RHC Performance Evaluation Form Original11.18.20

RHC PERFORMANCE EVALUATION FORM
PERFORMANCE FACTORS
 Traits Factor – traits or qualities such as leadership, cooperation, etc. rated according
to the rater’s judgment
 Job Goals/Target Factor – actual output, set and defined according to measurable
criteria
Weight factor Traits Job Goals Total

Staff Level 40% 60%
Supervisory 30% 70% 100%
Managerial 20% 80%
Put ( ) on the corresponding blank to indicate the below category:

________ 3rd month Evaluation
________ 5th month Evaluation
________ Semi-annual Evaluation
PERFORMANCE EVALUATION FORM

INSTRUCTION
Evaluate the performance of your employee under your supervision. Since your appraisal will
become an important part of the employee’s record, you are expected to appraise with utmost
care and attention.
The following are important reminders for your guidance:

1. Do your rating at a time and place with the least distraction.
2. Reach each factor or quality or trait carefully.
3. Be sure to rate each factor or trait/quality independent or other factors to avoid halo
effect.
4. Make your rating objectively and fairly. Base your rating on facts not on mere
impressions and personal feelings. Avoid over rating from mistaken motives of kindness
and understanding based on prejudice.
5. Length of service, physical qualities, age previous ratings, and similar factors should not
influence the rating.
6. Rate the person only on what is expected of someone in that position or how well he
satisfies the requirements of the job.
7. Rate the person, not the position.
8. The performance rating is highly confidential.
9. Human Resource Department will be responsible for the review and checking of the final
computation.
Page 1 of 5
NAME: _______________________ JOB TITLE: _____________ DEPT.:__________
EVALUATION PERIOD FROM: ____________ TO: ____________
FACTOR 1: TRAITS / ABILITY RATING

Instructions:
1. Encircle the number to indicate your rating.
2. Multiply Weight Factor by numerical rating by (ex. .12x5)
3. Add ALL results of computed (Weight Factor x Numerical Rating) to get Total
Weighted Rating
ex. (.12x5)+(.12x4)+(.12x4)…. And so on.
Legend: 1 – poor 2 – fair 3 – good 4 – very good 5–
excellent
PERFORMANCE FACTORS WEIGHT FACTOR RATING

1. KNOWLEDGE & SKILLS .12 1 2 3 4 5
2. JUDGMENT .12 1 2 3 4 5
3. PROBLEM SOLVING .12 1 2 3 4 5

4. LEADERSHIP .12 1 2 3 4 5
5. EFFICIENCY .10 1 2 3 4 5
6. WORK QUALITY .10 1 2 3 4 5
7. INITIATIVE .09 1 2 3 4 5
8. DEPENDABILITY .09 1 2 3 4 5
9. COOPERATION .07 1 2 3 4 5
10. ATTENDANCE .07 1 2 3 4 5
Total Weighted Rating: ____________
FACTOR 2: JOB TARGETS / GOALS RATING

NAME: ________________________ POSITION: _____________ DEPT.:__________
DATE: _______________ Evaluation Period: ________________________________
Instructions:
Page 2 of 5
1. Specify the goals/description and describe the performance for columns 1 & 2.
2. Decide/write the weight factor (in percentage or in proportion) of each job goal
description for column. The highest weight should be the most important task,
second highest the second most important task and so on. The total weight factor
should be 100 for percentage or 1 for proportion of all job factors.
3. Write the numerical rating, from 1 to 5 for column 4.
1 – poor 2 – fair 3 – good 4 – very good 5 – excellent
4. Multiply the number in column 3 & 4 to obtain the weighted rating in column 5.
5. Add the weighted rating of all job goals then divide it by 5 to obtain the total
weighted rating.
JOB GOAL PERFORMANCE WEIGHT NUMERICAL WEIGHTED

DESCRIPTION DESCRIPTION FACTOR RATING RATING
TOTAL WEIGHTED RATING _______________________________________
CONCLUSIONS, OTHER COMMENTS AND RECOMMENDATIONS
1. Workers’s overall performance evaluation in accordance with the requirements of his

position is:
( ) poor ( ) below average ( ) average ( ) above average ( ) excellent
Page 3 of 5
Explain reason or support with specific incidents:
2. Worker’s overall performance evaluation relative to the performance of the other

members of your staff is:
( ) lower 25% ( ) middle 50% ( ) top 25%
3. Identify skills, training, education and experience required of the job position that the
employee have or possess.
4. Identify skills, training, education and experience required of the job position that the
employee needs or lacks.
5. Identify or suggest training that you feel the employee needs to fill his inadequacy in
item 4.
6. Identify employee’s strengths and weaknesses that are not related to training.
STRENGTHS: WEAKNESSES:
7. Suggest ways for worker’s growth and development other than training.
8. Overall impression and recommendation.
Conforme: Evaluated by: Noted:
SUMMARY OF RATING
(FOR MANAGERIAL LEVEL)
Traits Rating --------------------- % X 0.2 = _______________
Page 4 of 5
Job Goals Rating --------------- % X 0.8 = _______________
Overall Rating -------------------- = _______________
(FOR SUPERVISORY LEVEL)
Traits Rating --------------------- % X 0.3 = _______________

Overall Rating -------------------- = _______________
(FOR STAFF LEVEL)
Traits Rating --------------------- % X 0.4 = _______________

Overall Rating -------------------- = _______________
Rater’s Comments and Recommendations
___________________________ _________________
Rater’s Signature over Printed Name Date
Employee Remarks:
___________________________ _________________
Employee Signature Date
Evaluated by: Reviewed by: Approved by:
Position: Position: Position:

_________________________ _________________________ _________________________
Signature: Signature: Signature:
_________________________ _________________________ _________________________
Page 5 of 5

RHC Performance Evaluation Form Original11.18.20

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RHC PERFORMANCE EVALUATION FORM

Weight factor Traits Job Goals Total

Supervisory 30% 70% 100%

Managerial 20% 80%

Put ( ) on the corresponding blank to indicate the below category:

PERFORMANCE EVALUATION FORM

The following are important reminders for your guidance:

FACTOR 1: TRAITS / ABILITY RATING

PERFORMANCE FACTORS WEIGHT FACTOR RATING

3. PROBLEM SOLVING .12 1 2 3 4 5

6. WORK QUALITY .10 1 2 3 4 5

10. ATTENDANCE .07 1 2 3 4 5

Total Weighted Rating: ____________

FACTOR 2: JOB TARGETS / GOALS RATING

JOB GOAL PERFORMANCE WEIGHT NUMERICAL WEIGHTED

TOTAL WEIGHTED RATING _______________________________________

CONCLUSIONS, OTHER COMMENTS AND RECOMMENDATIONS

1. Workers’s overall performance evaluation in accordance with the requirements of his

( ) poor ( ) below average ( ) average ( ) above average ( ) excellent

2. Worker’s overall performance evaluation relative to the performance of the other

( ) lower 25% ( ) middle 50% ( ) top 25%

8. Overall impression and recommendation.

Conforme: Evaluated by: Noted:

(FOR MANAGERIAL LEVEL)

Traits Rating --------------------- % X 0.2 = _______________

(FOR SUPERVISORY LEVEL)

Traits Rating --------------------- % X 0.3 = _______________

(FOR STAFF LEVEL)

Traits Rating --------------------- % X 0.4 = _______________

Rater’s Comments and Recommendations

Evaluated by: Reviewed by: Approved by:

Position: Position: Position:

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