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Change Management - Performance Management Assessment Sample #10


Performance Assessments that include Change Management:
Assessment 1 (5-point scale; IDP Comments)
Assessment 2 (3-point scale with Comments)
Assessment 3 (Manager Assessment; 360-Feedback)
Assessment 4 (3-point scale; Rating Limits)
Assessment 5 (3-point scale; Rating Limits)
Assessment 6 (5-point scale with Comments)
Assessment 7 (Comment Boxes Only; IDP)
Assessment 8 (Comment Boxes Only)
Assessment 9 (3-point scale with Letter Grade)
Assessment 10 (360-Feedback; Bonus/Merit Pay)
Assessment 11 (Core Values & Job Competencies)
Assessment 12 (4-point scale; 6 Comment Boxes)

Performance Management System
Supervisor: [Supervisor Name]


Signature: ___________________


Date: _____________ 		Employee: [Employee Name]


Signature: ___________________


Date: ___________
Job Title: Mid-Level Manager in X Department Hire Date:
Instructions:
This performance appraisal program is designed to provide a standardized method to:
  1. Provide an objective evaluation of an employee's performance and to share this feedback with the employee
  2. Assist in determining the true development needs of the employee and actions that should be taken to improve their job performance.
  3. This form is intended to ensure fair and equitable salary management. Please note that this review is one of several factors considered in salary decisions.

Employee Input

Please provide brief answers to the questions below. Your feedback is vital to us. We aim to capture all your achievements during the performance review period. The details you enter will be part of your Performance Appraisal. If you need to include any additional printed sheets, please sign, date, and submit them to your Department Head. Additionally, if someone else should contribute to this review, kindly provide their name and contact details.

Part 1: Status Recommendation

If currently on Probational Status:



If on Regular Employment Status:

Justification for the above Status Recommendation:


Competencies Included:
Change Management, Initiative, Managing Risk, Flexibility, Continual Improvement

Part 2: Results of 360-Degree Feedback

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  1. Change Management: Develops a strategy for implementing changes. Is a leading force driving changes. Able to get department employees to accept new changes. Adopts changes to set and example for others to follow.
Self
Manager
Peer
Direct Report
Other
1
Needs
Development
2
3
4
5
6
Role
Model
  1. Initiative: Takes action to implement new changes in the policies and procedures. Takes action without being asked. Initiates projects that have an impact on the department. Analyzes the needs of the situation and acts before being told to do so.
Self
Manager
Peer
Direct Report
Other
1
Needs
Development
2
3
4
5
6
Role
Model
  1. Managing Risk: Reduces risk to a manageable level. Presents regular/monthly reports to the audit committee. Quantifies current business practices to make better informed decisions. Ensures employees are aware of potential impacts by increasing risk visibility.
Self
Manager
Peer
Direct Report
Other
1
Needs
Development
2
3
4
5
6
Role
Model
  1. Flexibility: Effective in incorporating new ideas. Is able to make accommodations needed for changes to the working conditions. Regularly assesses current methods, welcomes feedback, and is willing to implement changes to improve efficiency and effectiveness. Embraces issues as opportunities to learn and grow.
Self
Manager
Peer
Direct Report
Other
1
Needs
Development
2
3
4
5
6
Role
Model
  1. Continual Improvement: Analyzes processes to determine areas for improvement. Encourages an employee culture of continuous improvement to seek out better ways of doing things. Open to the suggestions from others. Looks for ways to improve work processes and procedures.
Self
Manager
Peer
Direct Report
Other
1
Needs
Development
2
3
4
5
6
Role
Model

Part 3: Summary of 360-Degree Feedback

Managing Risk
Change Management
Initiative
Continual Improvement
Flexibility
1
Needs
Development
2
3
4
5
6
Role
Model



Overall Score

Overall Score
1
Needs
Development
2
3
4
5
6
Role
Model

Part 4: Bonus Pay

The supervisor now must consider which of the following adjustments to make to compensation.
Changes made here are reflected in the Salary Recommendations section at the beginning of this form.
Midpoint of Scale Status

Consider eligibility for Movement to Midpoint:
Yes: If Yes, continue with this section below
No, If no continue to next section

Depending on your responses, the computer may show (or hide) certain elements of the form.
Merit Pay Section
When this form was initially loaded, the employee was eligible for Merit Pay.
However, if the scores on Job Performance Criteria were too low, then the eligibility would change.

Consider eligibility for Merit Pay:
Yes: If Yes, continue with this section below
No, If no continue to next section
Change the scores on Job Performance Criteria to see how it affects this section.
Experience Pay Section

Eligible for Experience Pay:
Yes: If Yes, continue with this section below
No, If no continue to next section



Part 5: Individual Productivity and/or SMART Goals

Employee Comments


Supervisor Comments


Part 6: Team Productivity and/or SMART Goals

Employee Comments


Supervisor Comments