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STATE SYSTEM OF HIGHER EDUCATION
PERFORMANCE EVALUATION REPORT
EMPLOYEE:
SOCIAL SECURITY NUMBER: Evaluation Period:
CLASSIFICATION: Type of Evaluation: Regular
LOCATION: (Check One) Probationary
PERFORMANCE MONTH: Interim
GENERAL PERFORMANCE FACTORS- All
employees should be evaluated on the first six factors. EXCELLENT
VERY
GOOD GOOD FAIR
UNSATIS-
FACTORY
1. QUALITY OF WORK – Completion; accuracy;
professional; or technical proficiency.        
2. WORK HABITS- Planning and organization of work;
care of equipment and supplies.        
3. RELATIONSHIP WITH PEOPLE- Ability to get along
with others. Effectiveness in dealing with the public.        
4. DEPENDABILITY- Degree to which employee can
be relied upon to work steadily and effectively;
punctuality; regularity of attendance.
       
5. QUANTITY OF WORK-Amount of work performed.        
6. INITIATIVE-Resourcefulness; versatility; originality;
ability to conceive and carry out program improvements.        
7. ANALYTICAL ABILITY-Thoroughness and accuracy
of analysis of data, facts, laws, rules, and procedures.        
8. ABILITY AS SUPERVISOR-Proficiency in training
employees. In planning, organizing, laying out work for
work unit. Activity in promoting cost reduction leadership.        
9. ADMINISTRATIVE ABILITY-Promptness of action;
soundness of decision; application of good management
principles.
       
10. SAFETY-Application of accident prevention
techniques and unit’s safety.        
SPECIAL PERFORMANCE FACTORS- List below. Define
and rate employee on any appropriate factors not listed
above.
       
11. COMMITMENT TO SOCIAL EQUITY
OVERALL EVLAUATION        
Comments (Continue on additional sheets of 8.5 x 11 white paper.)
EVALUATOR SIGNATURE (EMPLOYEE’S IMMEDIATE SUPERVISOR) TITLE DATE
REVIEWING OFFICER SIGNATURE (EVALUATOR’S IMMEDIATE SUPERVISOR) TITLE DATE
I WOULD LIKE TO DISCUSS THIS REPORT WITH THE REVIEWING OFFICER:
YES NO
AS REQUESTED, REVIEWING OFFICER
DISCUSSED REPORT. REVIEWING
OFFICER SIGNATURE.
DATE
I ACKNOWLEDGE THT I HAVE READ THIS REPORT AND THAT I HAVE BEEN GIVEN AN OPPORTUNITY TO DISCUSS IT WITH THE
EVALUATOR. MY SIGNATURE DOES NOT NECESSARILY MEAN THAT I AGREE WITH THE REPORT.
EMPLOYEE SIGNATURE________________________________________________ DATE____________________________
I:PayrollSecretarPerformance Evaluation Report
STATE SYSTEM OF HIGHER EDUCATION
PERFORMANCE EVALUATION REPORT INSTRUCTIONS
PURPOSE OF REPORT
Performance evaluation is not just a once-a-year affair. Whether
the employees realizes it or not work performance is being evaluated
continually. Every day worked, every assignment completed gives the
supervisor a chance to observe how well duties are performed. The
performance evaluation report is designed to put down on paper a
summary of these day-to-day evaluations and is intended to help the
supervisor form these evaluations as objectively as possible.
WHEN TO RATE
A performance evaluation report shall be prepared for each
salaried employee at least every twelve (12) months. An interim report
may be prepared whenever there is a change in the employee’s
performance sufficient to affect the overall rating on the last annual
report on file for the employee, or whenever departmental procedures
require an interim report for a special purpose.
Special Requirements for Non-Civil Service Employees:
If an individual agency has a probationary period for non-civil service
employees, performance evaluation reports shall be prepared for
employees upon completion of the probationary period established by
the agency.
Complete policy and procedures for employee performance
evaluation are published through the Directives Management System.
WHO IS TO RATE
Rating shall be completed by supervisors who are familiar with the
work performance of the employe. Generally, this shall be the
immediate supervisor. However, the person who completes and signs
a performance evaluation report as the rater of an employe should not
be a member of the same collective bargaining or meet and discuss
unit as that of the employe being evaluated. The reviewing officer shall
generally be the rater’s immediate supervisor.
DEFINITION OF ADJECTIVAL RATINGS
UNSATISFACTORY: A rating of unsatisfactory means that the
employee’s performance with respect to the factor under consideration
is below acceptable standards.
FAIR: A rating of fair means that the employee’s performance with
respect to the factor under consideration no more than meets and
occasionally falls below acceptable standards.
GOOD: A rating of good means that the employee’s performance with
respect to the factor under consideration meets and occasionally
exceeds acceptable standards.
VERY GOOD: A rating of very good means that the employee’s
performance with respect to the factor under consideration frequently
exceeds acceptable standards.
EXCELLENT: A rating of excellent means that the employee’s
performance with respect to the factor under consideration consistently
exceeds acceptable standards.
Each factor, which is rated excellent or unsatisfactory, should
be documented in comments section of the performance
evaluation report.
The three (3) gradations within each adjectival rating (except
Unsatisfactory) act as a measuring stick and enable the rater to
describe the degree of performance within the rating more
accurately.
OVERALL RATING
Because the importance of different performance factors varies
from job to job, there is no prescribed formula for arriving at an
overall rating. If the overall rating is to be accurate, it must be
consistent with all the factor ratings. It is not an average of the
individual factor ratings, but rather reflects the influence of the
more important work performance factors as determined for a
position.
REVIEW OF REPORT
After signing the performance evaluation report, and before it is
shown and discussed with the employee, it shall be forwarded to
the reviewing officer for review and signature. A discussion of the
employee’s rating between the rater and the reviewing officer is
desirable and every effort should be made to accomplish this.
Any difference of opinion between the rater and reviewing
officer as to the employee’s performance should be resolved
before the reviewing officer signs the report. If any changes result,
a new report should be made out reflecting such change. Erasures
should not be made. After the reviewing officer signs the report it
shall be returned to the rater for discussion with the employee.
RATING INTERVIEW
This is the most important step in the performance evaluation
process. Each report shall be reviewed with the employee in a
face-to-face discussion. The discussion should be under
circumstances affording an informal, relaxed and private interview.
It is strongly recommended that the interview be held at the time
the employee is shown the report for the first time.
At the close of the interview, the rater shall ask the employee to
sign the report, not for the purpose of securing approval of the
rating, but to obtain the employee’s acknowledgement that the
report was reviewed. If the employee refuses to sign the report,
the rater should write in the space for the employee’s signature,
“Employee refuses to sign”.
If the employee desires to discuss the rating with the reviewing
officer, the rater shall inform the employee that an appointment will
be made. The rater shall then make an appointment for the
employee with the reviewing officer and subsequently notify the
employee. If, as a result of this discussion, the reviewing officer
sees merit in making any changes the rater should be conferred
with to resolve the question. If changes are made at this point, the
employee, the rater, and the reviewing officer shall initial them. If
the employee wishes to formally appeal the rating, this may be
done in accordance with departmental procedures .
Revised 2-16-94

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Performance evaluation report template

  • 1. STATE SYSTEM OF HIGHER EDUCATION PERFORMANCE EVALUATION REPORT EMPLOYEE: SOCIAL SECURITY NUMBER: Evaluation Period: CLASSIFICATION: Type of Evaluation: Regular LOCATION: (Check One) Probationary PERFORMANCE MONTH: Interim GENERAL PERFORMANCE FACTORS- All employees should be evaluated on the first six factors. EXCELLENT VERY GOOD GOOD FAIR UNSATIS- FACTORY 1. QUALITY OF WORK – Completion; accuracy; professional; or technical proficiency.         2. WORK HABITS- Planning and organization of work; care of equipment and supplies.         3. RELATIONSHIP WITH PEOPLE- Ability to get along with others. Effectiveness in dealing with the public.         4. DEPENDABILITY- Degree to which employee can be relied upon to work steadily and effectively; punctuality; regularity of attendance.         5. QUANTITY OF WORK-Amount of work performed.         6. INITIATIVE-Resourcefulness; versatility; originality; ability to conceive and carry out program improvements.         7. ANALYTICAL ABILITY-Thoroughness and accuracy of analysis of data, facts, laws, rules, and procedures.         8. ABILITY AS SUPERVISOR-Proficiency in training employees. In planning, organizing, laying out work for work unit. Activity in promoting cost reduction leadership.         9. ADMINISTRATIVE ABILITY-Promptness of action; soundness of decision; application of good management principles.         10. SAFETY-Application of accident prevention techniques and unit’s safety.         SPECIAL PERFORMANCE FACTORS- List below. Define and rate employee on any appropriate factors not listed above.         11. COMMITMENT TO SOCIAL EQUITY OVERALL EVLAUATION         Comments (Continue on additional sheets of 8.5 x 11 white paper.) EVALUATOR SIGNATURE (EMPLOYEE’S IMMEDIATE SUPERVISOR) TITLE DATE REVIEWING OFFICER SIGNATURE (EVALUATOR’S IMMEDIATE SUPERVISOR) TITLE DATE I WOULD LIKE TO DISCUSS THIS REPORT WITH THE REVIEWING OFFICER: YES NO AS REQUESTED, REVIEWING OFFICER DISCUSSED REPORT. REVIEWING OFFICER SIGNATURE. DATE I ACKNOWLEDGE THT I HAVE READ THIS REPORT AND THAT I HAVE BEEN GIVEN AN OPPORTUNITY TO DISCUSS IT WITH THE EVALUATOR. MY SIGNATURE DOES NOT NECESSARILY MEAN THAT I AGREE WITH THE REPORT. EMPLOYEE SIGNATURE________________________________________________ DATE____________________________ I:PayrollSecretarPerformance Evaluation Report
  • 2. STATE SYSTEM OF HIGHER EDUCATION PERFORMANCE EVALUATION REPORT INSTRUCTIONS PURPOSE OF REPORT Performance evaluation is not just a once-a-year affair. Whether the employees realizes it or not work performance is being evaluated continually. Every day worked, every assignment completed gives the supervisor a chance to observe how well duties are performed. The performance evaluation report is designed to put down on paper a summary of these day-to-day evaluations and is intended to help the supervisor form these evaluations as objectively as possible. WHEN TO RATE A performance evaluation report shall be prepared for each salaried employee at least every twelve (12) months. An interim report may be prepared whenever there is a change in the employee’s performance sufficient to affect the overall rating on the last annual report on file for the employee, or whenever departmental procedures require an interim report for a special purpose. Special Requirements for Non-Civil Service Employees: If an individual agency has a probationary period for non-civil service employees, performance evaluation reports shall be prepared for employees upon completion of the probationary period established by the agency. Complete policy and procedures for employee performance evaluation are published through the Directives Management System. WHO IS TO RATE Rating shall be completed by supervisors who are familiar with the work performance of the employe. Generally, this shall be the immediate supervisor. However, the person who completes and signs a performance evaluation report as the rater of an employe should not be a member of the same collective bargaining or meet and discuss unit as that of the employe being evaluated. The reviewing officer shall generally be the rater’s immediate supervisor. DEFINITION OF ADJECTIVAL RATINGS UNSATISFACTORY: A rating of unsatisfactory means that the employee’s performance with respect to the factor under consideration is below acceptable standards. FAIR: A rating of fair means that the employee’s performance with respect to the factor under consideration no more than meets and occasionally falls below acceptable standards. GOOD: A rating of good means that the employee’s performance with respect to the factor under consideration meets and occasionally exceeds acceptable standards. VERY GOOD: A rating of very good means that the employee’s performance with respect to the factor under consideration frequently exceeds acceptable standards. EXCELLENT: A rating of excellent means that the employee’s performance with respect to the factor under consideration consistently exceeds acceptable standards. Each factor, which is rated excellent or unsatisfactory, should be documented in comments section of the performance evaluation report. The three (3) gradations within each adjectival rating (except Unsatisfactory) act as a measuring stick and enable the rater to describe the degree of performance within the rating more accurately. OVERALL RATING Because the importance of different performance factors varies from job to job, there is no prescribed formula for arriving at an overall rating. If the overall rating is to be accurate, it must be consistent with all the factor ratings. It is not an average of the individual factor ratings, but rather reflects the influence of the more important work performance factors as determined for a position. REVIEW OF REPORT After signing the performance evaluation report, and before it is shown and discussed with the employee, it shall be forwarded to the reviewing officer for review and signature. A discussion of the employee’s rating between the rater and the reviewing officer is desirable and every effort should be made to accomplish this. Any difference of opinion between the rater and reviewing officer as to the employee’s performance should be resolved before the reviewing officer signs the report. If any changes result, a new report should be made out reflecting such change. Erasures should not be made. After the reviewing officer signs the report it shall be returned to the rater for discussion with the employee. RATING INTERVIEW This is the most important step in the performance evaluation process. Each report shall be reviewed with the employee in a face-to-face discussion. The discussion should be under circumstances affording an informal, relaxed and private interview. It is strongly recommended that the interview be held at the time the employee is shown the report for the first time. At the close of the interview, the rater shall ask the employee to sign the report, not for the purpose of securing approval of the rating, but to obtain the employee’s acknowledgement that the report was reviewed. If the employee refuses to sign the report, the rater should write in the space for the employee’s signature, “Employee refuses to sign”. If the employee desires to discuss the rating with the reviewing officer, the rater shall inform the employee that an appointment will be made. The rater shall then make an appointment for the employee with the reviewing officer and subsequently notify the employee. If, as a result of this discussion, the reviewing officer sees merit in making any changes the rater should be conferred with to resolve the question. If changes are made at this point, the employee, the rater, and the reviewing officer shall initial them. If the employee wishes to formally appeal the rating, this may be done in accordance with departmental procedures . Revised 2-16-94