 1

Job Knowledge and Skills

5 4 3 2 1

Quality of Work

5 4 3 2 1

Initiative and Motivation

5 4 3 2 1

Teamwork

5 4 3 2 1

General Conduct

5 4 3 2 1

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2/23/23, 1:53 PM Staff Performance Appraisal - SafetyCulture

Discipline

5 4 3 2 1

Completion

• Look at the total score above and select the relevant overall performance rating.

5 4 3 2 1

Reference Guide

Special task taken up or commendation obtained by the employee during the appraisal
period

Overall comments on performance

Sign-off

Full Name and Signature of Employee 

Hi there 👋

Full Name and Signature of Supervisor / HR Do you need some help finding the
right form?

Manager

Yes, I'd like some help.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's
solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
I want
You should seek your own professional advice to determine if the use of a template is permissible toworkplace
in your importormy own form.
jurisdiction. You should
independently determine whether the template is suitable for your circumstances.

No, I'm good. Thanks!

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