1. County of los Angeles Department of Public SOtlal 5eNicliis
Annual Performance Evaluation
GENERIC
Ilm~IIIIIIII!III~III!IlIfllll~1111111
Employee Name DEREK FOLLEY Employee Number 535486 11lem Number 1138
INTERMEDIATE CLERK
Position
Period From Jun 1,2008 Through May 31 2009
Depl
140
lDiv. 737 lPIL H1
Status
PERM
I
Due D:;.le
Jun 15, 2009
INSTRucnONS
1 trv.jjcill~ ~ln pilg,~ 2, wllh tM following symbols. wfl",fhN 1t19 employee tl)e~s the Departmental E:(p~c:13I1(lnl! (,~, exreeds It (+), or failS to me~ ~ H
:2 In the CQnlmcn~ 5ectlon tin the next pagll, Indicate sp€{:llic> Of 1M empl(}yoo's performance, Dccum'lnt bi' provldlnl ftxamp!es 01 abo",e-~verage
or llBlow-average WlJ rk.
3 Ellter (he allprtlpo'lale code IrIltle bOI( ned to tile Ri1llng Factor
0 .. Qutstandlng vG =Y"r.ry ~d C. f,.ompt'fenl IN =' !mprovemeTJ! bleel;led U =l.l'ls:llls(aetorj
4 In (he Olml'llil Rilting 5~1~IUn below, ct"oe-ck the apJlfllprlille rating_
5 DQC<Jml!lnt employee'~ goals Qn the I;MPLOYEE GOALS SHEET (Ollliooal) See C'-'510mlz", FQfJTls on PEeS to relfleve this stJeet
6­ R$lMmbef:
All 0",,1<111 ratlr;gs other than Co1J1petoJrtr must b!l suppe-rtecl by dO<:L>mantatlon
DEFINlllON OF RATING FACTORS
u'" /"e f<Jlt'O,A'!Ig *"Ol~= 01 ~ "'iJI'ry J~' en.u,. 1/791I'O<1r ra{Jn~ !oero.' IS MProP.'·~~ and rrl.'fficJ",-f!f;; oIx"",.nl..d 'f' 1/'1' COUIllENTS ooc!Jon on PilI1'" 2
OUTSTANDING: All wor~ performance Is r.DTSlstenUy a00V"" tha rllqulr9menls ollhe p<J:>lllon. P, substamlal part ollhe work pli'rfurmanco excoods 5uper­
I1~Of)' and rnan31!1ement e-.:pe-d8MnS most 01 ttle lime FacJ.Jill 9'>dance t11U5t t;.e presented in wrllin(l to subsla ntlate Itle. r8~lng.
VERY GOOD: A substanllal ~art of the work performanoa is w,,11 above the expectBtioro<; <A performance required for tM pCSJllon and alll)!tler partG of 1M
performance are allea:;( "Qompetem". f'actual eVltleflCe must bQ presented In YfIUng lIJ 6IJuSIanliaT9 tIns ra~ng,
COMPETENT- Wor( perfomnl'lnre II; O(mslS'lnUy up to {Jf 5Qmi.'What awvfl the reql)jremeM5 Of r~ position Thi3 15 the Ilerrormanoe elqlecled e-f Ii Il'1llned
and qualifiea empll))'EoIl NOTE: When;on t'mlltoyoo's performance lerxb.; to be borderline (high or 10wl wirllin thiS category, a nol"t,o[1 to fhls effect should
be made in ttle COMMENTS section
IMPROVEMENT NEEDED' This rating Inch:ate5 t~.t (1) a sigmfjeant part of [hI;: worY.llerlmmanoe IS belol'llhe eXp<lctatloll of perfonmance reCl~"l1Id fOl'
the poslllol'l aoo (2) rt IS rea~onattle, 10 llxpect ihElt lht' t'ffiplOYOO will bnn~ perfol1T1C1nCe up 10 aocep13ble standflma, Fal.1ual ellclllnCe must be presented In
wfil&llg 10 3ubstailtiElte ttl.. roiling_ -
UNSAT.SFACiO RY: A iRJo.<lnllal r>a rt of the wor1<. IS Inll.dequate and defi nitel)' infu nl)r to tt,,, ,,,pectallolls olllerfOfmS!lOll' re~ul~d lor the POslllOn Fao­
lual e!lkjcnre nUS51 be P~&li'ntE!d Irl "II'lung 10 sub~lBntl""~ thiS ratlrl1l 'l'ltJen Ih,s rll.t'f1g I>; gi.sn 1 must be accompanie(l by a disCf1arge or re.Juctiofl in thoEe
<;p~S lrl which ttle em~loy~ is "lill ill se(~ce
OvoraB Rating for the EVll~lllltlon Period
U!1SBb>l~~Ory ) Impmvemant t~eed9d r-'--- t;:ompel8nl ;' - - - v"ry GOM Outst~ndi"g
.;, :
Copy Qf r1!port to empll)~w on DATE: _
given/mailed
BY
R::'/IEWER ' DATE 6
I h<lle re'm~wed thiS mpCH.
"DEPT HEAD ~.~ IJAT[ 1 ;fl-~ ,_ _ ~ ~DATE)g jJtJN€ 'Zf1
or autholTLe'J r..~rescntar
F1io& 1,.,.~~OOl~
~A 212! (REV OJ,'O~) P"QC 1 Q 4

2. Annual Performance Evaluation
APPEAL PROCEDURE
If the employee disagrees Wittl the ratings given and IS still in County service, he/she may li'lltiate a grievance in
accordance with hislher departmerlt's grievance procedure within ten business days of receipt of the evaluation
He/She may grieve any sp8cmed item or Items of the report, including the overall reting, except for an overall rat­
ing of "unsatisfaclory." Upon completion of the gnevance process, the Department Head or his/her representative
must approve the report and rating as originally prepare<!, or direct lhat a new report be prepared and notify the
employee of the decision,
Out of Service Employees
if subsequent to hisJher resignation from Coonty service an employee receives an evaluatio[l with an overall rat­
Ing of 'Improvement Neooed' or "Unsatisfactory,' he/she may request reconsideration Of thiS rating by the Direc­
tor of PersonnaI. The request for reconsideration must tie receiVed 11'1 the Offi~ of the Director of Personnel
within ten business days aner receipt of hisltier evaluation. The request must be in writing aM must Include all
the facts and details upon whlCt1 the employee's case IS based.
: t acknowledge receipt of a copy of 'hi .F~~nfirm the e . of.this page,
Employee .~ I~at -. f£,Signature :8ig
IDSle: /8 .rUNe ae(J
1_­ . ID_a_te_,~ _
P"~e 2 <ft 4

3. County of Los Angeles De partment of Pub lie SOt;ial Serviw8
Annual Performance Evaluation
GENERIC
Rating- Factor .
D,,,,_""'E_t1~ ~
I,..Productivity: _ 8~m Amouflt of work performed
[±] Completlon of work on !>ched ule
2. Quality: §l
IB Demonstnlt88 accuracy and thorol.lghness
8 Applies feedback to improve performance
[±] Edits Ell"ld proofreads own lJI,'Ork
[±] Writes clearly, cOflcisely, and legibly
3. Work Habib!: f;"Gl
@ Observes organizational program~ policies. and­
procedure3
II! Plans and orgElnlz.es work
1"!1 Attendance
Il) Ob~IVe~ wOIKlng hours
@ Sets appro Pilate pnorilles
tIl Shares knowledge with others
!lJ Complies With instructions
G Meet:'> deadlines
'--I
4, Penlonal Relations: : v.C?J
[±] Representg the DepartmE!r1t In a professional and
effective manner
[±] F'rElctlce~ c.ooperatlOI and teamwtlrk.
o Exhibits conSideration In interactiofl5 with others
[Z) RespondI> promptly to Ir1qulries
ill Exnlblts appropriate personal appearance and
conduct
Iil Wof1s effecftvely with aU levels of staff
5. Adaptability: !VGj
ttl Adapts to ctlanges in the work er1VlrDnmem
I:±l Penorms effecti I'e~y In new s.ltuatiDns
m Perfoll"m effectl "ely In eme-rgencles
CB Performs effectively With minimum Instructions
G.. Job Kflowr9dge~
,-
IYc]
ff] Adhems to program poliCies and procedures
[Il Demonstrates reqUired Job sl<.ills
lIJ Uflderstands ~Ielant computer system~
[±] Makes appmpriate use Df lralfllng ~urre5
o Ability 10 dlag~ose and evaluate problems Of epplioablG)
o Has appropriate inteIVlewlng SKills lir"pplle<obIB)
o Abliity to develop appropriate SelNlce plan (if appl'<:ableJ
pr... <121 (REV OJ:OG)
. Jun 15, 2009
I::mployee Number 535486
COMMENTS (ReqIJiredl
Dlscl.lss the empl;,yee's ~rformaflce, gIVIng examples to support
yOLJr ratJngs, If nel&he has functioned in an Acting pOSltlOr1 dl!.ing
~Jie rating penod please dIseus!> his/her perform t:u1 ce In ttlat
~_ capacity Attach extra pages If n€eded
During this rating period, Mr. Derek Folley
continues his assignment as an Intennediate
= Clerk at the Hawthorne Medi-eal Sub-Office
District #93.
His primary responsibility is Mail Room
Operations. He processes all outgoing and
incoming mail for the district, ,including:
- weighing, meteril19, openi,ng, date stamping,
and d,istribution to a,ppropriate clig ibility
Staff. Mr. Folley assist with the (COC)
process, Case Op&nlng Clerk, our 1/800
phone lines, servicing, over 10,000 callers,
and is a tremendous help, frequently
providing coverage for the Administrative
..- Secretary. Mr. Folley a1so assisted With the
== massive transferring of cases.
-
PRODUCTIVITY:
Mr. Folley me~ts the standards for
processing all work assignments. He
performs and completes an adequate
amou nt of work accurately and timely.
QUALITY:<:.;.::
Mr. Folley is thorough and takes time to
proofread his own work to demonstrate
' .... ' accuracy. He applies gUidance received to
improve his work performance. He's an
efficient worker, and displays the ability to
-, multi- task.
WORK HABITS:
-- Mr. Folley demonstrates good organizational
- skills, and is a Team Player. He always offer
his assistance. He sets appropriate
priorities in order to com plete his
"_ assignments in a timely manner.
-" ..........
P¥3ol'

4. County of Los Angl/fo6 Dep"rtmllrlt of Public Social 5ervlC8s
Annual Performance Evaluation
GENERIC
Date' Jun 15. 2009
Employee, Nam8 DEREK FOLLEY
2009
EmpJO~'ee Number 535486
RalinQ Period From Jun 1, 2fl08
RlItlng fOactof COMMENTS IRequired)
DISCUSS the employee's performance. giving examples to support
.........tal E.p.,Ia,;...
I your ratings, If he/she has fUf}ctione<l1n an Acting position during
the rating period, please discuss hi&lher performance In that
17.-' Communication Skills: !-VC] capacity Attach extra pages if needed.
~ rn Provides prompt and oourteous cuslom",r
seNIC.e PERSONAL RELATIONS:
@ Maintains open ~nes of rommlH1lcatlon wit!l al~ Mr. Folley represents the Department in a
18vels of staff al1d communrly professional and effective manner. He Is
III Is able to Irnp<lT1 negative ir,fcrmatlon In a ~ congenial with all levels of staff. And he
courteous aTd respeclflll manner exhibits approprIate personal appearance
and conduct.
- ADAPTABILITY:
Mr. Folley performs effectively in the
workplace, with minimum instructions. He
has the ability to perform in an emergent,
- and new sItuations. He does not hesitate to
_ accept assignments that challenge his
abilities.
JOB KNOWLEDGE:
- Mr. Folley demonstrates the required skills to
perform his task effectively. He utilizes tile
computer system, and LEADER daily to
enhance know1edge gained to perform his
duty. He also makes appropriate use of our
- training resources.
COMMUNICATION SKILLS:
Mr. Folley provides prompt and courteous
customer service. He maintains an open line
-,- of communication with all levels of 2Jtaff. He's
a respectful and a great employee to work
with.
During this rating period, Mr. Derek Folley
earned a "Very Good."
PA 2121 (RE'J O~II>5) Poge 4 <;/4