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Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPART A PERFORMANCE PLANJohn DoeSusan Jones-RobinsonEmployee Name (as it appears on payroll)RaterOffice Support Level IIAdministrative Services ManagerEmployee TitleTitle123456XYZ DepartmentEmployee Identification Number (EIN)DepartmentPerformance Management Cycle / Effective Dates (min. 90 calendar days)From (mm/yy)02/16To (mm/yy)02/17Pr ogr ess R eview Discussion (m inim um one per cy cl e - r ecom m ended quar ter l y )(mm/yy) 05/16Actual Progress Review Discussion date(s)(mo/day/yr)(mm/yy) 08/16(mm/yy) 11/16(mo/day/yr)(mm/yy) 01/17(mo/day/yr)EAnticipated Progress Review Discussion date(s)(mo/day/yr)Performance Plan Section 1: Development OpportunitiesList targeted tr aining & devel opm ent goals for this Performance Management Cycle or indicate " None" .METHOD OF DEVELOPMENTDESIRED OUTCOMELAREA(S) OF DEVELOPMENTAttend Records Management training.Enhance knowledge of and skills inorganizing and maintaining file systems inthe Records Division.PFiling / Record KeepingMPerformance Plan Section 2: Performance ImprovementsList areas identified in the previous Cycle that require improvement, or indicate " None" .AREA(S) REQUIRING IMPROVEMENTEXPECTATIONSAProficiency with XYZ Software Program. To achieve less than a 1% error rate.TIMELINEImmediate and sustained improvement isexpected throughout this PerformanceManagement Cycle.SPerformance Plan Section 3: Organizational ConductAttendance and Punctuality (the degree to which the employee can be depended upon to be available for work and to fulfill positionresponsibilities) Time off is requested and/or scheduled in advance Work is begun on time Partial and full day absences follow guidelines Job duties are covered while on annual leave (unless concurrent with an approved leave of absence)Interactions with Others (the extent to which the employee shows understanding and sensitivity to the needs and problems of othersinternal to the organization or doing business with the County, such as contractors, consultants, etc.) Working relationships are effective Positive image of self and others is displayed Respectful and cooperative demeanor is observedWork Habits (the manner in which the employee conducts himself or herself in the work environment) Applicable laws, rules, policies and directives are observed Safety standards and procedures are followed County equipment is properly used and maintainedPart A: Performance Plan - Page 1rev 8.3.17

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPerformance Plan Section 4: Customized Performance DimensionsInclude a minimum of three / maximum of five dimensions for this Performance Management cycleAdaptability (the efficiency with which the employee works under stress and responds to change) Changes in assignments, supervision, work schedules or locations are well received Professional demeanor is observed in tough situations Competing demands are effectively handled within the scope of the positionLECommunications (the extent to which the employee applies routine oral and written communication skillsin daily work assignments) Unfamiliar terms and instructions are clarified Appropriate individuals are kept adequately informed of changes or new information Oral and written communications are clear and easy to understandSAMPCustomer Service (the degree to which the employee provides effective front-line services to externalcustomers) Customer confidence is increased through education Customers receive accurate guidance in service processing Customers are provided information consistent with the complexity and nature of their needsPart A: Performance Plan - Page 2Employee:John Doerev 8.3.17

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPerformance Plan Section 5: SignaturesPerformance Plans must not be retroactive, therefore the month / year following the Rater’s and Employee’s signatures belowmust match the beginning month / year of the Performance Management Cycle effective dates.Rater: I met with the employee and discussed this Performance Plan.Rater’s Signature (Signs first, immediately after discussing plan withemployee)Date (mo/day/yr plan discussed withemployee)EEmployee: I was given the opportunity to discuss the content of this Performance Plan with my Rater. I understand that I will receive anappraisal at the end of this appraisal cycle.Date (mo/day/yr plan discussed with Rater)LEmployee's Signature (Signs second, immediately after discussingplan with Rater)PReviewer: I concur with the content of this Performance Plan.Date (mo/day/yr)SAMReviewer’s Signature (Final approval - signs last, afterEmployee/Rater meet and sign)A copy of the issued and Reviewer-signed Performance Plan is given to the employee. The original is maintained in the departmentpersonnel file. Please do not send a copy of the Performance Plan to Human Resources.To print Performance Plan only: print pages 1-3 (please consider the environment and print double-sided)Part A: Performance Plan - Page 3Employee:John Doerev 8.3.17

PLEPerformance Management - APPENDIX A For Appraising Non-supervisory EmployeesSAMThis page intentionally left blankPage 4

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPART B PERFORMANCE APPRAISALJohn DoeSusan Jones-RobinsonEmployee Name (as it appears on payroll)RaterOffice Support Level IIAdministrative Services Manageremployee TitleTitle123456XYZ Departmentemployee identification number (ein)DepartmentPerformance Management Cycle / Effective Dates(Min 90 calendar days / max approx. 1 yr)Type: Annual Appraisal From (mm/yy) 02/16To (mm/yy) 02/17Actual Date Appraisal Issued to Employee:(mo/day/yr)Performance Appraisal Section 1: Development OpportunitiesAttend Records Management training.DESIRED OUTCOMEEnhance knowledge of and skills inorganizing and maintaining file systems inthe Records Division.PLFiling / Record KeepingMETHOD OF DEVELOPMENTETargeted tr aining and devel opm ent goals for this Performance Management Cycle, if any.AREA(S) OF DEVELOPMENTR ater 's Com m ents (to be completed as part of appraisal)AMJohn has really applied himself over the course of this performance management cycle. He no longer requires constantsupervision; his error rate is acceptable, and all work is completed in a timely manner. All filing duties are completed on timeand he is managing his workload consistently and expeditiously.Performance Appraisal Section 2: Performance ImprovementsAreas identified in the previous Cycle that require improvement, if any.EXPECTATIONSSAREA(S) REQUIRING IMPROVEMENTProficiency with XYZ Software Program. To achieve less than a 1% error rate.TIMELINEImmediate and sustained improvement isexpected throughout this PerformanceManagement Cycle.R ater 's Com m ents (to be completed as part of appraisal)John's error rate has improved dramatically during this Cycle; managers and coworkers have commented on his high level ofaccuracy and productivity. John takes pride in his work and strives to continually improve his work performance. All memos,reports, forms and correspondence are completed on time with minimal errors.Part B: Performance Appraisal - Page 5rev 8.3.17

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPerformance Appraisal Section 3: Organizational ConductRATINGSURPASSESInteractions with Others (the extent to which the employee shows understanding & sensitivity to the needs andproblems of others internal to the organization or doing business with the County, i.e., contractors, consultants, etc.) Working relationships are effective Positive image of self and others is displayed Respectful and cooperative demeanor is observedSURPASSESEAttendance and Punctuality (the degree to which the employee can be depended upon to be available for work andto fulfill position responsibilities) Time off is requested and/or scheduled in advance Work is begun on time Partial and full day absences follow guidelines Job duties are covered while on annual leave (unless concurrent with an approved leave of absence)LWork Habits (the manner in which the employee conducts him or herself in the work environment) Applicable laws, rules, policies and directives are observed Safety standards and procedures are followed County equipment is properly used and CONSISTENTUNACCEPTABLECategor y Nar r ative (reflects an overview of performance category ratings for Section 3)SAMJohn consistently arrives to work on time. He never misses work without prior approval and appropriate notification; he has hadno unscheduled absences during this rating period. John consistently maintains effective working relationships with hiscoworkers and supervisor. His demeanor is pleasant and courteous. He complies with work rules and procedures as directedand follows physical lifting safety procedures established for staff working in the Records Division.Performance Appraisal Section 4: Customized Performance DimensionsRATINGPlease rate this employee for each dimension listedAdaptability (the efficiency with which the employee works under stress and responds to change) Changes in assignments, supervision, work schedules or locations are well received Professional demeanor is observed in tough situations Competing demands are effectively handled within the scope of the EPart B: Performance Appraisal - Page 6Employee: John Doerev 8.3.17Clear Ratings

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPerformance Appraisal Section 4: Customized Performance Dimensions (cont'd)Communications (the extent to which the employee applies routine oral and written communication skillsin daily work assignments) Unfamiliar terms and instructions are clarified Appropriate individuals are kept adequately informed of changes or new information Oral and written communications are clear and easy to CCEPTABLEECustomer Service (the degree to which the employee provides effective front-line services to externalcustomers) Customer confidence is increased through education Customers receive accurate guidance in service processing Customers are provided information consistent with the complexity and nature of their SESASUCCESSFULINCONSISTENTSUNACCEPTABLECategor y Nar r ative (reflects an overview of performance category ratings for SECTION 4)John adjusts well to changes in the workplace. He looks for ways to streamline procedures to improve efficiency and customerservice. He sets priorities and adjusts them as needed when unexpected situations arise. John takes messages, writescorrespondence, deals with customers and coworkers with sufficient attention to detail. His reports are accurate and well writtenusing proper grammar and punctuation. John maintains a competent and professional demeanor in dealing with clients and thepublic. He is courteous and knowledgeable and answers all questions promptly and accurately.Part B: Performance Appraisal - Page 7Employee: John Doerev 8.3.17Clear Ratings

Performance Management - APPENDIX A For Appraising Non-supervisory EmployeesPerformance Appraisal Section 5: SignaturesRater: I conducted at least one progress review discussion with the employee during the Performance Management Cycle. I also discussedthe performance appraisal ratings with the employee and, if needed, explained job expectations, areas needing clarification, or performanceissues requiring improvement.Rater’s Signature (Signs first, immediately after discussing appraisalwith employee)Date (mo/day/yr appraisal discussed withemployee)R ater 's Com m ents (Optional):LEThanks, John for your contribution to the work unit and its clients. You have demonstrated your ability to be an effective teamplayer and your commitment to providing quality service is evident in the manner in which you communicate with clients,coworkers, customers and staff.PEmployee: I was given the opportunity to discuss the content of this appraisal with my Rater. I understand that I may: Respond to the appraisal in the space provided below or submit a single-sided legibly typewritten (minimum 10 pt font) or legiblyhandwritten response within five calendar days (following receipt of my appraisal) and/or Submit a request for reconsideration of ratings to my Appointing Authority or Designee with my written response within five calendardays (following receipt of my appraisal).I also understand the completed appraisal will be forwarded to Human Resources for inclusion in my official personnel file.MEmployee's Signature (Signs second, immediately following appraisaldiscussion with Rater or may sign and submit within five calendar days)Date (mo/day/yr - within five calendar days ofappraisal discussion with Rater)SAEm pl oy ee's Com m ents (Optional): It is advisable to wait for the employee response period (five calendar days)to elapse before submitting the appraisal to the Reviewer for final approval.The optional employee response is the only appraisal attachment permitted.Reviewer: I have reviewed and concur with the Rater's appraisal ratings and narratives.Reviewer’s Signature (Final approval - signs last, afterEmployee/Rater meet and sign)Date (mo/day/yr)To print Appraisal only: print pages 5-8 (please consider the environment and print double-sided)Original - Human Resources (Part B: Performance Appraisal only)Part B: Performance Appraisal - Page 8SavePrintEmployee: John DoeCopies - Department Personnel File & Employeerev 8.3.17Clear Form

Rater: I met with the employee and discussed this Performance Plan. Rater’s Signature (Signs first, immediately after discussing plan with employee) Performance Plan Section 5: Signatures Employee: I was given the opportunity to discuss the content of this Performance Plan with my Rater.I understand that I will receive an appraisal at the end of this appraisal cycle.

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