1. WORK-READINESS EVALUATION To be completed by Worksite Supervisor during final week of the work experience.
Worksite: t } / 7 'Mri4r^ Youth Name: /J^iyt'-J'
Worksite Supervisor/Reviewer: rl-- iMc ( j t / t i j i.-c. Youth Job Title: '^^fl'^^-^'
Review Date: / / ^ " / y Start Date: 7^ / /
Rating Scale --->
Needs
Significant
Development
(0)
Stiows Growth
Needs IVIore
Development
(1)
Meets
Expectations
(2)
Exceeds
Expectations
(3) N/A
COMMUNICATION S K I L L S
Listens attentively to supervisor, coworkers, and customers.
(0) • (1) • (2) • . {3)0 N/A •
Speaks clearly and uses work-appropriate language.
(0) • (1) • ( 3 ) n N/A •
Demonstrates appropriate non-verbal communication skills.
(0)0 (1) • (2) • N/A •
COMMENTS/EXAMPLES:
RELIABILITY
Shows up to work prepared and on time and returns from breaks in a timely
manner (0)0 (1) • ( 2 ) ^ (3) • N/A •
Gives best effort, addresses problems or issues in a timely manner
(0)0 (1) • (2) • (3) B^' N/A •
Performs required tasks without frequent redirection and completes
assignments in a timely manner (0) • (1) • (2) • ( 3 ) i a ^ N/A •
COMMENTS/EXAMPLES:
C O N D U C T
Dresses appropriately and practices adequate personal hygiene for the
position. (0) • (1) • (2) • ( 3 ) ) ^ N/A •
Follows workplace policies and procedures including scheduling and time-
keeping. (0) • (1) • ( 2 ) ^ (3) • N/A •
Acts with personal integrity - intent, words, and actions align. (0) • (1) • (2) • ( 3 ) ^ ' N/A •
COMMENTS/EXAMPLES:
J O B K N O W L E D G E
Knows and demonstrates understanding of company produci/service(s). (0)0 (1) • ( 2 ) ^ ( 3 ) n N/A •
Knows and demonstrates ability to perform position-specific duties and
responsibilities. (0)0 (1) • (2) • ( 3 ) ^ N/A •
Demonstrates fluency with common workplace tools including phones, email,
and word-processing software. (0)0 (1) • (2) • ( 3 ) t e N/A •
COMIVIENTS/EXAMPLES:
File Path: n:youthwex-ysupervisorevaluation_v_5.doc Revision Date: October 2, 2013

2. C U S T O M E R S E R V I C E S T A N D A R D S
Knows, supports, and complies with the company's customer sen/ice
expectations. (0) • ( i ) n ( 3 ) n N/A •
Consistently presents a positive, service oriented attitude. (0) • ( i ) n ( 2 ) n N/A •
Knows and understands boundaries and limitations of position authority. (0)0 (1) • (3) • N/A •
COMMENTS/EXAMPLES:
S E L F - M A N A G E M E N T
Articulates personal strengths and limitations to supervisor ( 0 ) n (1) • (3) • N/A •
Responds appropriately to supervision — accepts feedback and uses
information to improve work performance. (0) • (1) • ^^^^ ( 3 ) n N/A •
Maintains composure during workplace conflict, including receiving criticism,
and responds appropriately. ( 0 ) n (1) • (2) • ( 3 ) ' ^ N/A •
COMMENTS/EXAMPLES:
P R O B L E M S O L V I N G
Uses knowledge and infonvation from job to solve workplace problems and
address/mitigate issues that affect work output or quality. (0)0 (1) • ( 2 ) ^ ( 3 ) n N/A •
Asks clarifying questions and confirms understanding of expectations; Avoids
getting stuck by seeking guidance when instructions are unclear (0)0 iVD (2) • N/A •
Asks for help, seeks feedback, and notifies supervisor of task completion or
problems in a timely manner ( 0 ) n (1) • ( 2 ) ' ^ (3) • N/A •
COMMENTS/EXAMPLES:
T E A M W O R K / C O L L A B O R A T I O N
Works well with others and contributes to group efforts. (0) • ( ! ) • (2) • N/A •
Relates positively with co-workers, while maintaining appropriate boundaries
between work and personal life. (0) • ( ! ) • ( 2 ) n ( 3 ) , ^ N/A •
Respects the dignity, diversity, and rights of individuals/groups. (0)0 (1) • (2) • (3)^5<; N/A •
COMMENTS/EXAMPLES:
O V E R A L L SATISFACTION
Overall, are you satisfied with the performance of the youth during the work experience? Y E ^ - ^ NO •
Review Acknowledgement (please initial): Supervisor Intern
D-7-,