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POL: PERFORMANACE EVALUATION FORM JEFFERSON COUNTY PERFORMANCE EVALUATION FORM Employee: Position: Supervisor: Department: Date: Time in Position: SECTION I- GENERAL PERFORMANCE STANDARDS Consider each standard separately. A substandard performance rating on any performance standard must be supported by specific comment in the space provided. Use additional sheets if necessary. 1. JOB KNOWLEDGE, SHILLS AND ABILITIES: The employee demonstrates the knowledge, skills and abilities to perform work satisfactorily. Does not have the basic Has the basic knowledge, skills, Has exceptional knowledge, skill knowledge, skills and abilities to and abilities to perform work and abilities to perform work. perform work satisfactorily satisfactorily. COMMENTS: 2. QUALITY OF WORK: The employee demonstrates accuracy, attention to detail and effectiveness in completion of work. Work is sometimes inaccurate Work is usually accurate and Work is consistently of excellent or incomplete; fails to meet through; work meets quality, accuracy, and detail. departmental standards , departmental standards. COMMENTS: , 3. PRODUCTIVITY: Employee performs work with efficiency, consistency and timeliness. Work slower than expected; Completes work On time with` Quickly completes work,often work is of substandard consistency and efficiency; ahead of schedule;effectively consistency and timeliness. meets departmental standards. prioritizes work;exceeds departmental standards. COMMENTS: 4. RELIABILITY: The employee exhibits dependability and conscientiousness in performing work and in willingness to accept responsibilities. Sometimes is not dependable and Consistently dependable and Extremely dependable; follows conscientious in performing conscientious; usually accepts work; unwilling to accept responsibilities; meets through promptly on all tasks; xc e responsibilities. departmental standards. accepts responsibilities;; wh level of job goals; shows high level of ■ initiative. COMMENTS: 1111 1111 5. COMMUNICATION: The employee demonstrates the appropriate level of written and Y perform communication skills necessary to satisfactoril m the job. Communication skills impair Possesses the required work performance. communication skills and is Has excellent ecmmuniverion a effective in the position;meets annd d written very n r intera effective a ti in verbal departmental standards, wctions. COMMENTS: ■ ■ ■ 6. WORK RELATIONSHIPS: The employee possesses the ability to maintain effective and productive working relationships with fellow employees, supervisors and the public. Has trouble getting along with Has a generally positive Exceeds employees. approach in assisting others; highly departmental standards; maintains effective working omo e cooperative;positive work work hard to relationships;meets g promote ppsitive work departmental standards. relationships. COMMENTS: 11111 ■ ■ 7. SAFETY: The employee adheres to the rules and regulations to ensure safety standards are met. Fails to follow safety rules and Follows safety rules and meets Exceeds departmental standards regulations; falls below departmental standards. departmental standards. for safety. 1111 COMMENTS:: ■ ■ SECTION II JOB PERFORMANCE STANDARDS This section is designed to be"job specific". Refer to the"Job Performance Standards" of the employee's position description. Briefly list the major job duties specifically related to the performance of this job. Check the standard which represents the employee's work performance. Additional job performance standards may be attached. In the comment section, provide information to explain and support ratings that indicate substandard performance. BELOW STANDARD: Job performance generally falls below standards required for the position. MEETS STANDARDS: Job performance satisfactorily meets the requirements for the position. EXCEEDS STANDARDS: Job performance consistently exceeds the standards for the position. -Ayr r ;; a�a e ® jt x•k.% �r JOB PERFORMANCE STANDARDS ) I COMMENTS: I I 2. COMMENTS: I I • 3. COMMENTS: I I I 4. COMMENTS: I I I 5. COMMENTS: BELOW ,'.MEETS EXCEEDS JOB PERFORMANCE STANDARDS _= 6. COMMENTS: 7. --- COMMENTS: 8. COMMENTS: 9. COMMENTS: 10. -_ COMMENTS: 11. -_ COMMENTS: 12. COMMENTS: 13. -- COMMENTS: 14. COMMENTS: --a $ d& ........... JOB PERFORMANCE STANDARD 15. COMMENTS: I COMMENTS: I I 17. COMMENTS: 18. COMMENTS: COMMENTS: 20. COMMENTS: COMMENTS: 22. I _ COMMENTS: 23. COMMENTS: SECTION III-OVERALL WORK PERFORMANCE: Check the standard which matches the employee's OVERALL work performance. An overall work performance rating which does not meet"Job Requirements" requires specific explanation in the comment section. Explanation must include the specific job performance areas requiring improvement. Attach additional sheets as necessary. Performance needs improvement to Performance meets Job Performance exceeds Job meet Job Requirements. Requirements. Requirements. COMMENTS: SECTION IV- EMPLOYEE COMMENTS: Comments are encouraged either agreeing, disagreeing, or acknowledging the supervisor's evaluation. Attach additional information if needed. Supervisor's signature Date: Employee's signature _ Date: Chief Administrator's signature: Date: NOTE: By signing this form, the employee acknowledges only that this evaluation was discussed and a copy has been received by the employee. The employee's signature does not signify agreement with the evaluation.