Competency Proficiency Assessment - Hospitals

DEPARTMENT OF HEALTH
HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU
COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

Competencies are behaviors that predict superior performance and success within a particular job or function.
Instructions
Read
Read the competency definition and each proficiency level. Note that levels are spread from Level A (lowest level) to Level E (highest level). Take a moment
to understand how the competency progresses from Level A to Level E. You may refer to the definition of each proficiency level for guidance on what behavior
is expected under each level.
Assess
Mark by shading the level of behaviors consistently manifested by the Incumbent. This is the highest level routinely achieved and could reasonably be
expected to be repeated on an ongoing basis. Please do not assess anticipated or desired behaviors, but rather behaviors that are consistently demonstrated
on the job.
Do not select a particular level unless you can think of at least several specific critical incidents that manifest the behaviors indicated.
Since each level builds on the previous proficiency levels of a competency, consistent mastery of the behaviors in the lower levels must be shown.
Write
It is recommended that you provide critical incidents on the third column of the answer sheet. Critical incidents are indicators that you possess the
competency and will confirm how the competency is manifested in real work situations. Please use the back of the page or attach additional sheets if
necessary. On the fourth column, please cite your strongest points for each competency or recommend training and/or developmental interventions if
reinforcements are needed.
Assistance
Assistance is available in Health Human Resource Development Bureau. You may call Ms. Tsarie Ulanday or Ms. Tsiki Obedoza at 651-7800 or at local
4250-51
FOR SALARY GRADE 1 9 (SKILLED)

SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
Status of Appointment: ____________________________
No. of years in current position: _____________________
CORE COMPETENCIES
Organizational Commitment
Integrity
Quality Service Focus
Teamwork
Stewardship of Resources
Self-Development
Attention to Communication
FUNCTIONAL COMPETENCIES
Applied Learning
Energy
Initiative
Interpersonal Relations
Safety Awareness
Expertise on: (area/field)
Time Management
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
No. of years in service:_________________________________
Date accomplished: ___________________________________
D
LEVELS
C
CRITICAL INCIDENTS
COMMENTS ON
STRENGTHS/DEVELOPMENTAL NEEDS
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
DOH-HHRBD, CompetencyProficiencyAssessment
Revision 1
28 November 2013
Name and Signature of Staff

Date:
Name, Position and Signature of Supervisor

Date:
FOR SALARY GRADE 1 9 (NON-SKILLED)

SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Adaptability
Applied Learning
Initiative
Quality Orientation
Expertise on: (area/field)
Time Management
LEVELS
C
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
D
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:
FOR SALARY GRADE 10 14

SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Adaptability
Initiative
Networking
Results Orientation
Technical Expertise on: (area/field)
Time Management
LEVELS
C
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
D
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:

FOR SALARY GRADE 15-17
SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Adaptability
Analytical Thinking
Networking
Planning and Organizing
Program/Project Management
Results Orientation
Technical Consulting
Technical Expertise on; (area/field)
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
D
LEVELS
C
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:

FOR SALARY GRADE 18-24
SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Conceptual Thinking
Managing Performance
Political Savvy
Problem Solving and Decision Making
Results Orientation
LEVELS
C
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
D
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:
FOR DIVISION CHIEFS

SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Building a Successful Team
Managing Performance
Program/Project Management
Visionary Leadership
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
D
LEVELS
C
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:
FOR DIRECTORS
SELF ASSESSMENT
Name
: ___________________________________
Position Title : ___________________________________
CORE COMPETENCIES
Integrity
Teamwork
Self-Development
Financial Management
Managing Change
Managing Conflict
Political Savvy
Resource Management
Visionary Leadership
LEVELS
C
LEVELS
C
Office/Service:
___________________________________
Division
:
___________________________________
CRITICAL INCIDENTS
COMMENTS ON
CRITICAL INCIDENTS
COMMENTS ON
Validated by:
Revision 1
28 November 2013

Date:

Date:

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DEPARTMENT OF HEALTH

HEALTH HUMAN RESOURCE DEVELOPMENT BUREAU

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

FOR SALARY GRADE 1 9 (SKILLED)

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

FOR SALARY GRADE 1 9 (NON-SKILLED)

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

FOR SALARY GRADE 10 14

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

FOR DIVISION CHIEFS

Name and Signature of Staff

Name, Position and Signature of Supervisor

COMPETENCY PROFICIENCY ASSESSMENT HOSPITALS

Name and Signature of Staff

Name, Position and Signature of Supervisor

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