CITY OF ROCKVILLE

   EMPLOYEE PERFORMANCE PLANNING AND EVALUATION FORM
Employee's Name:                                  ...
LEADING
How well does the employee demonstrate a shared vision of Rockville City government’s mission
and his/her team’s g...
LEADING
To what degree does the employee serve and meet the needs of customers, including the public and
fellow employees?...
MANAGING
How well does the employee plan and organize his/her work, time and resources, and if applicable,
that of subordi...
TASK/TECHNICAL
To what degree does the employee’s work effort result in the desired quality, quantity and
timeliness?

 Hi...
TASK/TECHNICAL

Probationary/Mid
Highly Successful   Successful       Acceptable   Unsatisfactory
1.




Highly Successful...
TEAM SKILLS
How effectively does the employee communicate with peers, supervisors, subordinates and people
to whom service...
TEAM SKILLS
How consistently does the employee adhere to attendance standards? (Refer to Department
standards, if applicab...
GOALS
LEADING GOAL

Initial Goals




Probationary/Mid Goals




Final Goals




MANAGING GOAL

Initial Goals




Probatio...
Initial Review:
Are any attachments included?                    yes      no
Employee Comments:




______________________...
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EMPLOYEE PERFORMANCE PLANNING AND EVALUATION FORM

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EMPLOYEE PERFORMANCE PLANNING AND EVALUATION FORM

  1. 1. CITY OF ROCKVILLE EMPLOYEE PERFORMANCE PLANNING AND EVALUATION FORM Employee's Name: Position Title: Supervisor’s Name: Department: Probationary Employee yes no Administrative Union EVALUATION PERIOD Rating Period Dates: From – To Review Date Initial: ____________ – _____________ ______________ Probationary/Mid: ____________ – _____________ ______________ Final: ____________ – _____________ ______________ INSTRUCTIONS The appraisal process involves evaluating the employee’s work performance during the review period in the following performance categories: Leading, Managing, Technical/Task and Team Skills. Within each category, there are questions identifying specific areas of accountability. The employee's performance is evaluated using the descriptions listed under each of the performance levels. The following performance levels are employed: Highly Successful • Successful • Acceptable • Unsatisfactory The performance levels are defined in the boxes under each level. Please note that the definitions are intended to describe in general a given level of performance relative to the category being rated. They are not meant to be all inclusive of conditions which must exist in order to legitimately rate an employee at a given level. Rather, the definitions are intended to convey, in broad terms, a “snapshot” description of conditions which typically exist at a performance level. Under the Task/Technical Category, the employee’s performance related to the job description is rated. Select at least three duties, responsibilities or tasks from the employee's current job description and rate the employee's demonstration of the knowledge, skills and abilities for his/her job related to those tasks. This is to be done at the beginning of the rating period and a copy is to be given to the employee at that time. Space has been provided for the rater to note any goals to be met or worked on during the next review period and for the employee to record any comments regarding the evaluation and/or goals. Completing the evaluation form: • Review the information at the top of the page to ensure all the information is correct. • Assign a performance level for each area of accountability and enter comments as appropriate in the space provided. For any area of accountability rated as “Highly Successful” or “Unsatisfactory,” enter in the Comments section specific factors that justify the rating. • Entries in the Comments section for “Successful” or “Acceptable” ratings are optional. Add additional pages as necessary. • Select responsibilities to be evaluated in the Task/Technical category. These should be job specific to the work to be performed during the current rating period. • The form must be signed by the rater, the employee, the rater’s immediate supervisor and the department director. • All final evaluation forms must be sent to the Personnel Department for processing. “We are a dedicated organization committed to enhancing the quality of life in Rockville by providing premium services in response to the needs of everyone who visits, works, and lives in our city.” - City Mission Statement The employees of the City of Rockville are dedicated, talented and skilled individuals. We strive for the highest level of professionalism, integrity, and leadership, and recognize our accountability to the community. We are proactive and take pride in our work. We value flexibility, teamwork, and fiscal responsibility. We support and encourage creativity and innovation by respecting each other’s ideas and contributions. – The Rockville Way
  2. 2. LEADING How well does the employee demonstrate a shared vision of Rockville City government’s mission and his/her team’s goals? (See front page) Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Demonstrates a clear vision Understands and acts in Is making a conscious Unwilling to make an of Rockville City accordance with Rockville effort to understand the effort to understand the government’s mission. City government’s mission. vision of Rockville City vision of Rockville City This includes exceeding Meets individual government’s mission. government’s mission. individual performance performance objectives and Strives to meet his or her Does not meet individual objectives and team goals. team goals. Shows the performance objectives performance objectives and Facilitates a high ability and willingness to and team goals. Is team goals. performance environment work in a high performance learning the importance of by showing initiative environment. a high performance through constant learning, organization. planning and empowering others to do the same. Initial Comments Probationary/Mid Comments Final Comments To what extent does the employee represent the "Rockville Way" ? (See front page) Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Exemplifies the “Rockville Practices the “Rockville Is learning the “Rockville Has not accepted the Way.” Consistently offers Way.” Offers ideas for Way.” Is willing to accept “Rockville Way.” Is not ideas for improvements improvements that ideas for improvements willing to accept ideas and that contribute to work contribute to work group that contribute to work improvements that group and organization and organization group and organization contribute to work group productivity. Exhibits all productivity. Exhibits productivity. Exhibits and organization of the following: most of the following some of the following productivity. professionalism, integrity, qualities: professionalism, qualities: professionalism, flexibility, fiscal integrity, flexibility, fiscal integrity, flexibility, fiscal responsibility, creativity responsibility, creativity responsibility, creativity and innovation. and innovation. and innovation. Initial Comments Probationary/Mid Comments Final Comments
  3. 3. LEADING To what degree does the employee serve and meet the needs of customers, including the public and fellow employees? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Exceeds Customer Service Meets the Customer Service Attempts to meet Customer Is not making progress Standards. Processes both Standards including timely, Service Standards by towards meeting all routine and non-routine courteous and informed responding to requests in a Customer Service customer inquiries and responses to customer fully acceptable manner. Standards. Is content concerns in ways that inquiries and concerns. Occasionally may not fully with an unsatisfactory result in a high degree of When an immediate deliver desired level of level of customer service. customer satisfaction. Goes response is not possible, satisfaction due to lack of May appear indifferent to beyond basic inquiry to customer is kept informed. experience, knowledge, or customer concerns. learn of and respond to Initial inquiries are confidence. Provides minimal response relevant issues that may or addressed. Generally has a to customers. May be may not be apparent positive attitude about discourteous. initially. Consistently has a customers. positive attitude about customers. Initial Comments Probationary/Mid Comments Final Comments MANAGING How effectively does the employee assess his/her work performance or the work performance of the team? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Is able to assess work/team Is able to assess the work/ In some cases can determine Is unable to determine performance and team performance and whether a job was completed whether a job was completed consistently comes up with determine whether the job satisfactorily. Is working on satisfactorily. Does not look ways to improve the was completed well. Usually offering suggestions for at the work product to workflow and product. identifies areas that need improving his or her work determine if improvements improvement. performance or the team can be made. performance. Initial Comments Probationary/Mid Comments Final Comments
  4. 4. MANAGING How well does the employee plan and organize his/her work, time and resources, and if applicable, that of subordinates? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Demonstrates the ability to Identifies resources required Is learning to effectively apply Plans and preparation often anticipate what might to complete assignment. planning, preparation and do not include pertinent otherwise be overlooked in Prepares either formally or organizational skills. In some elements. Does not monitor the planning process. Sets informally, an effective work cases assignments are well plan execution, resulting in up/uses monitoring and plan. Monitors progress and planned and accomplished in backtracking and delays. control tools to make sure follows up to make sure an acceptable manner. Spends an inordinate assignment is accomplished assignment is accomplished amount of time responding as scheduled. Is well versed as scheduled. Makes to events that the employee in the details of assignment efficient use of available should have anticipated. execution while maintaining resources. a view of the big picture. Ensures timely completion of all tasks, often ahead of schedule, consistent with human factors. Initial Comments Probationary/Mid Comments Final Comments How effectively does the employee contribute to the development of others and/or the working unit or overall organization? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Identifies and recommends Contributes to development Responds positively to Is unwilling to work with, ways to improve processes plans. Has developed a cross- requests for help with and share cross-training and/or products. This training plan so at least one development plans. Has information, with coworkers. employee's peers and/or other employee can fill in. Is begun to share information to Frequently does not allow supervisors seek advice on open to and considers the help facilitate cross training. the discussion of different development issues. Has expression of differing ideas. Is tolerant toward the ideas and alternatives. initiated and developed a expression of differing ideas. cross-training plan so at least one other employee can fill in. Promotes an open environment that encourages the exploration of different ideas. Initial Comments Probationary/Mid Comments Final Comments
  5. 5. TASK/TECHNICAL To what degree does the employee’s work effort result in the desired quality, quantity and timeliness? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Assignments are Assignments are completed Assignments usually are Assignments often are not completed ahead of on or, ahead of schedule and completed on time and as completed as scheduled schedule and at a level of at the desired level of quality specified. Occasionally, and/or the desired levels of quality and/or quantity and quantity. If conditions delivery is not on time or at work output are not met. well beyond expectations. impacting productivity and/or the desired level of quality The employee or others, Ideas and suggestions to work products are outside the and quantity. Sufficient resulting in delays, must improve productivity are control of the employee, he or progress toward eliminating often redo work resulting offered and frequently she notifies the supervisor in these situations is being in delays. generate positive results. a timely manner. made. Initial Comments Probationary/Mid Comments Final Comments To what degree does the employee demonstrate the knowledge, skills and abilities specified in the job description? Select at least three responsibilities from the job description that the employee was responsible for during this time period and rate his or her performance accomplishing those duties. Initial Highly Successful Successful Acceptable Unsatisfactory 1. Highly Successful Successful Acceptable Unsatisfactory 2. Highly Successful Successful Acceptable Unsatisfactory 3. Comments
  6. 6. TASK/TECHNICAL Probationary/Mid Highly Successful Successful Acceptable Unsatisfactory 1. Highly Successful Successful Acceptable Unsatisfactory 2. Highly Successful Successful Acceptable Unsatisfactory 3. Comments Final Highly Successful Successful Acceptable Unsatisfactory 1. Highly Successful Successful Acceptable Unsatisfactory 2. Highly Successful Successful Acceptable Unsatisfactory 3. Comments
  7. 7. TEAM SKILLS How effectively does the employee communicate with peers, supervisors, subordinates and people to whom service is provided? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Effectively comunicates on Presents well organized and Is learning to listen better Tends to rush through multiple levels so that each timely written and verbal as well as communicate general oral and written audience understands the information on multiple thoughts and ideas to others, communications. This often issue at hand. Provides levels. Keeps supervisor, both verbally and in writing. results in skipping pertinent timely information in customers, subordinates Is improving communication information and less than anticipation of others' needs. and peers informed. problem areas. thorough understanding by Uses verbal and written Frequently anticipates the audience. Does not keep communications to avoid or information needs of others. supervisor, customers, minimize Asks questions and seeks subordinates, and/or peers misunderstandings and necessary information. informed. Does not problems. Asks and answers Listens and provides demonstrate listening skills. questions in a thoughtful meaningful feedback. Does not provide effective and informed manner. and meaningful responses. Listens and provides Does not ask questions to meaningful feedback. obtain necessary information. Initial Comments Probationary/Mid Comments Final Comments To what degree does the employee understand and value the differences and input of others? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Actively seeks opinions and Values input and ideas. Is Attempts to understand Makes no attempt to input from people with sensitive to others’ others’ points of view and understand others’ points varied viewpoints and/or perspectives, experiences values different opinions. of view. Dismisses different backgrounds to find new and values. Appreciates Works toward accepting ideas and thoughts as approaches or to improve different points of view. others’ ideas as valid. invalid. Seldom seeks current work procedures. others’ viewpoint. Considers all input and ideas. Initial Comments Probationary/Mid Comments Final Comments
  8. 8. TEAM SKILLS How consistently does the employee adhere to attendance standards? (Refer to Department standards, if applicable.) Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Consistently observes a Consistently adheres to the Shows effort to adhere to Demonstrates a pattern of regular work schedule and appropriate attendance regular work schedule and disregard for assigned is available to work both standards. Accepts overtime overtime as assigned. On work schedule. Avoids scheduled and unscheduled as assigned. During the work occasion may arrive late for overtime as assigned. Is overtime. Readily works period, arrives at meetings, scheduled start of workday, often late for appointments during emergencies or work sites, etc. prepared and meetings or assignments. or assignments and responds promptly to calls on time or slightly ahead of extends break and meal received at home typifying schedule. Makes appropriate periods. Shows no effort to these actions. Willingly notification about unavoidable correct condition. changes work hours to fit delays. Consistently is the needs of the City. regarded as a reliable employee. Initial Comments Probationary/Mid Comments Final Comments How does the employee conduct himself or herself in the work environment? Highly Successful Successful Acceptable Unsatisfactory Initial Final Initial Final Initial Final Initial Final Probationary/Mid Probationary/Mid Probationary/Mid Probationary/Mid Consistently models a Consistently displays a Is increasing positive Rarely has positive positive behavior with positive behavior with regard behavior with regard to work. behavior with regard to regard to work. Seek out to work. Willingly accepts Accepts some constructive work. Rarely accepts and acts on constructive constructive criticism. Is criticism. Is working toward constructive criticism. criticism. Encourages a respectful of others. demonstrating respect to Rarely demonstrates positive work attitude in Willingness to work as part others. respect toward others. others. Demonstrates of a team, to demonstrate respect in dealing with team skills and to perform a others. fair share of team responsibilities. Initial Comments Probationary/Mid Comments Final Comments
  9. 9. GOALS LEADING GOAL Initial Goals Probationary/Mid Goals Final Goals MANAGING GOAL Initial Goals Probationary/Mid Goals Final Goals TASK/TECHNICAL GOAL Initial Goals Probationary/Mid Goals Final Goals TEAM SKILL GOAL Initial Goals Probationary/Mid Goals Final Goals
  10. 10. Initial Review: Are any attachments included? yes no Employee Comments: ______________________________________________ ____________ ______________________________________________ ____________ Immediate Supervisor Signature Date Employee Signature* Date ______________________________________________ ____________ ______________________________________________ ____________ Secondary Supervisor Signature Date Department Director Signature Date Probationary/Mid Review: Are any attachments included? yes no Employee Comments: ______________________________________________ ____________ ______________________________________________ ____________ Immediate Supervisor Signature Date Employee Signature* Date ______________________________________________ ____________ ______________________________________________ ____________ Secondary Supervisor Signature Date Department Director Signature Date Final Review: Are any attachments included? yes no Employee Comments: An employee receiving two or more unsatisfactory ratings on his or her final review is not eligible for a salary increment. This employee received ________ unsatisfactory rating(s) and is is not eligible for a pay increment. ______________________________________________ ____________ ______________________________________________ ____________ Immediate Supervisor Signature Date Employee Signature* Date ______________________________________________ ____________ ______________________________________________ ____________ Secondary Supervisor Signature Date Department Director Signature Date * Employee's signature indicates having received the evaluation and not necessarily concurrence or agreement with the rating as assigned.

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