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PERFORMANCE APPRAISAL 360 Review Form

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PERFORMANCE APPRAISAL 360 Review Form

Employee Name Unit / Department

Position

Date of Hire Date Entered Current Position

Appraisal Completed By

(Manager or Supervisor’s Name) Date Completed

PURPOSE FOR APPRAISAL:

Annual – Peer Review

Annual – Supervisor Review

Change to Positiion

Probation

Casual / End of Contract

Other: ____________________________ Overall Competency Rating

Name of employee providing feedback:

________________________________

Title:

________________________________

Name of Staff under review

________________________________

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Section One: Competency Areas

What follows are a series of traits or competency areas that Davenport-Perth Neighbourhood

Centre sees as important components in the realization of personal, departmental, and

organizational goals. Each section contains several points that contribute to excellence in that

particular competency area.

Please provide a rating and supporting comments for each section based on the following:

Evaluation Criteria – Rating Definitions

4

MEETS AND FREQUENTLY EXCEEDS EXPECTATIONS: Employee

consistently demonstrates the required competencies and may be

developing competencies beyond what is required in their current job

3

CONSISTENTLY MEETS EXPECTATIONS: Employee demonstrates

most required job competencies.

2

NEEDS REFINING OF FOCUS TO MEET EXPECTATIONS Given the

length of time and experience in the current position, employee

demonstrates many required job competencies, but has not sustained

performance and/or requires development in some competencies

1

NEEDS TO SUSTAIN AND/OR DEVELOP PERFORMANCE TO

MEET EXPECTATIONS: Employee does not demonstrate sufficient,

required job competencies for someone with the training and

experience acquired to date, even though some aspects of the

competencies are demonstrated

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Section Two: Ratings

1. Client Focus: Score

Recognizes that our purpose is to serve our community 1 2 3 4 Listens to the voice of the participant to understand their real

need 1 2 3 4

Makes realistic commitments that they can deliver; actively

solicit feedback; provide timely and appropriate feedback 1 2 3 4 Involves community members (i.e.: clients, patients, volunteers,

program participants) directly in the planning and execution of actions that will directly affect them.

1 2 3 4

Demonstrates flexibility when approached to supervise, give feedback, and/or provide opportunity to student placement or volunteers.

1 2 3 4

Comments:

2. Communication and Listening Score

Communicates clearly and consistently 1 2 3 4

Delivers both good and bad news directly 1 2 3 4 Demonstrates flexibility in responding to audience needs 1 2 3 4 Follows directions and gives appropriate feedback 1 2 3 4 Recognizes the need for patience and tact 1 2 3 4 Comments:

(4)

3. Relationship Building Score

Establishes and maintains productive relationships with others 1 2 3 4 Maintains personal availability and accessibility 1 2 3 4 Identifies new opportunities to build relationships 1 2 3 4 Cultivates potential partnerships or alliances 1 2 3 4 Comments:

4. Learning and Development Score

Champion continuous innovation efforts: seeks and assess opportunities that will provide improvement. Reflects on and continually learns from experience; gathers information on best practices within and outside the organization. Accepts new challenges

1 2 3 4

Seeks and assesses opportunities that will provide improvement both at personal and service level

Assesses the effect of introducing new or improved practices; seeks standards for performance, against which improvements can be assessed

1 2 3 4

Allows for differences in approach and style 1 2 3 4 Supports the ideas of others

1 2 3 4

(5)

5. Cultural Competency Score

Able to engage in recovery process: receive/provides

constructive feedback to/from colleagues/clients, acknowledge and rectify behavior.

1 2 3 4

Initiates / reviews existing projects, programs and or services to

ensure that they are delivered in a culturally competent manner 1 2 3 4 Practices self-reflection and self-awareness: acknowledges

power, privilege and oppression; acknowledges personal principles, values, and social location and implications for practice

1 2 3 4

Able to advocate for programs, policies and procedures that

challenge systemic oppression. 1 2 3 4

Promotes and supports an anti oppressive and harassment free

service and work environment 1 2 3 4

Comments:

6. Leadership Integrity: Score

Demonstrates personal energy and dynamism, always demonstrating integrity in their actions and decisions. Inspire others by acting as a role model.

1 2 3 4

Maintains confidentiality and fosters a work environment of trust

and mutual respect 1 2 3 4

Focuses on effective results. Determine what they personally can do to improve results and take responsibility and action when required

1 2 3 4

Strives to improve and engages in ongoing development. Are not afraid to try new things. Set a personal standard for performance that is challenging, Embrace change as a way of working

1 2 3 4

Encourages other to provide input on better ways to work

together as a team; Able to build a strong sense of commitment 1 2 3 4 Comments:

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Collaborates with co-workers and demonstrates initiative by participating in and supporting activities that address DPNC Strategic priorities. Supports team/ committee work to achieve their work plan activities that connect to cross centre initiatives.

1 2 3 4

Able to adapt and/or develop or improve program or service

delivery that is aligned with DPNC’s strategic priorities. 1 2 3 4 Supports team work to achieve work plan activities that connect

to cross centre initiatives. 1 2 3 4

Fully Participates in strategic priority task forces, supporting the activities of the task forces, takes initiative and completes assignments

1 2 3 4

Able to articulate DPNC strategic priorities and aligns work plans

with organizational goals (strategic priorities, mission and values) 1 2 3 4 Comments:

8. Quality of Work Score

Completes work with the expected degree of quality 1 2 3 4 Displays a positive and cooperative attitude about job role,

assigned work, and the organization 1 2 3 4

Displays open-mindedness accepts and addresses of

constructive feedback by peers 1 2 3 4

Follows through on commitments and job duties consistently and

accepts accountability for work 1 2 3 4

Is proactive about OH&S matters; protects own health and safety by working in compliance with the law and with safe work

practices and procedures established by the centre; is proactive and participate in adequate training in specific work tasks; ensures the health and safety of the client and/or other staff members.

1 2 3 4

Functions within the agency in a professional manner including: attends regularly; always punctual; notify of absences/illness; completes assigned tasks in a timely manner; seeks and accepts direction when necessary.

1 2 3 4

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Clearly articulates staff roles and responsibilities 1 2 3 4 Provides frequent feedback and demonstrates commitment to an

effective performance management process. Conducts regular supervision meetings. Ensures performance is viewed as an ongoing process, striving to provide timely and relevant feedback through the annual cycle.

1 2 3 4

Recognizes and respects diversity of perspectives and personal

styles when responding to individual staff needs 1 2 3 4 Demonstrates knowledge of relevant policies, procedures and

protocols; set best practices within staff and expectations for compliance and holds staff accountable

1 2 3 4

Respects diversity of perspectives and personal styles when responding to individual staff needs. Considers unique individual capabilities when delegating duties.

1 2 3 4

Leads by example. Demonstrates personal energy and dynamism, always demonstrating integrity in their actions and

decisions. Inspires others by acting as a role model. 1 2 3 4 Encourages independence, knowing when to intervene or provide

assistance. Exhibits the belief that others can and want to achieve. Knows when to intervene, assigns resources, provide tools or seeks other ways to support staff efforts and motivates them to achieve.

1 2 3 4

Creates an environment that supports employee achievement. Takes the time to acknowledge and celebrate successes. Promotes open and ongoing dialogue. Encourages initiative, setting clear limits without discouraging creativity. Uses setbacks as a chance to learn, rather than to punish

1 2 3 4 Comments: Other Comments: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

References

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