PERFORMANCE EVALUATION FORM
C O N F I D E N T I A L
Employee Information (Please Type)
Name
Department/Division Classification/Position
Immediate Supervisor Classification/Position
Evaluation Period From To
Evaluation Period (Check One):
Probationary Period (6 mos./12 mos.)
Annual Review
Special (please explain)
Comments:
Rev. 6/13
Evaluation Guide
The purpose of the Employee Performance Evaluation and Development Plan is: 1) to increase communication
among employees and supervisory personnel concerning the performance of employees in the accomplishment of
their assigned duties; 2) to establish specific work-related goals and objectives; and 3) to prepare a personal
development plan for further employee development. The evaluation process informs the employee how he/she is
performing the duties of his/her position. The process also promotes improved customer service (both internal
and external) by pinpointing performance areas for commendation and/or improvement. Well-planned
coaching/counseling sessions during the evaluation also assist an employee in his/her development. An
evaluation should be conducted with fairness, honesty and with a sincere interest in the employee.
The objectives of a good evaluation are:
● To recognize and commend good performance.
● To assure quality performance by identifying and correcting areas requiring improvement.
● To provide consistent feedback and discussion between an employee and the supervisor regarding
performance expectations.
● To improve job satisfaction, productivity and morale.
● To provide documentation to support personnel actions.
This evaluation guide provides supervisors with a uniform format for the evaluation of an employee.
The supervisor is to provide a performance rating score for each category during the evaluation. The scale has
five possible ratings. Each is assigned a numerical value for the purpose of determining an overall score for the
evaluation period. Please review the following definitions of the performance ratings before you evaluate the
employee’s overall performance.
Ratings
Outstanding
A performance level demonstrating consistent excellence in the scope, quantity and quality of the achieved
results. The excellent results are obvious to all, and the employee’s contribution to the goals and objectives of the
organization are extraordinary.
Exceeds Job Requirements
A performance level consistently higher than the “Meets Job Requirements” level and occasionally
“Outstanding.” Achieved results exceed performance objectives and standards and occasionally result in an
extraordinary and highly effective contribution by the employee.
Meets Job Requirements
Employee demonstrates solid performance in the completion of the full scope of the duties for the position. The
employee takes initiative, plans and follows through on all responsibilities, and has satisfactory work habits and
relationships with others. Achieved performance results are compatible with the organization’s goals and
objectives.
Needs Instruction or Development
A performance level below the “Meets Job Requirements” level. Achieved results are not compatible with goals
and objectives of the organization and the employee requires additional instruction or development. This level
may be anticipated from a new employee who is learning the job duties and does not have sufficient experience or
training to achieve the “Meets Job Requirements” level.
1 Rev. 1/08
Unsatisfactory
A performance level that is significantly below the “Needs Instruction or Development” level. The employee
does not satisfy basic job standards and does not satisfactorily perform the scope of duties. The employee does
not comply with currently accepted principles, methods, and practices in regards to job responsibilities, work
habits, and relationships. Performance results are disruptive of goals and objectives of the organization.
Signatures and Comments
Raters - All raters are not management. They may be senior workers, crew leaders, leadworkers, etc. They are
responsible for overseeing, reviewing, and planning daily assignments of subordinate personnel. If they are
responsible for any of these functions, their comments and signature must be provided in the evaluation on page
7.
Supervisors - Supervisors are management level personnel that supervise, plan, coordinate, schedule, and assign
work within a division unit. Their comments and signature must be provided in the evaluation on page 7.
Division and Department Directors - Division and Department Directors must sign on the applicable line. If
either the Division or Department Director wants to add comments to an employee’s evaluation, the employee
must see the comments prior to signing the form. Additional comments should not be a surprise to the
employee.
Development Plan
This section should be used for defining goals and objectives for the next evaluation period.
Instructions
Descriptions used for each Performance Category are intended to assist the supervisor in the evaluation process.
The rating scale is provided for reference. The overall score of the employee’s evaluation must be entered in the
Employee’s Overall Score section at the bottom of page 6. Supervisors are to include comments for each
Performance Category in the space provided. If a Performance Category is not related to the employee’s job
duties, place an “N/A” on the score line for that category. Comments provided must be typed. Form is available
in s:\personnel\perform. After evaluation form is completed and signed, please provide the employee with a copy
and send the original to the Human Resources Department.
SCALE
SCORE Rating
9 Outstanding
7-8 Exceeds Job Requirements
4-6 Meets Job Requirements
2-3 Needs Instruction & Development
1 Unsatisfactory
N/A Not Applicable
2 Rev. 1/08
Performance Categories and Definitions
Performance Category 1. Quality of Work
Demonstrates accuracy and thoroughness, displays commitment to excellence, looks for ways to improve and promote quality,
applies feedback to improve performance, monitors own work to ensure quality. Work is completed and submitted in a timely
fashion to meet deadlines.
Comments:
SCORE
Performance Category 2. Quantity of Work
Produces the required amount of work efficiently and in an organized manner within established time frames.
Comments:
SCORE
Performance Category 3. Job Knowledge
Possesses and demonstrates the skills and abilities of typical requirements of the job. Remains current with the job environment.
Understands and follows City policies, practices and procedures. Readily responds to questions about job duties. Understands
organizational responsibilities and rarely requires supervision.
Comments:
SCORE
3 Rev. 1/08
Performance Category 4. Internal Customer Service
Demonstrates the ability to work effectively with co-workers. Promotes a cooperative working environment by being courteous,
helpful and tactful when dealing with staff members. Supports and works harmoniously to achieve the goals and objectives of the
organization.
Comments:
SCORE
Performance Category 5. External Customer Service
Projects a positive City image when interacting with the public. Effectively and promptly responds to concerns and inquiries and
takes follow-up action. Accurately and effectively presents and interprets the City’s policies, practices and procedures to the
public. Is open, receptive, and approachable and interacts with the public with sensitivity, tactfulness and politeness.
Comments:
SCORE
Performance Category 6. Responsibility and Initiative
Work product reflects thoroughness and accuracy. Identifies, prioritizes and organizes workload in order to meet deadlines.
Demonstrates independent ability to recognize and carry out tasks without direct supervision. Completes tasks within appropriate
time frame or communicates reasons for delays.
Comments:
SCORE
4 Rev. 1/08
Performance Category 7. Judgment and Use of Resources
Identifies, analyzes and contributes to problem resolution. Assesses risks and liabilities appropriately for job assignment. Makes
consistently sound decisions based on available information. Uses time wisely on work that contributes to the success of the
organization. Uses all available resources to provide the best quality of service.
Comments:
SCORE
Performance Category 8. Communication
Effectively communicates information, orally and in writing, to the public and co-workers. Demonstrates listening skills
characterized by attentiveness, understanding and responsiveness. Uses sensitivity and diplomacy when communicating with
others. Recognizes and addresses conflict situations in a positive and timely manner.
Comments:
SCORE
Performance Category 9. Supervision
Directs and coordinates people and resources to complete work assignments and accomplish the goals and objectives of the
organization. Ensures that standards of work quality are established and maintained. Monitors and facilitates completion of
delegated tasks. Utilizes staff effectively to achieve objectives. Provides ongoing feedback regarding job performance. Prepares
and conducts comprehensive performance evaluations for each employee in a timely manner. Provides counseling and/or
disciplinary measures which are necessary to correct deficiencies in performance and treats staff in an equitable and consistent
manner.
Comments:
SCORE
5 Rev. 1/08
Performance Category 10. Team Effort and Leadership
Inspires teamwork, demonstrates enthusiasm to work towards a common objective, and desires to assume responsibility.
Originates or develops ideas and demonstrates initiative. Encourages co-workers to develop knowledge and skills by guidance,
coaching and on-the-job training.
Comments:
SCORE
Performance Category 11. Safety Consciousness
Displays knowledge and concern for job safety as well as City policies, practices and procedures. Minimizes public liability.
Observes safety practices in handling equipment, tools, vehicles and other instruments. Corrects safety hazards in work areas.
Demonstrates good safety habits on a regular basis.
Comments:
SCORE
Using the Performance Category scores,
summarize the employee’s overall job
performance in the context of the nine-
point evaluation scale. (This is not a
mathematical calculation.)
EMPLOYEE’S OVERALL SCORE
6 Rev. 1/08
Rater’s Comments
(Must be included in the Evaluation)
This evaluation is based on my observation and knowledge and represents my best judgment of the employee’s
performance during the subject evaluation period.
Rater’s Signature Date
Supervisor’s Comments
This evaluation is based on my observation and knowledge, and represents my best judgment of the employee’s
performance during the subject evaluation period.
Supervisor’s Signature Date
Employee’s Comments
This performance evaluation has been discussed with me.
Employee’s Signature Date
Division Manager’s Signature Date
Department Director’s Signature Date
Next Evaluation Period
7 Rev. 1/08
DEVELOPMENT PLAN
DEVELOPMENT PLAN AND OBJECTIVES FOR NEXT EVALUATION PERIOD
List below the most important responsibilities, projects, and/or performance objectives that will contribute to the
success of the employee during the next evaluation period. Include development plans for the employee.
Consider actions, activities, or special continuing education, specialized training, or new on-the-job experiences
that will challenge the employee to improve his/her performance.
Supervisor’s Initials
Employee’s Initials
Performance Evaluation PRINTABLE version
8 Rev. 1/08
