Staff Appraisal - Checklist
Employee Name Title
Department
Appraisal Period
Type of Review (check one) Annual Special
Staff Appraisal of Performance on Relevant Factors
Rating Scale: 1=lowest 5=highest
Adaptability Rating:
Adapts to changes in the work environment
Manages competing demands
Accepts instruction and/or constructive feedback
Changes approach or method to best fit the situation
Comments:
Attendance and Punctuality Rating:
Schedules time off in advance
Begins working on time@7am
Ends working on time @4 pm
Keeps absences within guidelines
Ensures work responsibilities are covered when absent
Arrives at meetings and appointments on time
Comments:
1
Communications Rating:
Expresses ideas and thoughts well verbally
Expresses ideas and thoughts well in written form
Exhibits good listening and comprehension
Keeps others adequately informed
Selects and uses appropriate communication methods
Comments:
Cooperation/Collegiality Rating:
Establishes and maintains effective relations
Exhibits tact and consideration
Displays positive outlook and pleasant manner
Offers assistance and support to co-workers
Works cooperatively in group situations
Works actively to resolve conflicts
Comments:
Dependability Rating:
Responds to requests for service and assistance
Follows instructions, responds to management direction
Takes responsibility for own actions
Commits to doing the best job possible
Keeps commitments
Comments:
Initiative Rating:
Volunteers readily
Undertakes self-development activities
Seeks increased responsibilities
Takes independent actions and calculated risks
Looks for and takes advantage of opportunities
Asks for help when needed
Willing to working outside normal hours (overtime)
Comments:
2
Job Knowledge Rating:
Competent in required job skills and knowledge
Exhibits ability to learn and apply new skills
Keeps abreast of current developments
Requires minimal supervision
Displays understanding of how job relates to others
Uses resources effectively
Comments:
Organization Support Rating:
Follows policies and procedures
Completes administrative tasks correctly and on time
Supports organization’s goals and values
Benefits organization through outside activities
Supports and respects diversity
Comments:
Planning and Organization Rating:
Prioritizes and plans work activities
Uses time effectively
Plans for additional resources
Integrates changes smoothly
Sets goals and objectives
Works in an organized manner
Comments:
Problem Solving Rating:
Identifies problems in a timely manner
Gathers and analyzes information skillfully
Develops alternative solutions
Resolves problems in early stages
Works well in group problem solving situations
Comments:
3
Productivity Rating:
Consistently handles assigned workload
Establishes and manages priorities effectively
Works efficiently and uses time effectively
Establishes processes and procedures for getting work done
Comments:
Quality Rating:
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
Comments:
Core Values Rating:
Demonstrates student centeredness
Demonstrates professional development and scholarship
Demonstrates integrity and ethics
Demonstrates respect, diversity and pluralism
Demonstrates innovation and flexibility
Demonstrates teamwork and collaboration
Comments:
Additional Performance Factors Related to this Position
• Rating:
Comments:
• Rating:
Comments:
• Rating:
Comments:
4
Signatures and Statements
Immediate Supervisor: Date:
Next Level Supervisor: Date:
*Employee: Date:
*Signature acknowledges that the appraisal was discussed with employee; it does not necessarily signify
employee’s agreement with the appraisal.
Overall Annual Performance Rating
(Circle one rating below)
5 Exceptional Performance during appraisal period was consistently superior and significantly exceeded
expectations for the position.
4 Highly Effective Performance during appraisal period frequently exceeded expectations for the position.
3 Proficient/Successful Performance during appraisal period met expectations for the position.
2 Inconsistent Performance during appraisal period met some, but not all expectations for the position.
Performance improvement process should be initiated.
1 Unsatisfactory Performance during appraisal period consistently failed to meet minimum expectations for the
position. Individual lacks or did not apply knowledge, skills, or behavior expected for the
position. Performance improvement process should be initiated.
.
N/A New Individual has not been in position long enough to fully demonstrate the competencies
required for the position. This appraisal is provided for feedback purposes. Individual will,
therefore, be formally reviewed and rated at a later agreed upon date.
Optional Employee Statements:
□ I agree with the appraisal as written (no response provided).
□ I agree with the appraisal as written (response provided).
□ I do not agree with the appraisal as written (no response provided).
□ I do not agree with the appraisal as written (response provided).
Reviewed:
HR Services Manager: Date:
Updated January 2012
