DISCLAIMER

This document is provided for general informational purposes, may not apply to your city's
specific situation and should not be considered a comprehensive employee evaluation. It
should be used for comparative purposes only. The employee evaluation should be tailored to
reflect the actual qualifications and job duties relevant for a position in the context of your
city. You should consult with a human resources professional and your city attorney before
taking any action based on this document.

EMPLOYEE PERFORMANCE EVALUATION FORM

EMPLOYEE NAME: DEPT:

POSITION TITLE: DIV:

SUPERVISOR/TITLE

ANNUAL EVALUATION END OF PROBATION EVALUATION

PERFORMANCE PLANNING AND RESULTS

Performance Review:
* Use a current job description (job descriptions are available from the HR Department).
* Rate the employee's level of performance, using the definitions below.
* Review with employee each performance factor used to evaluate his/her work performance.
* Give an overall rating in the space provided, using the ratings/definitions below as a guide.

PERFORMANCE RATING DEFINITIONS

The following ratings must be used to ensure commonality of language and consistency on overall ratings:
(There should be supporting comments to justify ratings of “Outstanding”, “Below Expectations, and
"Unsatisfactory")
1. Unsatisfactory: - Performance is consistently unacceptable
2. Below Expectations: - Performance fails to meet job requirements on a frequent basis
3. Meets Expectations: - Performance is regularly competent and dependable
4. Exceeds Expectations: - Performance is routinely above job requirements
5. Outstanding: - Performance is consistently superior

A. EMPLOYEE CORE PERFORMANCE FACTORS (Use the job description as basis of this evaluation)
1. Customer Service and Customer Responsiveness
Honors all of the department and City's commitments to customers by providing Outstanding - 5
helpful, courteous, accessible, responsive, and knowledgeable service. Measures Exceeds Expectations - 4
responsiveness and courtesy in dealing with internal staff, external customers and
vendors, and employee projects in a courteous manner. Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

2. Team and Cooperation

Cooperates with others to accomplish common goals, works with employees Outstanding - 5
within and across the department to achieve shared goals, treats others with Exceeds Expectations - 4
dignity and respect and maintains a friendly demeanor, and values the
contributions of others. Meets Expectations - 3
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dignity and respect and maintains a friendly demeanor, and values the
contributions of others.
Below Expectations - 2
Unsatisfactory - 1
Comments:

3. Results Orientation
Consistently delivers required business results; sets and achieves achievable, yet Outstanding - 5
aggressive, goals; consistently complies with quality standards and meets Exceeds Expectations - 4
deadlines, and maintains focus on organizational goals.
Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

4. Communication
Measures effectiveness in listening to others, expressing ideas, both orally and in Outstanding - 5
writing and providing relevant and timely information to management, co- Exceeds Expectations - 4
workers, subordinates and customers.
Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

5. Accountability
Accepts full responsibility for self and contribution as a team member; displays Outstanding - 5
honesty and truthfulness; confronts problems quickly; displays a strong Exceeds Expectations - 4
commitment to organizational success and inspires others to commit to goals;
demonstrates a commitment to delivering on his/her public duty and presenting Meets Expectations - 3
oneself as a credible representative of the department and/or the City to maintain Below Expectations - 2
the public’s trust. Unsatisfactory - 1

Comments:

6. Decision Making/Judgment/Problem Solving

Measures effectiveness in understanding problems and making timely, practical Outstanding - 5
decisions. Analyzes problems by evaluating available information and resources, Exceeds Expectations - 4
and develops effective, viable solutions to problems which can help drive the
effectiveness of the department and/or the City as a whole. Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

7. Dependability
Measures how well employee complies with instructions and performs under Outstanding - 5
unusual circumstances, and considers record of attendance and punctuality. Exceeds Expectations - 4
Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

8. Job Knowledge
Measures effectiveness in keeping knowledgeable of methods, techniques and Outstanding - 5
skills required in own job and related functions, and remains current on new Exceeds Expectations - 4
developments affecting the department and/or the City and its work activities.
Meets Expectations - 3
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developments affecting the department and/or the City and its work activities.

Below Expectations - 2
Unsatisfactory - 1
Comments:

9. Initiative and Independent Action

Proactively identifies ways to contribute to the City's goals and missions; achieves Outstanding - 5
results without needing reminders from others; identifies and takes action to Exceeds Expectations - 4
address problems and opportunitie, and measures effectiveness in time
management, initiative and independent action within prescribed limits. Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

10. Flexibility and Employee's Responsiveness

Measures responsiveness in completing job tasks in a timely manner; adapts to Outstanding - 5
change and different ways of doing things quickly and positively; does not shy Exceeds Expectations - 4
away from addressing setbacks or ambiguity; deals effectively with a variety of
people and situations, and appropriately adapts one’s thinking or approach as the Meets Expectations - 3
situation changes. Below Expectations - 2
Unsatisfactory - 1
Comments:

11. Managing Change and Improvement

Measures effectiveness in initiating changes, adapting to necessary changes from Outstanding - 5
old methods when they are no longer practical, identifying new methods and Exceeds Expectations - 4
generating improvement in facility's performance.
Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

12. Professional Development

Demonstrates a commitment to professional development by proactively seeking Outstanding - 5
opportunities to develop new capabilities, skills, and knowledge, and acquires the Exceeds Expectations - 4
skills needed to continually enhance his/her contribution to the department and/or
the City and to his/her respective profession. Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

13. Professional Appearance

Measures neatness and personal hygiene appropriate to position while abiding by Outstanding - 5
the City's Dress Code Policy. Exceeds Expectations - 4
Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

14. Safety
Measures individual's work habits and attitudes as they apply to working safely, Outstanding - 5
considers their contribution to accident prevention, safety awareness, ability to Exceeds Expectations - 4
care for the department and or/ the City's property and keeps workspace safe and
tidy. Meets Expectations - 3
Below Expectations - 2
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 Unsatisfactory - 1
Comments:

CORE PERFORMANCE FACTORS SUB-TOTAL: 0

(CORE PEFORMANCE FACTORS FINAL SCORE) 0

(SUPERVISORS/MANAGERS ADDITIONAL FACTORS EVALUATION SECTION)

Complete #15 - #18 for subordinates with supervisory/management duties. The Core
Performance Factors Sub-Total and Final Score will be calculated along with the
Supervisor/Manager's Total and Score to determine the Final Score.
15. Team Leadership
Measures effectiveness in accomplishing tasks through subordinates - delegating Outstanding - 5
and coordinating effectively. Manages and guides group efforts; promotes Exceeds Expectations - 4
innovation; tracks team progress; adequately anticipates roadblocks; establishes
Meets Expectations - 3
challenging goals; changes course as needed to achieve team goals, and provides
appropriate feedback concerning performances, including areas for improvement. Below Expectations - 2
Unsatisfactory - 1

Comments:

16. Talent Management

Clearly establishes and communicates expectations and accountabilities; monitors Outstanding - 5
and evaluates performance; provides effective feedback and coaching; identifies Exceeds Expectations - 4
development needs and helps employees address them to achieve optimal
performance and gain valuable skills that will translate into strong performance in Meets Expectations - 3
future roles. Below Expectations - 2
Unsatisfactory - 1
Comments:

17. Business Process Management

Develops innovative approaches to address problems and drive continuous Outstanding - 5
improvement in programs and processes; drives effective and smooth change Exceeds Expectations - 4
initiatives across the organization by communicating, confirming understanding,
actively working with employees to overcome resistance. Meets Expectations - 3
Below Expectations - 2
Unsatisfactory - 1
Comments:

18. Project Management

Effectively manages project(s) by appropriately focusing attention on the critical Outstanding - 5
few priorities; effectively creates and executes against project timelines based on Exceeds Expectations - 4
priorities, resource availability, and other project requirements (i.e., budget);
effectively evaluates planned approaches, determines feasibility, and makes Meets Expectations - 3
adjustments when needed. Below Expectations - 2
Unsatisfactory - 1
Comments:

SCORES: SUPERVISORS/MANAGERS TOTAL: 0

SUPERVISORS/MANAGERS SCORE: 0
CORE PERFORMANCE FACTORS SECTION SCORE 0
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 FINAL SCORE: 0

THE ITEMS BELOW, ADDITIONAL INFORMATION MAY BE ATTACHED ON A SEPARATE PAG

B. EMPLOYEE STRENGTHS AND ACCOMPLISHMENTS: (Include those which are relevant

during this evaluation period. This should be related to performance or behavioral aspects in their performance)

C. PROFESSIONAL DEVELOPMENT PLAN:

D. PERFORMANCE AREAS WHICH NEED IMPROVEMENT:

E. PLAN OF ACTION TOWARD IMPROVED PERFORMANCE:

F. EMPLOYEE COMMENTS: (Additional information may be attached on a separate page)

G. JOB DESCRIPTION REVIEW SECTION: (Please check the appropriate box.)

 Employee job description has been reviewed during this evaluation and no changes has been made
Emplo to the job description at this time.
yee
job
descri Employee job description has been reviewed during this evaluation and modifications have been
ption proposed to the job description. The modified job description is attached to this evaluation.
has
H.been
SIGNATURES: (Completed document with original signatures should be submitted to Human
Resources)
review
ed
Employee's
during Signature: Date Signed:
this
Evaluator's
evalua Name: Eval Date:
tion
Evaluator's
and no Signature: Date Signed:
chang 5 of 7
Reviewer's Name: Review Date:

Reviewer's Signature: Date Signed:

Department Head: Date Signed:

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