Company Name

LOGO Comptency Assessment

Human Resources Department

Section 1 Employee Data:

Employee Name: Job Title: Department:

Joining Date: Evaluation Period: From: To:

Performance Cycle: Annual Bi-Annual Quarterly Others (please specify)

Section 2: Department head (evaluator) completes this section and discusses the rating with employee during the
evaluation meeting. Document any level of improvement needs in Section 3.
Competency Assessment Rating Criteria
Exceeded Achieved Partially Achieved Not Achieved
(exceed some areas of job (regularly meet job targets & (meet some areas of job (fail to meet the majority of
expectations) expectations) expectations) job expectations)
4 3 2 1

Competency Competency Proficiency Level Rating

Innovative & Learning Basic Proficient Advanced 0

Teamwork Basic Proficient Advanced 0

Effective Communication Basic Proficient Advanced 0

Core

Problem Solving Basic Proficient Advanced 0

Quality & Continuous Improvement Basic Proficient Advanced 0

Discipline & Compliance Basic Proficient Advanced 0

Developing Others Basic Proficient Advanced 0

Leadership

Decision Making Basic Proficient Advanced 0

People / Team Management Basic Proficient Advanced 0

Negotiation & Influencing Basic Proficient Advanced 0

Total Competency Assessment Score: 0.00

Distribution: Original in Employee Personnel File Form No. 01

Copy: Concern Department Head, Employee, and Training Department
 Company Name
LOGO Comptency Assessment
Human Resources Department

Section 3 Development Plan: To be completed by the evaluator. What are the key development requirements of the
employee? Describe the employee’s key development activities i.e. training, job rotation, special project, certifications,
coaching & mentoring, workshops, etc. List in priorities and indicate appropriate development timeline for completion. Use
additional sheets, if required.

Development Timeline for

Key Development Activities
Completion

Employee Comments (use additional sheets, if required):

Evaluator Comments (use additional sheets, if required):

By signing this form, you confirm that you have discussed this evaluation in detail with your Department Manager
(evaluator).

Employee Signature & Date Department Manager Signature & Date

Distribution: Original in Employee Personnel File Form No. 01

Copy: Concern Department Head, Employee, and Training Department