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STATE SYSTEM OF HIGHER EDUCATION
PERFORMANCE EVALUATION REPORT
EMPLOYEE:
SOCIAL SECURITY NUMBER: Evaluation Period:
CLASSIFICATION: Type of Evaluation: Regular
LOCATION: (Check One) Probationary
PERFORMANCE MONTH: Interim
GENERAL PERFORMANCE FACTORS- All
employees should be evaluated on the first six factors.
EXCELLENT
VERY
GOOD
GOOD
FAIR
UNSATIS-
FACTORY
1. QUALITY OF WORK – Completion; accuracy;
professional; or technical proficiency.
2. WORK HABITS- Planning and organization of work;
care of equipment and supplies.
3. RELATIONSHIP WITH PEOPLE- Ability to get along
with others. Effectiveness in dealing with the public.
4. DEPENDABILITY- Degree to which employee can
be relied upon to work steadily and effectively;
punctuality; regularity of attendance.
5. QUANTITY OF WORK-Amount of work performed.
6. INITIATIVE-Resourcefulness; versatility; originality;
ability to conceive and carry out program improvements.
7. ANALYTICAL ABILITY-Thoroughness and accuracy
of analysis of data, facts, laws, rules, and procedures.
8. ABILITY AS SUPERVISOR-Proficiency in training
employees. In planning, organizing, laying out work for
work unit. Activity in promoting cost reduction leadership.
9. ADMINISTRATIVE ABILITY-Promptness of action;
soundness of decision; application of good management
principles.
10. SAFETY-Application of accident prevention
techniques and unit’s safety.
SPECIAL PERFORMANCE FACTORS- List below. Define
and rate employee on any appropriate factors not listed
above.
11. COMMITMENT TO SOCIAL EQUITY
OVERALL EVLAUATION
Comments (Continue on additional sheets of 8.5 x 11 white paper.)
EVALUATOR SIGNATURE (EMPLOYEE’S IMMEDIATE SUPERVISOR) TITLE DATE
REVIEWING OFFICER SIGNATURE (EVALUATOR’S IMMEDIATE SUPERVISOR) TITLE DATE
I WOULD LIKE TO DISCUSS THIS REPORT WITH THE REVIEWING OFFICER:
YES NO
AS REQUESTED, REVIEWING OFFICER
DISCUSSED REPORT. REVIEWING
OFFICER SIGNATURE.
DATE
I ACKNOWLEDGE THT I HAVE READ THIS REPORT AND THAT I HAVE BEEN GIVEN AN OPPORTUNITY TO DISCUSS IT WITH THE
EVALUATOR. MY SIGNATURE DOES NOT NECESSARILY MEAN THAT I AGREE WITH THE REPORT.
EMPLOYEE SIGNATURE________________________________________________ DATE____________________________
I:\Payroll\Secretar\Performance Evaluation Report