PERFORMANCE APPRAISAL FORM

P.O. BOX 1, KYAMBOGO

Tel: 0414-286452, Fax: 041-220464
Email: [email protected], www.kyambogo.ac.ug
Directorate of Human Resources

Appraisal Form
Preamble

Staff Performance Appraisal is part of the Performance Management System of Kyambogo University. It is used as a
management tool for establishing the extent to which set targets within overall goals of the University are achieved. Through
staff performance appraisal, performance gaps and development needs of an individual employee are identified. The
appraisal process offers an opportunity to the Appraisee and Appraiser to dialogue and obtain a feedback on performance.
This therefore, calls for a participatory approach to the appraisal process.

The Appraiser and Appraisee are therefore, advised to read the detailed guidelines before filling this form.
DD MM YYYY DD MM YYYY
Period of Assessment: From To

SECTION A: PERSONAL INFORMATION (To be filled by the Appraisee)

Name of the Appraisee ___________________________________________________________________________

DD MM YYYY
Date of Birth

Job Title ______________________________________________ Salary scale _________________________

DD MM YYYY
Date of Current Appointment

Terms of employment (Probation, Permanent, Contract):_______________________________________________

If contract or probation indicate start date: ___________________ end Date: ________________________

Name of the Appraiser:__________________________________________________________________________

Appraiser’s Job Title:_____________________________________ Salary scale: ____________________________

Division/section: _______________________________________________

Department: __________________________________________________________________________________

Faculty (where applicable): ______________________________________________________________________

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SECTION B: ASSESSMENT OF THE LEVEL OF ACHIEVEMENT

This section should be filled by both the Appraiser and the Appraisee. At the beginning of each assessment period, the Appraiser and Appraisee will agree on the key outputs for the
assessment period. The means by which performance shall be measured (Performance Indicators) and the minimum level of performance (performance targets) for each output shall
be agreed upon. If in the course of the assessment period, other activities are assigned to the Appraisee, the outputs related to the new activities should be agreed upon and included
immediately or at least before the end of the assessment period. It is recommended that the maximum number of outputs for each assessment period should not exceed 10.

At the end of the assessment period, an appraisal meeting should be conducted by the Appraiser. The Appraisee completes part B(1); before the appraisal meeting, by indicating the
key outputs, performance indicators and targets agreed upon in the performance plan at the beginning of the assessment period. The Appraiser should complete part B(2), after the
appraisal meeting. The assessment should reflect the jointly agreed position.

The assessment of the Individual outputs shall be reflected as a performance level under section B(2); this will be supported by relevant comments on performance under the same
section. The performance levels shall be described as Excellent, Very Good, Good, Fair and Poor. In order to quantify the assessment, the performance levels shall be awarded
scores namely; 5 for excellent, 4 for Very Good, 3 for Good, 2 for fair and 1 for Poor. Right after the table below is a detailed description of the performance levels.
B (1) B (2)
Agreed Key Outputs, performance Indicators and Targets Assessment of Performance

Performance Indicators Performance targets Self Supervisors Agreed Rating Comments of Performance
Key Outputs (How will results be measured) (An agreed minimum level of Rating Rating
performance)

TOTAL
OVERALL SCORE

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DEFINITION OF THE PERFORMANCE LEVELS

Excellent (5): The Appraisee has exceeded the agreed targets and has consistently produced results of excellent quality and demonstrated
a high level of productivity and timeliness.
The Appraisee is a model of excellence in both the results achieved and the means by which they are achieved.

Very good (4): The Appraisee achieved all the agreed output in line with the agreed targets. The Appraise consistently meets expectations
for the out puts achieved and the means by which they are achieved.

Good (3): The Appraisee achieved most, but not all the agreed out puts in line with the agreed targets, and there is no supporting
rationale for not meeting the other commitments.

Fair (2): The Appraisee has achieved minimal outputs in line with the agreed and without a supporting rationale for inability to meet
the commitments.

Poor (1): The Appraisee has not achieved most of the agreed targets and without supporting rationale for not achieving them.

Overall Assessment of Performance

Overall assessment of performance should be derived by adding the scores at each performance level and the total divided by the total number of outputs. The average of the scores
obtained shall be the overall assessment.

Overall Performance Level Excellent Very Good Good Fair Poor

5 4 3 2 1
Tick the relevant box

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SECTION C: ASSESSMENT OF CORE COMPETENCIES

This section should be filled by the Appraiser after joint discussions between the Appraiser and
Appraisee. The assessment will help establish any areas where some training or development is
necessary. The Appraisee should be rated only in areas, which are relevant to his/her job. The maximum
points per competence are 5, where 5 is for Excellent, 4 - Very Good, 3 - Good, 2 - Fair, 1 – Poor,
N/A - Not Applicable. The Appraiser should give work related examples under comments, to justify
their rating.

COMPETENCE ASSESSMENT COMMENTS

Performance level
attained
(Please tick)
5 4 3 2 1 N/A
Professional knowledge/skills
Draws on own experience, knowledge and expertise to demonstrate
good judgment; relates professional knowledge to work.

Planning, organizing and coordinating

Prioritizes own work, develops and implements plans; rationally
allocates resources, builds group capacity for effective planning and
executing of work. Has ability to meet deadlines.
Leadership
Keeps people informed; models and encourages personal
accountability; uses power and authority fairly; demonstrates credible
leadership, champions new initiatives; reinforces and communicates a
compelling vision for change.

Decision Making
Makes logical analysis of relevant information and factors; develops
appropriate solutions and takes action, generates ideas that provide
new insight; provides reasons for decision or actions, is objective.

Team work
Works cooperatively and collaboratively; builds strong teams; shares
information and develops processes to improve the efficiency of the
Team.

Initiative
Shows persistence by addressing current problems; acts proactively,
plans for the future and implements comprehensive plans.
Is open to new ideas; curious about and actively explores new
possibilities; identifies how to create more value for customers; takes
action on innovative ideas and champions innovation.

Communication
Actively listens and speaks respectfully; seeks to send clear oral and
written messages; understands the impact of messages on others.

Result Orientation
Takes up duty willingly and produces results.

Integrity
Communicates values to others, monitors own actions for consistency
with values and beliefs, takes pride in being trust worthy; is open and
honest and provides quality services without need for inducements.

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Human Resource Management

Works effectively with people to achieve organizational goals.
Motivates the supervisees, focuses on the knowledge, skills and
attitudes and the general work environment that affects their efficiency
and effectiveness. Trains, mentors, coaches, inspires, motivates the
supervisees, delegates effectively and are able to build a strong
working team.

Financial Management
Knows the basic financial policies and procedures; familiar with the
overall financial management processes.

Management of other resources (equipment & facilities)

Effectively and efficiently uses resources to accomplish tasks.

Time Management
Always in time and accomplishes tasks in time required and maximizes
the use of time to achieve set targets.

Customer care
Responds well and attends to clients. Reflects a good image for the
University.

Loyalty
Complies with lawful instructions of Supervisor and is able to provide
ongoing support to Supervisors.

Any other relevant Competence

SECTION D: ACTION PLAN TO IMPROVE PERFORMANCE

The Action Plan shall be jointly agreed during the performance appraisal meeting, taking into
consideration the Appraisee’s required job competences and the identified performance gaps.

The action plan to improve performance may include; Training, Coaching, mentoring, attachment, job
rotation, counseling and or provision of other facilities and resources.

Where the plan(s) involve formal training of the Appraisee, the record should be forwarded to the Staff
Development Committee through the Director Human Resources.

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Performance Gap Agreed Action Time frame

SECTION E: COMMENTS, RECOMMENDATIONS (IF ANY) AND SIGNATURES

This section is to be completed by the Appraisee, Appraiser and the counter signing Officers. It is a
confirmation that the appraisal meeting took place and that there was agreement or if there was
disagreement, it was resolved. It is also confirmation that the action plan to improve performance was
discussed and agreed upon. The Appraisee / Appraiser / countersigning officer should use this section to
comment about the job, career and any other relevant information.

Describe how effectively you have been utilized by the University.

How would you like Management to assist you improve your performance?

List the skills and training you need in order to improve performance.

What are your aspirations in terms of career development?

Any other general comments?

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DD MM YYYY
Signature:_____________________________________

COMMENTS OF THE APPRAISER

DD MM YY
Signature ____________________________________

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COMMENTS OF THE COUNTERSIGNING OFFICER/SUPERVISOR OF APPRAISER

Name of Countersigning Officer: _______________________________________________________

Job Title: ___________________________________________________________________________

DD MM YY
Signature:___________________________________
_

COMMENTS OF THE RESPONSIBLE OFFICER (DHR/University Secretary/Vice Chancellor)

Name: (DHR/US/VC): __ ___________________________________________________________

Job Title: ___________________________________________________________________________
DD MM YY
Signature: _______________________________