Safety - Performance Management Assessment Sample #3


Performance Assessments that include Safety:
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.
Manager-Assessment
As a manager, your feedback is crucial in capturing the achievements and performance of your employees during the review period. Please provide brief answers to the questions below. The information you share will be included in the employee's Performance Appraisal.

If you have additional printed sheets to submit, ensure they are signed, dated, and handed over to your Department Head. If you believe another individual 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:
Safety, Analytical, Quality, Results Oriented, Customer Focus, Conflict Management, Global Perspective, Adaptability, Self-Management, Management

Part 2: Results of 360-Degree Feedback


The following are results from the 360-Degree Assessment conducted earlier in the year. This information can help guide the development of focus areas for the Individual Development Plan.
  1. Safety: Keeps accurate safety records. Works to implement corrective safety measures. Develops a sustainable safety culture. Commits adequate resources toward safety measures.
  1. Analytical: Asks the "right" questions to size up or evaluate situations. Uses appropriate techniques to solve problems. Implements data validation techniques and methods. Identifies the root cause of a problem.
  1. Quality: Creates quality improvement programs and processes. Successfully implements quality controls within the department. Implements quality control feedback loops to enhance services and products. Presents quality information and data in an easy to understand format.
  1. Results Oriented: Completes all required coursework. Plans the best course of action to achieve the goal. Highly motivated to complete tasks despite obstacles that may arise. Has a work ethic with a strong desire to obtain results.
  1. Customer Focus: Creates innovative solutions to meet customer needs. Helps customers to feel satisfied with our work/services. Does not hesitate to address customer concerns or complaints. Is honest in all communication with the customers.
  1. Conflict Management: Identifies who holds the authority to make decisions. Prefers to resolve conflicts through negotiation rather than coersion. Possesses the necessary skills to manage conflict and relationships. Persuades others to accept ideas that may be difficult and uncomfortable.
  1. Global Perspective: Exemplifies the skills of a global worker. Attends training seminars and conferences to increase skills in working with others globally. Collaborates with others respectfully and effectively with other people regardless of differences in cultural backgrounds. Aligns personal vision with global strategies.
  1. Adaptability: Able to adjust to changes as needed. Able to adapt to changes in technology and processes. Is aware of changes to team personnel. Responsive to the needs of others.
  1. Self Management: Analyzes interpersonal problems instead of reacting to them. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger. Steps away from a situation to process appropriate response. Uses patience and self-control in working with customers and associates.
  1. Management: Makes you feel enthusiastic about your work Takes responsibility for things that go wrong Sets an example for others to follow Delegate tasks effectively

Part 3: Individual Productivity and/or SMART Goals

Employee Comments


Supervisor Comments


Part 4: Team Productivity and/or SMART Goals

Employee Comments


Supervisor Comments