The Bureau of Public Service System PERFORMANCE EVALUATION FORM



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The Bureau of Public Service System PERFORMANCE EVALUATION FORM GENERAL INFORMATION In accordance with Public Service System Rules and Regulations Part 9.1 The performance evaluation system is designed primarily for the purpose of appraising each employee on how well he/she is performing his/her duties and responsibilities; and of indicating areas in his performance where he could be more effective in the application of his knowledge, skill, and abilities. It provides a means for letting the employee know where he stands with the organization. Employee Name: Position Title: Position Type: Ministry/Bureau: Type of Evaluation: Period Covering: Annual Quarterly Periodic Post-Probation 3-Months Probation Other: From To RATING DEFINITIONS 4 - Exceptional Sustained exceptional performance. Achievements are clearly the best among peers or have significance to project outcomes. 3 - Good Consistently exceeds established standards. Performance is significantly better than average. 2 - Satisfactory Performance satisfies the requirements of the job. Performance meets standards set for the position on a consistent basis. 1 - Unsatisfactory Performance does not meet and/or fails standards established for the job. Significant performance improvement needed. Performance at this level could lead to adverse action. SECTION 1: DUTIES & RESPONSIBILITIES: Instructions: Supervisor and employee to review Duties & Responsibilities of employees current Position Description and rate employees knowledge and ability to perform the duties outlined in the PD. Please attach the PD used in the evaluation to this form. Supervisor should have Employee rate self in the Self Appraisal by Employee column first, then Supervisor to enter the rating. NOTE TO SUPERVISOR: Allow employee to self rate FIRST. Both the employee and supervisor to include written comments in APPENDIX A to justify ratings if needed. Section 1 Rating See above for rating definitions. Enter the numerical rating in the appropriate column. Self Appraisal by Employee Supervisor Employee: COMMENTS Job Knowledge Supervisor: Employee: Job Performance based on Key Duties and Responsibilities outlined in the Position Description (attach) Supervisor: TOTAL POINTS FOR SECTION 1 SUPERVISOR'S POSITION/JOB DESCRIPTION CERTIFICATION: By checking this box, I certify that the position description on file for this employee s position is NOT current and needs to be updated. A revised position description will be submitted to the Bureau of Public Service System within one month from signing this form. EMPLOYEE S POSITION DESCRIPTION CERTIFICATION: By checking this box position is NOT current and needs to be updated., I certify that the job description on file for my BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)

SECTION 2: PERFORMANCE COMPETENCIES: Instructions: Employee and Supervisor both enter the score which most adequately describes the employee s ability to demonstrate the performance competencies listed. Use Appendix A if there are comments by both Employee and Supervisor; OR if rating is 4 (exceptional). Please see rating definitions above. NOTE TO SUPERVISOR: Allow employee to self rate FIRST. TO BE COMPLETED FOR ALL POSITIONS Performance Competencies #2A 1) ATTENDANCE/WORK HABITS: Appropriate use of leave, consideration of work load, prompt, appropriate notification of tardiness, maintains required hours, effective use of time. 2) COOPERATION: Ability and willingness to work w/ associates, superiors and others outside the workplace (i.e. customers, other agencies) Develops cooperation while working toward solutions and goals. 3) ADAPTING TO CHANGE: Responds positively to change, showing willingness to learn new ways to accomplish work. 4) COMMUNICATION: Ability to communicate effectively orally & in writing to associates, superiors, and others outside the workplace (i.e. customers, other agencies, etc.) Uses appropriate channels, assumes responsibility for communicating to superiors/coworkers. Shares relevant information. 5) DEPENDABILITY/COMMITMENT TO WORK: Conscientious, responsible, reliable with respect to work completion. Commits fully to the job. Strong work ethic. 6) INITIATIVE: Contributes new ideas; able to work independently toward approved goals; able to take initiative to complete work without being told; Improves working skills and abilities. 7) INTEGRITY: Is widely trusted; is seen as a direct truthful individual, can present the unvarnished truth in an appropriate and helpful manner, keeps confidences, admits mistakes, doesn t misrepresent him/her self for personal gain. 8) LEARNING ABILITY: Readily grasps job requirements. Has a clear understanding of facts or factors pertinent to the job. 9) PRODUCTIVITY: Demonstrated accomplishment, volume of work. Submits assignments timely. Operates with a clear sense of priorities. 10) QUALITY OF WORK: Thoroughness, accuracy and neatness of work. Committed to continuous improvement efforts. Takes appropriate action to reduce errors. 11) SAFETY AWARENESS: Contributes to and encourages a safe work environment. Follows safety rules, follows good practices, and takes proper care of equipment. Total Points For Performance Competencies #2A (All Employees): Performance Competencies #2B Self Appraisal by Employee Self Appraisal Rating The following categories apply only to SUPERVISORY, MANAGERIAL and/or PROFESSIONAL LEVEL (SMP) positions. 1) ATTENDANCE AT TRAINING: Attends supervisory-related training provided by the BPSS and/or Government. 2) LEADERSHIP SKILLS: Employee successfully demonstrates appropriate leadership skills to motivate and encourage employees to be more productive; realizes and complements accomplishments of staff; forward thinking and fosters such abilities in his/her staff; able to recognize and foster potential in his/her 3) MANAGING SUBORDINATES: Effective in evaluating, communicating to, and developing subordinates; to ensure programs and staff under him/her have sufficient funds and proper office tools (equipments) to complete their duties and responsibilities. 4) PROBLEM SOLVING/DECISION MAKING CAPABILITIES: Shows capability to analyze and solve problems requiring analytic or innovative thinking. 5) VISION/MISSION ALIGNMENT: Articulates and implements the vision and mission of the department and Ministry. Sets high expectations for achieving the mission, and personally demonstrates behavior and activities that symbolize and further that mission. Demonstrates the capacity to maintain the departments direction and consistency in meeting their defined strategic objectives. Total POINTS for Performance Competencies #2B: Supervisor Supervisor Page 2 of 6 BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)

SECTION THREE OVERALL SUMMARY RATING BY SUPERVISOR: Instructions: Check ( ) the summary rating that equals that of the employees total Points. For Non-Supervisory/Managerial/Professional Positions, add the total points for Section 1 and Section 2A and check the appropriate points in SUMMARY 1 BOX. For Supervisory, Management, and Professional (SMP) Positions add total points from Section 1 + Section 2A + Section 2B and check the appropriate points in SUMMARY 2 BOX. Note: In accordance with the Public Service System Rules and Regulations Part 9.5,Employees that receive any "Unsatisfactory rating in Sections 1 and/or 2, despite the overall summary rating will be warned and counseled, and lack of improvement may result in disciplinary action. SUMMARY 1: FOR NON-SUPERVISORY/MANAGERIAL/PROFESSIONAL POSITIONS (Total Points for Section 1 + Section 2A): Exceptional: 40-52 POINTS and must not have any Unsatisfactory ratings in Sections 1 or 2. Good: 27-39 POINTS Satisfactory: 14-26 POINTS Unsatisfactory: 0-13 POINTS SUMMARY 2: FOR SUPERVISORY/MANAGERIAL/PROFESSIONAL POSITIONS (Total Points for Section 1 + Section 2A + 2B) Exceptional 55-72 POINTS and must not have any Unsatisfactory ratings in Sections 1 or 2. Good 37-54 POINTS Satisfactory 19-36 POINTS Unsatisfactory - 0-18 POINTS SECTION FOUR: INDIVIDUAL DEVELOPMENT PLAN Instructions: Use this section to highlight strengths, weaknesses, and specific goals or projects for the employee. If there are areas in Section 1 and/or 2 that were rated as Unsatisfactory, identify action plan to improve such areas. Use a separate sheet if more space is needed. NOTE: This form will be returned to department if this section is incomplete. 1. For Supervisor - What do you consider: a. his/her strong points or things he/she does well at? b. areas he/she could improve on? What steps are being taken to strengthen this (or these) areas for opportunity? Page 3 of 6 BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)

2. Problem Areas and Action Plan List any areas that were rated as Unsatisfactory and/or just areas that supervisor and employee think needs improvement and identify action plan to improve each area. Page 4 of 6 BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)

3. Goals, tasks, projects, activities, etc. for the upcoming year. Both supervisor and employee should discuss and list down these goals and include a timeline to help guide employee: 4. For Employee - In what ways do you believe that your supervisor/manager could help to improve your performance and professional growth on future assignments? SECTION FIVE ADMINISTRATIVE REVIEWS: EMPLOYEE: By signing below, I acknowledge that this evaluation was reviewed with me by my supervisor. Print Name Signature: Date: RATER: Print Name Signature: Date: AUTHORIZED MANAGEMENT OFFICIAL: Print Name Signature: Date: Page 5 of 6 BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)

APPENDIX A: Use and attach this sheet if Additional Comments is needed. Section 1 Job Knowledge Job Performance Section 2 Page 6 of 6 BPSS 2014-04-02 Performance Evaluation (Revised 9/2015)