Delegation - Performance Management Assessment Sample #10


Performance Assessments that include Delegation:
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:


Part 2: Results of 360-Degree Feedback


  1. Delegation: Tells subordinates what to do, not how to do it. Allows employees to decide how they wish to complete the tasks. Defines goals and objectives for subordinates. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Self Management: Does not allow own emotions to interfere with the performance of others. Steps away from a situation to process appropriate response. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analytical: Analyzes issues and reduces them to their component parts. Asks the "right" questions to size up or evaluate situations. Identifies problems and issues needing resolution. Balances risks and costs with the rewards and probabilities of success when decisions.
  1. Client Focus: Persistent in solving client issues. Makes sure their interests are aligned with the client's interests. Is competent in handling difficult clients. Creates innovative solutions to meet client needs.
  1. Recognition: Recognizes the abilities and skills of self and others Lets employees know when they have done well Readily shares credit and gives others opportunity for visibility. Makes people around them feel appreciated and valued.

Part 3: Summary of 360-Degree Feedback

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