CityHouse Annual Performance Evaluation
Employee Name
First Name
Last Name
Title
Date of Hire
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of Review
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor Name
First Name
Last Name
Scoring
Outstanding: Work performance is consistently superior to standards required for the job. -Exceeds Expectations: Work performance is consistently above the standard of performance for the position. Meets Expectations: Work performance consistently meets the standards of performance for the position. Improvement Needed: Work performance does not consistently meet the standards of performance for the position. Serious effort is needed to improve performance. Unacceptable: Work performance is inadequate and inferior to the standards of performance required for the position. Performance at this level cannot be allowed to continue.
Technical Skills
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Job Knowledge
1
2
3
4
5
Analyzes Problems
6
7
8
9
10
Provides suggestions for work improvement
11
12
13
14
15
Employs tools of the job competently
16
17
18
19
20
Follows proper safety procedures
21
22
23
24
25
Quality of Work
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Accuracy or Precision
26
27
28
29
30
Thoroughness/ Neatness
31
32
33
34
35
Reliability
36
37
38
39
40
Responsiveness to requests for service (including after hours)
41
42
43
44
45
Follow-through/ Follow-up
46
47
48
49
50
Judgment/ Decision Making
51
52
53
54
55
Interpersonal Skills
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
With co-workers
56
57
58
59
60
With supervisors
61
62
63
64
65
With other volunteers, interns, and/or community
66
67
68
69
70
Team participation/ contribution
71
72
73
74
75
Commitment to team success
76
77
78
79
80
Communication Skills
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Written expression
81
82
83
84
85
Oral expression
86
87
88
89
90
Shares information willingly
91
92
93
94
95
Tact and diplomacy
96
97
98
99
100
Maintains confidentiality where appropriate
101
102
103
104
105
Approach to Work
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Actively seeks ways to streamline process
106
107
108
109
110
Open to new ideas and approaches, flexible/ adaptable
111
112
113
114
115
Initiatives
116
117
118
119
120
Planning and organization
121
122
123
124
125
Seeks additional training and development
126
127
128
129
130
Follows instructions (including Policy and Procedure)
131
132
133
134
135
Challenges status quo processes in appropriate ways
136
137
138
139
140
Respects authority and follows chain-of-command
141
142
143
144
145
Attendance/ Punctuality (including staff meetings)
146
147
148
149
150
Maintains ethical standards
151
152
153
154
155
Professional representation of organization
156
157
158
159
160
Quantity of Work
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Priority Setting
161
162
163
164
165
Amount of work completed
166
167
168
169
170
Work completed on schedule
171
172
173
174
175
Job Specific Duties
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Be a team member in seeing that the philosophy, purpose, and objec6ves of CityHouse are being implemented with each family.
176
177
178
179
180
Leadership Skills
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Support of ministry efforts/ Programs
181
182
183
184
185
Trains and develops staff
186
187
188
189
190
Faces performance problems squarely
191
192
193
194
195
Supports responsible risk taking
196
197
198
199
200
Controls costs and maximizes resources
201
202
203
204
205
Instills pride in performance, service, innovation, and quality
206
207
208
209
210
Sets high standards for self, as well as others
211
212
213
214
215
Supports useful debate and disagreement
216
217
218
219
220
Welcomes and provides constructive feedback
221
222
223
224
225
Fosters respect for facts, data, and objective analysis
226
227
228
229
230
231
232
233
234
235
236
Leadership Skills
Rows
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
Uses analytical tools and models for process improvement
237
238
239
240
241
Supports experimentation and brainstorming that leads to innovation and learning
242
243
244
245
246
Overall Performance
Please Select
Outstanding
Exceeds Expectations
Meets Expectations
Improvement Needed
Unacceptable
List five desired outcomes (results or goals) in the upcoming year, and actions to produce outcomes/ results/ goals (“Action”):
Action 1:
Action 2:
Action 3:
Action 4:
Action 5:
Has this employee been counseled or disciplined in the last year?
Please Select
Yes
No
If yes, please explain:
Supervisor's Comments:
Employee, please check one:
If you disagree with your supervisor's assessment and recommendations, please use the section below to specify. Additionally, if employee wishes to do so, any comments concerning the appraisal may be indicated in this section, or by any attachment.
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Employee Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Supervisor Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Director of Programs Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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