Empowering Others - Performance Management Assessment Sample #10


Performance Assessments that include Empowering Others:
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. Empowering Others: Supports the decisions of others even if those decisions may sometimes lead to mistakes. Trusts employees with important responsibilities. Creates a culture where employees are given the opportunity to take the initiative and make impactful decisions. Gives employees the freedom to set their own schedule.
  1. Negotiation: Researches the needs of the other party to identify strengths and weaknesses of positions. Sets and maintains firm negotiating limits and boundaries. Does what it takes to ensure that the final agreement aligns with core interests. Able to clearly express thoughts and concerns.
  1. Planning: Able to look ahead (beyond the present) when addressing the work/needs of the department. Determines the allocation of funds based on plans for future development. Able to balance the needs of multiple stakeholders in developing the plan for the division. Adjusts plans as needed according to situational/strategic changes.
  1. Adaptability: Effective in working with different personnel of the team. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments. Is aware of changes to team personnel. Adjusts tactics and strategies.
  1. Quality: Regularly measures product specifications to ensure uniformity and quality control. Ensures the hiring of employees that have a quality focus. Reflects on what is working and what could be improved. Encourages others to achieve high quality standards.

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