PERFORMANCE ASSESSMENT FORM

Rating Scale
Contract of Service/Job Order Outstanding (O) 5
Very Satisfactory (VS) 4
Satisfactory (S) 3
Name: Unsatisfactory (U) 2
First Middle Last Poor (P) 1
_____________________________________________________________________________________ 6 months=1 assessment period

Position: ___________________________________________________ Period From: OCTOBER To: DECEMBER 2019

CRITERIA RATING
1 JOB KNOWLEDGE P-1 U-2 S-3 VS-4 O-5
1.1 Knowledge and understanding of the work being done and manners of doing it
1.2 Follows instruction carefully, uses resources properly
1.3 Demonstrates creativeness, initiative, and resources
1.4 Displays mastery of the procedure and assigned task with minimal wastage of
supplies/resources
1.5 Can get along well with co-employees and supervisors
1.6 Handles new challenges and complex tasks
Sub-total ___÷6= ( (Sub-total÷6 items)
2 WORK ATTITUDE P-1 U-2 S-3 VS-4 O-5
2.1 Shows respect and politeness to his/her superiors, peers, and clients
2.2 Shows obedience and self-control of the difficult/challenging situations
2.3 Observe rules and regulations affecting the organization and public service
Sub-total ____÷3= (Sub-total÷3 items)
3 WORK OUTPUT P-1 U-2 S-3 VS-4 O-5
3.1 Quality of work meets standards of accuracy and neatness
3.2 Thinks through each assignment and prepare the needed materials before
starting
3.3 Works in order of priority
3.4 Observes rules and regulations of the management with unquestioned honesty
and integrity
Sub-total ____÷4= (Sub-total÷4 items)
4 GENERAL HEALTH P-1 U-2 S-3 VS-4 O-5
4.1 Physically fit and seldom suffering from ailment/illness
Sub-total _____÷1= (Sub-total÷1 item)
5 VERSATILITY P-1 U-2 S-3 VS-4 O-5
5.1 Ability to do variety of things
Sub-total _____÷1= (Sub-total÷1 item)
6 PERSONAL RELATIONS P-1 U-2 S-3 VS-4 O-5
6.1 Ability to get along with supervisors, peers, and other employees
Sub-total ______÷1= (Sub-total÷1 item)
7 PUNCTUALITY AND ATTENDANCE P-1 U-2 S-3 VS-4 O-5
7.1 Render overtime services as needed
7.2 Late and Undertime
7.3 Unauthorized absences
Sub-total ______÷3= (Sub-total÷3
items)

TOTAL SCORE: ________ ÷7 = (total score÷7 items)

Total Score Rating Scale (P/U/S/VS/O)

Note: Overall Rating of Poor or Unsatisfactory for one (1) Recommendation/s:

assessment period shall constitute non-renewal of contract

60 times and above tardiness and undertime shall
constitute non-renewal of contract
15 times unauthorized absences shall constitute non-
renewal of contract

________________________________
RATER (Signature over PRINTED name)
Immediate Supervisor
Immediate Supervisor
Concurred:

(Signature over PRINTED name)

Rater's Supervisor
 ___________________________________
(Name & Signature)
Department Manager/Division Chief