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Employee Evaluation Report

Employee's Name: Department: Position: Employee Grade:

Date:

Anniversary Date:

Fire

Reason for Evaluation: ______ Completion of Probation

Exceeds Requirements

______Scheduled Performance Rating

_____ Other

Meets Requirements

Needs Improvement

SECTION 1

Outstanding

Not Satisfactory

WORK PROGRESS FACTOR CHECK LIST 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Observance of work hours Attendance Grooming and dress Safety practices Public contacts Employee contacts Knowledge of work Work judgments Planning and organizing Job skill level Quality of work Volume of acceptable work Meeting deadlines Accepts responsibility Accepts direction Accepts change Effectiveness under stress Appearance of work station Operation & care of equipment Work coordination Initiative Physical ability Communications

Doesn' t Apply

SECTION 2

Explain each factor for which "Outstanding" was checked. Cite Examples.

SECTION 3

Explain each factor for which " Needs Improvement" was checked. Cite Examples.

SECTION 4

Explain each factor for which " Satisfactory" Not was checked. Cite Examples.

FOR EMPLOYEES WHO SUPERVISE AND EVALUATE OTHERS 26. Planning & organizing 27. Scheduling & coordinating 28. Training & instruction 29. Productivity 30. Evaluating subordinates 31. Judgments & decisions 32. Leadership 33. Operational economy 34. Supervisory control 35. 36.

SECTION 5

Comment on how weaknesses might be improved.

SECTION 6

OVERALL PERFORMANCE RATING BY REVIEWER

Consider all factors carefully and view this rating from the last interview. Check anywhere within the box that best describes the overall abilities as directly related to work performance.

Not Satisfactory

Needs Improvement

Meets Requirements

Exceeds Requirements

Outstanding

Comment on employee'potential: s _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Signature (Reviewer) ________________________________ Date: _____________

SECTION 7

To be completed by the employee at the conclusion of review. _________ I agree with this evaluation. _________ I wish to discuss the evaluation with the Reviewer' s Supervisor

Signature (Employee) ________________________________ Date: _____________

SECTION 8

OVERALL PERFORMANCE RATING BY THE REVIEWER' S SUPERVISOR __________ Agree __________ Do not agree with its contents.

If not, please explain: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Signature _________________________________________ Date: ______________

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Blank Evaluation

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