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Responsible - Performance Management Assessment Sample #10


Performance Assessments that include Responsible:
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:
Responsible, Developing Others, Strategic Insight, Action, Goals

Part 2: Results of 360-Degree Feedback

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  1. Responsible: Behavior is ethical and honest. Acts as a resource without removing individual responsibility. ...takes personal responsibility for results. Works in a way that makes others want to work with her/him.
  1. Developing Others: Provides constructive feedback to others. Creates opportunities for professional development. Is open to receiving feedback. Assigns tasks and responsibilities to develop skills of others.
  1. Strategic Insight: Creates a vision for the organization based on insights gathered from other companies in the industry. Anticipates business cycles and trends and makes adjustments in a timely manner. Observes employees at work to get better insight into the issues they are dealing with. Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
  1. Action: Successfully identifies the right person for a job when distributing tasks. Identifies needs and takes steps to address them. Takes advantage of changes to the current situation. Delegates tasks and assignments to subordinates as soon as a request has been made.
  1. Goals: Establishes and documents goals and objectives. Makes sure that team members have a clear idea of our group's goals. Achieves goals. Goal Setting

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