BICOL-CENTER FOR HEALTH & DEVELOPMENT

BEHAVIORAL ASSESSMENT: PART I

FORM: BA_PART1 Series 2022 Rev 10-22
HUMAN RESOURCE FOR HEALTH
Behavioral Assessment Form

NAME of RATEE 2 Has some difficulty in dealing with the public,

= = = = = = = = = = = = = = = = = = = =========== occasionally discourteous except when attending to
_____________________________________________________ important or influential persons.
1. Courtesy – the HRH behavior to be polite, kind manner of
PLACE OF ASSIGNMENT:: speech and actuation and relations with you and other publics. 1 Has considerable difficulty in dealing with the
public. Draws negative reactions. Often discourteous
_____________________________________________________ 5 Always goes all the way to make people comfortable and irritable.
and satisfied even under pressure and occupied with
work; very effective in dealing with people. 3. Integrity – the HRH adherence to the Code of Conduct &
NO OF YEARS DEPLOYED ______________ Ethical Standards and Values. Demonstrated ability in the
Frequently goes out of the way even under pressure and adherence to a code of moral conduct and values.
4
occupied with work; generally courteous and
DATE OF RATING ______________ accommodating. 5 Always righteous, upright and can be trusted on any
matter; always straight, uncompromising and
Usually goes out of the way to assist the public; able to incorruptible in this daily dealings.
3
PLEASE READ THE INSTRUCTIONS deal with public & peer although need some advise at
CAREFULLY BEFORE times. 4 Consistently sincere in his/her dealings with others;
ACCOMPLISHING THIS FORM free from fraud and deception.
2 Occasionally assist the public; at times discourteous;
shows lack of patience in dealing with people. 3 Fair and just in dealing with self and others; since in
purpose and deed and unpretentious most of the time.
INSTRUCTIONS 1 Oftentimes discourteous and irritable; regularly
complained due to inconsiderate attitude. 2 Insincere, not trustworthy in carrying out duties and
1. This form is used for evaluating the performance of the HRH responsibilities; allows him to be used by others in
in this rating period. Please use pen or ball pen when 2. Human Relations – the HRH integrated concern for people at situations, which may lead to fraud and deception.
accomplishing this. work, office clientele, and supervisor-subordinate relationship
1 Dishonest in any transaction and dealing with others.
into work situations.
2. Please observe fairness and objectivity when rating the HRH.
Very effective in dealing with public. Gets along 4. Stress Tolerance – the HRH demonstrated ability of
5
3. In rating the HRH, please CHECK the box that most easily with other members of the workforce. Has performance under pressure or opposition.
objectively describes his/her attitude and behavior in the cordial relationship with subordinates and peers.
performance of his/her functions. Where 5 is Outstanding, 4 is 5 Always calm and shows pleasant disposition;
Very Satisfactory, 3 is Satisfactory, 2 is Unsatisfactory, 1 is Can be relied upon to deal with the public and is consistently confidently and positive even during
Poor 4 stressful conditions at work; never loses patience and
generally courteous and accommodating.
never allows tension and anxiety to affect workplace
4. After accomplishing this form, please affix your signature over Has the ability to deal pleasantly with the public, (performance in workplace)
3
printed name. subordinates, and peers

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BICOL-CENTER FOR HEALTH & DEVELOPMENT
BEHAVIORAL ASSESSMENT: PART I
FORM: BA_PART1 Series 2022 Rev 10-22
HUMAN RESOURCE FOR HEALTH
Behavioral Assessment Form
4 Most of the time clam, confident and positive;  For Renewal  For Non-Renewal
occasionally loses emotional control during stressful 6. Compliance to office rules and regulations – the HRH
conditions. observance and adherence to existing office policies/rules. COMMENTS:
3 Normally calm, confident and positive; occasionally 5 Always complies to office rules and reminds others to
loses emotional control during stressful conditions. observe them

2 Often loses emotional control in dealing with stressful 4 Generally complies to office rules with minimal
work situations; often complains about people and reminders
situations at work.
3 Occasionally lax in observing office rules and RATED BY:
1 Cannot handle stress; highly emotional and into regulations
violent arguments with others.
2 Regularly reminded of existing rules and regulations
5. Initiative and Resourcefulness – the HRH demonstrated ________________________________________
ability to start action and project. 1 Ignore and violates office rules and regulations Name
5 Highly creative with new ideas and suggestions that 7. Punctuality and Attendance – the HRH observed behavior
result in increased effectiveness, efficiency, and of coming to office on time as to b present at work to ________________________________________
productivity; has an ideal outlook and concern to the complete assigned responsibilities. Position & Date
work and can perfectly solve problems own initiative,
attentive to work; usually overcomes extra ordinary 5 Always within the working area or place of work
problems.
4 Mostly within the working area or place of work
4 Resourceful in doing his own job more efficiently, ADJECTIVAL RATING:
effectively and productively; takes own initiative, Often times within the working area or place of work
3
attentive to work; usually overcomes extra ordinary
problems
2 Rarely within the working area or place of work Score: Adjectival Rating
3 Average attitude and interest in his work; performs 4.6-5.0 Outstanding
1 Always not within the working area or lace of work Very Satisfactory
accordingly to his job descriptions and 3.6-4.5
responsibilities; fairly competent to handle ordinary 2.6-3.5 Satisfactory
problems 1.6-2.5 Needs Improvement
TOTAL SCORES: ________ Poor/Failed
Hardly performs his job description and 1.0-1.5
2
responsibilities; works only after consistent prodding.
Average Score: (Total Score) / 7
1 Requires very close coordination; rarely meets
deadlines; fails to find ways out of any difficulties. RECOMMENDATION: Please check:

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