Employee Evalua on Form 2023

I. EMPLOYEE INFORMATION

Employee Name Job Title

Supervisor/Reviewer Review Period

From: / / To: / /

II. CORE VALUES

PERFORMANCE CATEGORY RATING COMMENTS AND EXAMPLES

Love ❑ Consistently Observed

❑ Observed
❑ Observed Some mes
❑ Seldom Observed
Joy ❑ Consistently Observed
❑ Observed
❑ Observed Some mes
❑ Seldom Observed
Faithfulness ❑ Consistently Observed
❑ Observed
❑ Observed Some mes
❑ Seldom Observed
Excellence ❑ Consistently Observed
❑ Observed
❑ Observed Some mes
❑ Seldom Observed
Respect ❑ Consistently Observed
❑ Observed
❑ Observed Some mes
❑ Seldom Observed

A SAFE HAVEN CHILDREN’S HOME FOUNDATION INC.

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 II. Job-Speci c Performance Criteria

PERFORMANCE CATEGORY RATING COMMENTS AND EXAMPLES

Quality of Work: ❑ Consistently Observed

Work is completed accurately (few ❑ Observed
or no errors), efficiently and within ❑ Observed Some mes
deadlines with minimal supervision
❑ Seldom Observed
A endance & Punctuality: ❑ Consistently Observed
Reports for work on time, provides ❑ Observed
advance notice of need for absence ❑ Observed Some mes
❑ Seldom Observed
Reliability/Dependability: ❑ Consistently Observed
Consistently performs at a high ❑ Observed
level; manages me and workload ❑ Observed Some mes
effectively to meet responsibilities
❑ Seldom Observed
Communica on Skills: ❑ Consistently Observed
Wri en and oral communica ons ❑ Observed
are clear, organized and e ec ve; ❑ Observed Some mes
listens and comprehends well
❑ Seldom Observed
Judgment & Decision-Making: ❑ Consistently Observed
Makes though ul, well-reasoned ❑ Observed
decisions; exercises good ❑ Observed Some mes
judgment, resourcefulness and
❑ Seldom Observed
crea vity in problem-solving
Ini a ve & Flexibility: ❑ Consistently Observed
Demonstrates ini a ve, o en ❑ Observed
seeking out additional responsibility; ❑ Observed Some mes
iden es problems and solu ons;
❑ Seldom Observed
thrives on new challenges and
adjusts to unexpected changes
Coopera on & Teamwork: ❑ Consistently Observed
Respec ul of colleagues when ❑ Observed
working with others and makes ❑ Observed Some mes
valuable contribu ons to help the
❑ Seldom Observed
group achieve its goals
Knowledge of Posi on: ❑ Consistently Observed
Possesses required skills, ❑ Observed
knowledge, and abili es to ❑ Observed Some mes
competently perform the job
❑ Seldom Observed

A SAFE HAVEN CHILDREN’S HOME FOUNDATION INC.

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III. JOB-SPECIFIC OBJECTIVE CRITERIA
PERFORMANCE CATEGORY RATING COMMENTS AND EXAMPLES

A SAFE HAVEN CHILDREN’S HOME FOUNDATION INC.

 IV. PERFORMANCE GOALS

Set objec ves and outline steps to improve in problem areas or further employee development.

V. OVERALL RATING
❑ EXCEEDS EXPECTATIONS ❑ MEETS EXPECTATIONS ❑ NEEDS IMPROVEMENT ❑ UNACCEPTABLE
Employee consistently Employee sa s es all Employee consistently Employee is unable or
performs at a high level essen al job performs below required unwilling to perform
that exceeds expectations requirements; may exceed standards/expectations for required duties
expecta ons periodically; the posi on; training or according to company
demonstrates likelihood of other action is necessary standards; immediate
eventually exceeding to correct performance improvement must be
expecta ons demonstrated
Comment on the employee's overall performance.

VI. EMPLOYEE COMMENTS (OPTIONAL)

VII. ACKNOWLEDGEMENT
I acknowledge that I have had the opportunity to discuss this performance evalua on with my manager/
supervisor and I have received a copy of this evalua on.
Employee Signature: Date:
Reviewer Signature: Date:

A SAFE HAVEN CHILDREN’S HOME FOUNDATION INC.

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