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Others - Performance Management Assessment Sample #10


Performance Assessments that include 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:


Competencies Included:
Others, Strategic Insight, Creativity, Problem Solving, Safety

Part 2: Results of 360-Degree Feedback

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  1. Others: Includes others in the decision making processes. ...treats others with respect and dignity. Forms working relationships with employees from other departments. Is able to see issues from others' perspectives.
  1. Strategic Insight: Creates a mission statement describing the purpose for the organization. Attends industry conferences to gain further insight into how other companies deal with similar issues. Lets employees know how their roles contribute toward the achievement of strategic company objectives. Identifies potential problems before they become critical incidents.
  1. Creativity: Is creative and inspirational. Inspires creativity in their team. Develops solutions to challenging problems. Creates a lot of new ideas.
  1. Problem Solving: Analyzes alternatives and selects a course of action. Evaluates alternative courses of action. Identifies and assembles the necessary resources (e.g., budget, tools, equipment, personnel) required to implement the action plan. Quantifies the discrepancy between expected outcomes and measures of performance.
  1. Safety: Mitigates hazards and safety issues that arise. Ensures that all supervisors are aware of regulatory and compliance measures. Points out behaviors in others that may be unsafe. Participates in safety training as applicable.

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