FIREFIGHTER

CITY OF LOGANVILLE
PERFORMANCE APPRAISAL

NAME TITLE

Mike Moon Firefighter

(Employee being appraised)

Jason Ford Carl Morrow Deputy Chief/Lieutenant

(Evaluating Supervisor)

Terry Pilcher Chief

(Department Head)

Appraisal Date: 10/5/2006_____________________ Department: Fire___________________________

INSTRUCTIONS FOR PERFORMANCE APPRAISAL

(TO BE COMPLETED BY IMMEDIATE SUPERVISOR)

Review the individual’s position description prior to completing the appraisal, and be sure to base your appraisal on only those factors listed on the
position description. Any exceptions to factors listed on the position description must have the concurrence of the Human Resources Director.
Individuals must be advised by their supervisor of the factors upon which they will be appraised at the beginning of the appraisal period and with
proper notification following revision of a position description, reclassification, new assignment, or promotion.

1. Complete your appraisal of the employee’s performance on each factor as follows:

a. Read definition of each performance factor. Think about the specific areas of job performance described in that factor.
b. Look at the rating scale that will be used to describe the employee’s performance. Read the definition associated with each of
the five levels of performance. These definitions should help you determine the level that best describes this employee’s
performance.
c. Circle the number that best describes this employee’s performance.
d. Exceptional ratings. If you rated the employee’s effectiveness as “Ineffective”, “Marginally Effective”, or “Outstanding”, you
must document your rating in the “Comments” section with specific examples of job performance which led you to provide this
rating. Comments are encouraged for all ratings.
e. Review the appraisal to be sure that you have provided a rating on each factor.
2. Discuss form with the Department Head to reach mutual understanding and obtain signature.
3. Discuss appraisal with employee to gain their understanding and obtain signature.
4. Forward Performance Appraisal summary through the Department Head to Personnel.

PERFORMANCE LEVELS RATING SCALE

5 – Performance is clearly and consistently outstanding. Demonstrates a very high degree of proficiency. Performance compares only with the
best employees. Far exceed standards of normally expected performance.

4 – Performance is at a very high level. Demonstrates unusual proficiency. Frequently exceeds standards of normally expected performance.

3 – Performance is satisfactory and consistently at a level expected of employees.

2 – Performance is only marginally acceptable. Meets performance requirements only periodically or only in certain areas of this factor. Specific
areas of performance improvement are indicated.

1 – Performance is poor; clearly below the level of acceptability. Improvement is mandatory in nearly all aspects of this factor.

N/A – No basis for appraising the employee on this factor. Duties used to define the factor are not part of the job or no opportunity is available for
the supervisor to observe the employee’s performance in this area.

A. PREPARING FOR AND DOING WORK FIREFIGHTER

 PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

1. ABSENTEEISM AND TARDINESS N/A 1 2 X 4 5

Employee works required days; works required hours; reports to work on time and returns
from breaks on time.

Comments Mike is
always on time, he comes back form his breaks on time. Mike had a couple of shifts
where he came in late but reported it properly.

2. ATTITUDE N/A 1 2 X 4 5

Exhibits a positive attitude, shows initiative, demonstrates dependability, accepts direction

from qualified sources, displays commitment and involvement, interacts well with co-workers.

Comments Mike's attitude is always up beat and he gets along well with other employees. DC Ford Mike is
always professional and interacts well with other employees.

3. APPLYING FIREFIGHTING TECHNIQUES N/A 1 2 X 4 5

Is proficient in applying knowledge of firefighting techniques; uses the appropriate equipment

in the appropriate manner while performing entry, rescue, ventilation, salvage, or suppression
activities; knows where to find equipment at the fire scene; demonstrates knowledge of standard
operations and safety procedures when acting independently at the fire scene; applies knowledge
in areas such as first aid, hydraulics, mechanical concepts, proper extinguishing agents, or fire behavior.

Comments Mike is always applying his knowledge to his job and he is also willing to learn new ways to do
his job. DC Ford Mike knows his job very well.

4. MAINTAINING FIRE EQUIPMENT N/A 1 2 X 4 5

Carries out cleaning and maintenance of fire equipment; follows departmental procedures in
cleaning and driving equipment after use; checks equipment for loss, wear, or damage after fire
and reports to supervisor; carries out daily or periodic cleaning and inspection of equipment;
performs minor maintenance on equipment as needed or required.

CommentsMike is a driver in training and he is staying on top of his maintenance. He makes sure his
equipment is ready at all times. DC Ford Mike does a great job reporting any problems with his
equipment and tries to resolve the problem or makes the minor repair to the equipment.

A. PREPARING FOR AND DOING WORK FIREFIGHTER

PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

5. CARING FOR PERSONAL EQUIPMENT N/A 1 2 X 4 5

Maintains assigned personal equipment (protective clothing, etc.) in top working order; does not
abuse assigned equipment; checks equipment after fire to avoid loss, reports lost and or
equipment problems to supervisor.

Comments Mikes assigned equipment is always ready at all times whatever the job may bring.
6. LEARNING NEW SKILLS N/A 1 2 X 4 5

Actively participates in departmental training and undertakes development of new skills on

individual basis; attends and participates in daily or periodic drill sessions; undertakes efforts
to learn about new firefighting techniques or equipment; uses spare time to learn about work
outside own area of assignment; learns new material quickly and performs new tasks without
repeated retraining or direction.

Comments Mike is always willing to train and while training he will make sure he understands before we
move on.

7. DEMONSTRATING AND APPLYING KNOWLEDGE N/A 1 2 X 4 5

OF CITY GEORGRAPHY

Demonstrates a knowledge of city geography; demonstrates in depth familiarity with street

layout and numbering, building locations, and hazardous areas in area of assignment; shows
a general knowledge of the same features on a city and county wide basis; applies
knowledge of city geography to choose or suggest the quickest, safest route to the fire scene.

Comments Mike knows the city well and knows our automatic aid area with the county as well. He needs to
stay on top of the new streets and developments. If Mike doest not know where the street is he knows
where to find it.

8. DRIVING SKILLS N/A 1 2 X 4 5

Demonstrates skill in driving assigned department vehicles; follows safety procedures in entering
and exiting the fire station; applies defensive driving techniques in transit to fire scene; maintains
control of vehicle in hazardous or emergency driving situations; quickly and accurately positions
vehicle at fire scene according to own judgment or supervisory direction.

Comments Mikes driving skills are in line with the company policies. When he is driving he always drives
in a safe manor.

A. PREPARING FOR AND DOING WORK FIREFIGHTER

PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

9. OPERATING FIREFIGHTING APPARATUS N/A 1 2 X 4 5

Operates assigned equipment (pumper, ladder, or other heavy equipment) at fire scene; quickly sets
up equipment according to technical knowledge or supervisors direction; monitors operation of
equipment (water pressure, vehicle performance, aerial ladder or platform placement, snorkel
operation, etc.) ensures proper operation of apparatus to support other firefighters; follows proper
equipment shutdown procedures after fire is suppressed.

Comments Mike is still learning to set up the ladder truck and is on top of his skills with the engines.

10. FOLLOWING SAFETY PROCEDURES N/A 1 2 X 4 5

Follows accepted departmental safety guidelines; uses appropriate safety techniques at fire scene
(ladder holds, proper methods for using tools or equipment, procedures for entering burning structures,
etc.); uses assigned safety equipment (mask, safety belt, protective clothing); follows safety procedures
in operating assigned vehicles and other equipment; works consistently with established safety
procedures at station house.

Additional for Supervisors: Ensures that subordinates are furnished copies of all safety regulations,
attends safety training session, and observes on-the-job safety regulations.
Comments Mike is a team player when it comes to safety and he makes sure that everyone is being safe.

B. DEALING WITH PEOPLE

11. DEALING WITH THE PUBLIC N/A 1 2 X 4 5

Deals with the public in situations other than at the fire scene; greets individuals stopping at the
station; is courteous in answering questions or providing directions; assists during station tours;
actively attempts while on duty to develop a positive image of the Fire Department.

Additional for Supervisors: Sets high public relations standards and ensures that assigned
personnel demonstrate appropriate conduct when dealing with the public.

Comments Mike treats everyone as he would want to be treated. DC Ford Mike is always professional and
polite to everyone he comes in contact with.

B. DEALING WITH PEOPLE FIREFIGHTER

PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

12. WORKING WITH FELLOW EMPLOYEES N/A 1 2 3 X 5

Interacts well with fellow firefighters; maintains friendly relations with other members of the
department; cooperates with others; provides assistance and works as part of a team; exchanges
information about the job or about firefighting methods with other employees.

Additional for Supervisors: Motivates subordinates to achieve desired goals; appraises performance
In a competent manner; recommends disciplinary action and deals with grievances; arranges work
assignments to meet the needs and utilizes the capacities of subordinates.

Comments Mikes works well with others and he is the one on the shift who helps keep harmony among the
shift. DC Ford Mike comes to work ready for work he does not let personal feelings get in the way of
doing a great job while he is here.

13. FOLLOWING SUPERVISORY DIRECTION N/A 1 2 X 4 5

Accepts work assignments from supervisors without refusal or constant complaint; follows
supervisors’ direction regarding how work is to be completed and when work should be finished;
seeks review of the job performance by supervisor, discusses areas where work needs improvement,
and shows effort to improve performance in areas where supervisors point out deficiencies.

Comments Mike follows orders exact and to the point. He questions those orders that need to be more exact.

C. ACHIEVING RESULTS

14. WORKING UNDER HAZARDOUS CONDITIONS N/A 1 2 X 4 5

Performs under conditions involving danger requiring physical effort and quick and accurate
decisions; applies correct firefighting techniques under conditions requiring quick reactions and
allowing little time for thought; is able to maintain a high level of physical exertion from arrival
on the scene until the fire is controlled; works in close coordination with other members of the
team; is able to notice critical situations at the scene and report them to the supervisor.

Comments Mike is able to work and think under hazardous conditions and is able to work in close
coordination with the other members of the department .

15. RECEIVING AND PROVIDING INFORMATION N/A 1 2 X 4 5

Understands information provided by others and is able to provide information to other personnel;
follows written or verbal directions required to perform the job; accurately communicates information
to supervisors or co-workers.

Comments Mike is bale to understand both verbal and written directions and accurately communicates
back to supervisors and co-workers.
C. ACHIEVING RESULTS FIREFIGHTER
PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

16. PERFORMING DURING COMPANY SURVEYS N/A 1 2 X 4 5

Actively participates and provides input during Company surveys; assists the rest of the survey team
in checking the building floor plan, identifying the type of construction, and locating hazardous
materials; is able to sketch or diagram building layout; actively assists the team in developing
an approach to fire suppression at the site.

Additional for Supervisors: Ensures proper performance of subordinates during Company Surveys.

Comments Mike is very familiar with construction and blue prints. If someone else does not understand he
will take the time to explain it.

17. COMPLETING ROUTINE STATION ASSIGNMENTS N/A 1 2 X 4 5

Accepts and completes routine station assignments; performs housekeeping and maintenance
Tasks in assigned areas without complaint; actively participates in maintaining station and grounds
And does not purposely avoid work; assists other individuals in routine station work as time and
Other assignments permit.

Additional for Supervisors: Ensures subordinates perform above duties.

Comments Mike completes all routine station assignments on time and also motivates the other guys to do
there share.

18. ACCEPTING RESPONSIBILITY N/A 1 2 X 4 5

Can be counted on to accept assignments and follow through; accepts responsibility for assuring that
an assignment is carried out correctly without close supervision and without constant personal
complaint; submits reports on time; expends effort and time necessary to do the job well; and responds
to calls without delay.

Additional for Supervisors: Delegates authority necessary to subordinates to achieve results; refrains
from making decisions for subordinates who are delegated the necessary authority.

Comments Mike can be counted onto complete any task with or without supervision.

19. DOING WORK IN A TIMELY MANNER N/A 1 2 X 4 5

Completes reports on time; follows through to completion and meets deadlines; plans
work and sets priorities to make use of available time; and delegates work appropriately in
order to meet deadlines and/or quantity and quality goals.
Comments Mike
completes work assignments on time and he does it correctly.
C. ACHIEVING RESULTS FIREFIGHTER
PERFORMANCE FACTOR – The level of effectiveness to which this employee: N/A 1 2 3 4
5

20. COMMUNICATING VERBALLY N/A 1 2 X 4 5

Verbally expresses ideas and information in an understandable form; uses understandable
vocabulary; speaks so that individuals from a wide range of backgrounds can understand;
reports problems clearly and provides information to other employees and the public in a
clear, understandable manner.

Comments Mike communicates in a manor so that everyone understands. He also reports problems and
follows up to make sure they were fixed.

21. COMMUNICATING IN WRITING N/A 1 2 X 4 5

Expresses ideas and information understandably in writing; uses proper grammar and punctuation
reads and understands written communication and reports.

Comments Heunderstands all written communications and is able to write using proper grammar and
punctuation.
22. PERFORMING UNDER PRESSURE N/A 1 2 X 4 5
Makes sound, logical decisions when working under stress; maintains a stable level of performance
in situations that are dangerous, emotional, or require a large amount of work in a short time;
takes charge and does not “freeze” in pressure situations; is willing to confront a potentially dangerous
situation and to back up fellow firefighters when danger exists.

Additional for Supervisors: Sets a good example for subordinates when performing
under stressful situations.

Comments Mike is bale to work under stressful situations and will back up fellow firefighters when needed.

23. EVALUATION/SUPERVISOR RATINGS N/A 1 2 3 4 5

For Supervisors Only
Evaluates employees with fairness and impartiality in regard to ratings given and participates in
counseling rated employees; successful in carrying out the latter role in performance evaluation
system; ensures that the ratings are applied uniformly; completes evaluations in timely manner.

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OVERALL PERFORMANCE AVERAGE

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ADDITIONAL COMMENTS
Evaluating Supervisor’s Summary:

Areas of strength: Mike is always staying on top of medical changes and any training pertaining to his
job. DC Ford Mike is a team player. He comes in ready to work. He gets along with everyone. Very
knowledgeable on firefighting and driving and operating an apparatus. Mike can be given special
projects to complete and he always completes them on time and correctly.

Areas needing improvement:

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Suggested future goals:

Mike is on the road to becoming an officer. I would like to see him take more training to become one.

Employee’s Comments:
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Department Head’s Comments:

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I have reviewed and discussed the contents of the Performance Appraisal with my Supervisor. Signing this
document does not indicate concurrence or agreement.

Signature _________________________________ Date ____________________________

Employee

Signature _________________________________ Date ____________________________

Evaluating Supervisor

Signature _________________________________ Date ____________________________

Department Head