EMPLOYEE PERFORMANCE REVIEW

363L (Rev. 8/2005) EPR Factor Links

GENERAL

INFORMATION

TYPE REPORT

PROBATIONARY (CS/NCS union covered)

PROBATIONARY (CS non-union covered)

INTERIM ANNUAL

INTERIM (6 month NCS/NUC/SMS)

EMPLOYEE NAME

AGENCY

EMPLOYEE NUMBER

CLASS TITLE

SUPERVISOR

NON-SUPERVISOR

STATUS

CIVIL SERVICE NCS SMS

ORGANIZATION

RATING PERIOD

FROM TO

SUPERVISOR NAME

SUPERVISOR POSITION NUMBER

GENERAL INSTRUCTIONS

Verify/complete General Information. Indicate whether employee is a supervisor or non-supervisor.

Review with the employee the employee’s job description, job standards (expectations/objectives/duties) for the

rating cycle to ensure the appraisal relates to the specific responsibilities, job assignments, and standards that

were conveyed to the employee for the rating cycle.

(On-line Position Description Application)

Base the appraisal on the employee’s performance during the entire review period, not isolated incidents or

performance prior to the current review period. Obtain/review necessary input and supporting data.

Rate each factor in relation to the standards established and the guidelines listed on the form for each rating.

Provide an overall rating based on the rating of the individual factors, adherence to significant performance

standards, and accomplishment of essential functions. Each factor need not be of equal weight but comments

should justify significant differences impacting on the overall rating.

Assess employee strengths and identify opportunities where the employee could improve or requires additional

knowledge or skill. Include projected development needs to meet anticipated assignments during the next rating

period. Obtain employee input regarding their training needs. When rating employees, consider their

participation and willingness to participate in employee development opportunities.

The comments sections should be used to: support performance ratings, indicate problem areas and provide

guidance to employees on how to improve performance. Comments MUST be provided for outstanding, needs

improvement, and unsatisfactory ratings, and are highly recommended for all other ratings. Supervisor,

reviewing officer, and employee comments are to be relevant and job related. (Additional comments for any sections should be

placed on Page 5 of this form if completing the form electronically or by attaching additional 8 ½ by 11 paper in similar format.)

Discuss/obtain comments and signature/date of reviewing officer before discussion with employee.

Sign/date the form, meet with employee to discuss the rating, and obtain the employee’s signature/date/comments.

Arrange for reviewing officer discussion if requested.

Update with the employee job description, essential job functions, and performance standards/objectives for the

next rating cycle.

COMMUNICATION OF PERFORMANCE STANDARDS

Indicate when you conveyed job standards to the employee and when progress review(s) was conducted:

1. Performance standards (objectives, duties, expectations, etc.) for this rating period were conveyed to employee

on .

date(s)

2. Progress Review(s) was conducted on (at least one during rating cycle)

date(s)

EMPLOYEE NAME:

EMPLOYEE NUMBER:

JOB FACTORS

1. JOB KNOWLEDGE/SKILLS Measures employee’s demonstrated job relevant knowledge and essential skills, such as work practices, policies, procedures,

resources, laws, customer service, and technical information, as well as the relationship of work to the organization’s mission. Also measured are the employee’s self-

improvement efforts to enhance skills and knowledge and to stay current with changes impacting the job.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Possesses superior job

skills and knowledge;

effectively applies them to

work assignments.

 Willingly mentors staff;

shares knowledge.

 Seeks/applies innovative

and relevant techniques.

 Work reflects thorough and

current knowledge/

skill of job and impact on

agency activities/related

resources.

 Uses opportunities to expand

knowledge/skills, sharing

information with staff.

 Work reflects adequate

knowledge/skills for job.

 Has some knowledge of

related work.

 Stays current with major

changes impacting on

knowledge or skill.

 Accepts change.

 Often demonstrates a lack of basic or

sufficient job knowledge/skills to

perform routine functions of the job.

 Occasionally is resistant to changing

knowledge and/or skill requirements

or processes, including opportunities

for knowledge/skill enhancement.

 Consistently demonstrates a

lack of basic job knowledge

and/or skills to perform job.

 Rarely takes advantage of

available skill enhancement or

training opportunities.

 Often is resistant to changing

requirements.

Comments:

2. WORK RESULTS Measures employee’s results in meeting established objectives/expectations/standards of quality, quantity, customer service, and timeliness both

individually and in a team.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Work consistently exceeds

expectations of quality,

quantity, customer service,

and timeliness.

 Work frequently exceeds

expected quality, quantity,

customer service, and

timeliness standards.

 Work usually meets

expectations of quality,

quantity, customer service,

and timeliness.

 Often has difficulty meeting

expected quality, quantity, customer

service, and/or timeliness standards.

 Consistently fails to meet

expected quality, quantity,

customer service, and/or

timeliness standards.

Comments:

3. COMMUNICATIONS Measures employee’s performance in exchanging information with others in an effective, timely, clear, concise, logical, and organized

manner. Communications include listening, speaking, writing, presenting, and sharing of information. Consideration is given to client/data complexity/sensitivity.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Consistently communicates

in clear, effective, timely,

concise, and organized

manner.

 Is articulate and persuasive

in presenting, soliciting

complex or sensitive data.

 Frequently communicates in

an effective, timely, clear,

concise, and organized

manner.

 Proficiently organizes and

presents difficult facts and

ideas orally and in writing.

 Seeks/provides feedback.

 Usually communicates

effectively and exchanges

relevant information in a

timely manner.

 Speaks and writes clearly.

 Keeps others informed.

 Listens with understanding.

 Often fails to communicate

effectively or in a timely manner.

 Lacks clarity of expression orally or

in writing.

 Is inconsistent in keeping others

informed.

 At times, fails to listen effectively.

 Consistently fails to

communicate effectively or

timely.

 Often does not keep others

informed.

 Is an ineffective listener

and/or frequently interrupts.

Comments:

4. INITIATIVE/PROBLEM SOLVING Measures the extent to which the employee is self-directed, resourceful, and creative in performing job duties individually or

in a team. Also measures employee’s performance in identifying and resolving problems; following through on assignments; and initiating or modifying ideas, methods,

or procedures to provide improved customer service, redesign business processes, and accomplish duties.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Consistently resolves

unit/team problems and

promotes improvements.

 Maximizes resources,

innovation/technology to

streamline/improve.

 Analyzes full dimension of

complex problems.

 Requires minimal

supervision.

 Prevents/resolves unit/team

problems.

 Suggests innovations to

improve operations or

streamline procedures.

 Defines and analyzes

complex problems.

 Develops/implements

solutions with moderate

supervision.

 Addresses existing and

significant potential

problems.

 Suggest or assists in

developing solutions

individually or in a team.

 Carries through solution

implementation with routine

supervision or follow-up.

 Resolves routine problems.

 Exhibits little initiative in

identifying problems, solutions, or

improvements and/or working

proactively as part of a team to

address issues of concern.

 Requires more than routine

supervision.

 Consistently fails to recognize or

seek help in resolving routine

problems.

 Demonstrates inability to work

individually or in a team.

 Rarely suggests improvements.

 Requires frequent reminders and

supervision.

Comments:

EMPLOYEE NAME:

EMPLOYEE NUMBER:

5. INTERPERSONAL RELATIONS/EQUAL EMPLOYMENT OPPORTUNITY (EEO) Measures employee’s development and maintenance of positive and

constructive internal/external relationships. Consideration should be given to the employee’s demonstrated willingness to function as a team player, give and receive

constructive criticism, accept supervision, resolve conflicts, recognize needs and sensitivities of others, and treat others in a fair and equitable manner. Supervisors

and team leaders also are to be assessed on their demonstrated commitment to Equal Employment Opportunity, diversity and proactive actions to prevent/address all

forms of discrimination.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Consistently promotes

and maintains a

harmonious/productive

work environment.

 Is respected and trusted

and often viewed as a role

model.

 Actively promotes

EEO/diversity programs.

 Frequently fosters teamwork,

cooperation, and positive

work relationships.

 Handles conflict

constructively.

 Promotes and adheres to

EEO/diversity program

requirements.

 Usually interacts in a

cooperative manner.

 Avoids disruptive behavior.

Deals with conflict, frustration

appropriately.

 Treats others equitably.

Adheres to EEO/diversity

program requirements.

 Often has difficulty getting along

with others. Allows personal bias

to affect job relationships.

 Requires reminders regarding

needs and sensitivities of others.

 Inconsistently adheres to EEO/

diversity program requirements.

 Interpersonal relationships

are counter-productive to

work unit or team functions.

 Often ignores EEO/ diversity

program requirements.

Comments:

6. WORK HABITS Measures employee’s performance relative to efficient methods of operation, customer service, proper conduct, speech ethical behavior, and

Commonwealth/agency/work unit policies and procedures, such as attendance, punctuality, safety, security, proper care and maintenance of assigned equipment, and

economical use of office supplies.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Work reflects maximum

innovative use of time

and resources to

consistently surpass

expectations and improve

operations.

 Serves as a role model

with regard to work

policies and safety

standards.

 Frequently plans/organizes

work to timely and effectively

accomplish job duties with

appropriate use of resources.

 Suggests/implements

improvements and exceeds

organizational work/safety

rules and standards.

 Work is planned to meet

routine volume and

timeliness and usually

fulfills operational and

customer service needs.

 Adheres to organizational

work policies/safety rules

and procedures with few

exceptions.

 Frequently lacks organization and

planning of work and does not

adequately use available resources.

 Often does not meet standards in

complying with work policies/safety

rules and/or care of equipment.

 Consistently fails to meet

expected standards due to lack

of effective organization, use

of equipment/resources, or

inattention to customer service

needs.

 Resists established work

policies/safety rules and

procedures.

Comments:

7. SUPERVISION/MANAGEMENT (Required for all supervisors/managers) Measures leadership, judgment, initiative, and achievement of expectations.

Effectively managers program/projects, employees, budget, technology, and organizational change to produce positive results. Engages in strategic planning and

measurement, performance management, teamwork, staff development, and recognition of accomplishments. Promotes customer service, diversity, inclusiveness,

collaboration, effective communication, and positive labor/management relations. Uses innovation and fulfills administrative requirements.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Regularly exceeds

expectations.

 Implements innovative

policies, resources, and

technology to maximize

efficiency and service.

 Committed to and

promotes excellence;

leads by example

energizing performance

and teamwork.

 Uses and encourages

creative decisions and

solutions.

 Acts a positive change

agent.

 Meets and frequently exceeds

expectations.

 Improves efficiency and

customer service.

 Provides staff with

innovative and constructive

direction, delegation,

feedback, mentoring, and

recognition.

 Adheres to performance

management/

administrative policies.

 Makes sound decisions.

 Promotes and maintains

teamwork, inclusiveness,

respect, and creativity.

 Meets most expectations

timely and effectively.

 Maintains acceptable

efficiency and customer

service.

 Provides staff necessary

direction, feedback,

development, and

recognition.

 Makes decisions that

usually reflect sound

judgment.

 Usually adheres to

administrative policies.

 Encourages innovation,

teamwork, and

inclusiveness.

 Often fails to meet expectations

timely and effectively.

 Efficiency and customer service

occasionally fall below standards.

 Inadequately directs, trains,

monitors, and recognizes staff.

 Inadequately fulfills administrative

and performance management

functions.

 Often lacks good judgment in

decisions.

 Lacks leadership in promoting

innovation, teamwork, and

inclusiveness.

 Consistently fails to meet

expectations timely or

effectively.

 Delivers unacceptable

customer service or

operational efficiency.

 Disregards or ineffectively

provides staff direction,

monitoring, and development.

 Often ignores performance

management or administrative

policies.

 Is indecisive or lacks good

judgment.

 Resists change.

Comments:

EMPLOYEE NAME:

EMPLOYEE NUMBER:

OVERALL RATING

INSTRUCTIONS: Provide an overall rating based on the rating of the individual factors, adherence to significant performance standards, and

accomplishment of essential functions. This rating provides an overall impression of job performance that is supported by the job factor ratings, not

necessarily an average of those ratings. Thus, each factor need not be of equal weight but comments should justify significant differences on the

overall rating.

OUTSTANDING

COMMENDABLE

SATISFACTORY

NEEDS IMPROVEMENT

UNSATISFACTORY

 Employee consistently

and significantly exceeds

job expectations and

standards and

demonstrates a high

degree of initiative,

customer service, and

quality of work.

 Employee meets and

frequently exceeds job

expectations and standards

and demonstrates a high

degree of initiative, customer

service, and quality of work.

 Employee meets the

expectations and standards

of the employee’s job in a

fully adequate way.

 Employee meets many of the

expectations of the job in a

satisfactory manner but often fails to

adequately meet some of the

expectations or standards.

Improvement is required.

 Employee fails to meet many

job expectations and

standards. Performance

deficiencies must be corrected.

Overall Comments:

EMPLOYEE STRENGTHS: (Identify strong attributes, abilities, or proficiency in an area, to maximize the employee’s contribution to the

organization in utilizing these abilities and skills and to identify potential mentor relationships.)

Comments:

OPPORTUNITIES FOR DEVELOPMENT: (Identify knowledge, skills, and abilities that may need improvement. Address developmental

activities to assist the employee in addressing either areas of concern or opportunities for professional growth.)

Comments:

Rater’s Signature:

Date:

REVIEWER’S COMMENTS

Comments:

Reviewer’s Signature:

Date:

EMPLOYEE’S COMMENTS

I AGREE WITH THIS RATING I DISAGREE WITH THIS RATING

I WOULD LIKE TO DISCUSS THIS RATING WITH MY REVIEWING OFFICER

DISCUSSION WITH MY REVIEWING OFFICER OCCURRED

(DATE)

I ACKNOWLEDGE THAT I HAVE READ THIS REPORT AND I HAVE BEEN GIVEN AN OPPORTUNITY TO DISCUSS

IT WITH THE EVALUATOR; MY SIGNATURE DOES NOT NECESSARILY MEAN THAT I AGREE WITH THE REPORT.

Comments:

Employee’s Signature:

Date:

EMPLOYEE NAME:

EMPLOYEE NUMBER:

ADDITIONAL RATER COMMENTS

(Space will open as you type)

JOB KNOWLEDGE/SKILLS:

WORK RESULTS:

COMMUNICATIONS:

INITIATIVE/PROBLEM SOLVING:

INTERPERSONAL RELATIONS/EQUAL EMPLOYMENT OPPORTUNITY:

WORK HABITS:

SUPERVISION:

OVERALL RATING:

EMPLOYEE STRENGTHS:

OPPORTUNITIES FOR DEVELOPMENT:

ADDITIONAL REVIEWER’S COMMENTS

ADDITIONAL EMPLOYEE’S COMMENTS