Fillable Performance Feedback Supervisory Management Fillable PERFORMANCE FEEDBACK

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Performance Feedback Supervisory Management Fillable PERFORMANCE FEEDBACK

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Performance Feedback Planning Worksheet Page 1 of 5
Supervisor/Management Positions
Revised December 2017
CITY OF LITTLE ROCK
PERFORMANCE FEEDBACK PROCESS
SUPERVISOR / MANAGEMENT POSITIONS
The Performance Feedback Process packet includes two (2) documents:
• Planning Session Worksheet (PSW)
• Performance Feedback Form
NOTE: These documents may be completed electronically or manually.
During a planning session prior to, or near the beginning of, the evaluation period, the
supervisor shall:
• Complete the Planning Session Worksheet,
• Discuss the completed worksheet with the employee to develop mutual
understanding of the performance factors and examples of performance goals and
priority work related to the factors,
• Obtain the required worksheet signatures,
• Provide a signed copy of the completed worksheet to the employee, and
• Maintain the original PSW for review during the year and for use during the end
of rating period evaluation.
Near the end of the annual review period, the supervisor shall complete the Performance
Feedback Form utilizing, but not limited to, the completed Planning Session Worksheet
(see instructions on the performance feedback form).
Performance Feedback Planning Worksheet Page 2 of 5
Supervisor/Management Positions
Revised December 2017
PERFORMANCE FEEDBACK
PLANNING SESSION WORKSHEET
SUPERVISOR / MANAGEMENT POSITIONS
EMPLOYEE NAME: EMPLOYEE ID:
EMPLOYEE POSITION / DEPARTMENT: /
SUPERVISOR:
EVALUATION PERIOD: TO
DATE:
Please complete this worksheet during the planning session near the beginning of the evaluation period. To
develop mutual understanding regarding the attached performance factors, illustrate examples of performance
expectations and goals, and priority work related to each performance factor.
PERFORMANCE FACTOR
EXAMPLES OF RELEVANT PERFORMANCE GOALS
AND PRIORITY WORK
1. Professional Competence and
Expertise – Demonstrates a high level
of professional knowledge and
proficiency related to the
responsibilities of his/her position
(reflected via related contributions and
accomplishments during the rating
period).
2 Interpersonal Skills – Interacts with
people–employees and customers in a
constructive way (produces good
results through interaction with others;
open and considerate of needs and
views of others; recognizes “people”
or “service aspects of issues,”
sensitive and responsive to customers;
cooperative.)
3. Written Communications –
Expresses thoughts and ideas clearly
and thoroughly in writing
(memoranda, letters, proposals,
reports, etc.).
Performance Feedback Planning Worksheet Page 3 of 5
Supervisor/Management Positions
Revised December 2017
PERFORMANCE FACTOR
EXAMPLES OF RELEVANT PERFORMANCE GOALS
AND PRIORITY WORK
4. Problem Solving/Decisiveness –
Defines problems/issues
systematically, makes objective
decisions based on the facts, makes
requests or executes decisions
effectively.
5. Flexibility/Adaptability – Adapts
and modifies behavior to perform
effectively under varying
circumstances, changing organizational
requirements, or unclear conditions.
6. Leadership –
Provides effective
advice, direction, guidance, and training
to others (work unit or City wide) to
enhance work products; including,
timely and objective performance
feedback and employee development.
7. Conflict Management – Manages
conflict and collaborates effectively
with other organizational elements, e.g.,
customers, other managers, work units,
and departments.
8. Finance –
Develops and manages
resources and services within approved
budgetary and operational guidelines.
Performance Feedback Planning Worksheet Page 4 of 5
Supervisor/Management Positions
Revised December 2017
PERFORMANCE FACTOR
EXAMPLES OF RELEVANT PERFORMANCE GOALS
AND PRIORITY WORK
9. Teamwork – Fosters teamwork and
cooperation with other operating units
in pursuit of the City’s goals by
proactively assisting and involving
others, sharing relevant information,
and providing constructive feedback.
10. Ethics – Models and communicates
high ethical standards.
11. Initiative – Identifies immediate action
needed; addresses current and
imminent issues and opportunities, and
seizes opportunities to enhance
organizational p
erformance and
advance organizational goals.
12. Planning – Forecasts the future needs
of the organization and develops a Plan
of Action, with goals, strategies and
milestones.
13. Quality of Work - Work processes and
results are accurate, efficient and meet
established standards; takes early
corrective action to avoid
problems/errors; incorporates values
and standards (internal and external) in
preparing products and in providing
service.
14. Dependability -
Achieves work
assignment and project deadlines;
consider absences and tardiness as well
as attentiveness to work assignments.
Performance Feedback Planning Worksheet Page 5 of 5
Supervisor/Management Positions
Revised December 2017
The performance factors, along with performance expectations and goals, and examples of priority
work related to each performance factor, were reviewed and a mutual understanding of these
performance management elements was achieved.
It is understood that the performance expectations and goals, and priority work items listed in Column
2 of the Planning Session Worksheet are only examples of factors to be observed during the evaluation
period. I further understand that the list of examples is not intended to be all-inclusive and that the final
evaluation will be based on any/all observed related work behaviors.
Employee Name / Number
Supervisor Name
Employee’s Signature
Supervisor’s Signature
Job Title
Date
Date
Performance Feedback Form Page 1 of 7
Supervisor/Management Positions
Revised December 2017
Employee Name:
Employee ID:
Date:
Evaluation Period: from to
P
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B
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A
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C
K
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F
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P
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E
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The following assessment should be completed for all supervisor / management employees near
the end of the annual review period. Before completing this performance feedback form, please
review the performance expectations and goals, and examples of related priority work as reviewed
during the planning session. Provide employee development feedback by citing specific examples
for each of the factors identified. Use additional paper, if appropriate.
Based on observations during the review period, rate the employee utilizing the following scale:
4 Fully Demonstrated – Performance factor was consistently demonstrated with no
significant exceptions.
3 Usually Demonstrated – Performance factor was consistently demonstrated with only a
few significant exceptions.
2 Sometimes Demonstrated – Performance factor was frequently demonstrated but with
several significant exceptions.
1 Seldom Demonstrated – Performance factor was only occasionally demonstrated.
Not Applicable – Performance factor not applicable to employee’s job.
Remember! The purpose of your narrative comments is to describe behavior and results, not
evaluate it using words such as good, excellent, or poor. This can best be achieved by means of
specific, quantifiable examples. Put an “X” at the point on the scale which you believe best
represents the employee’s overall performance on that particular item. Mark “not applicable” if it
is determined that the performance factor does not apply to the duties of the subject employee
(Remember to reduce the number of factors when calculating the summary rating, if a factor is
omitted).
Performance Feedback Form Page 2 of 7
Supervisor/Management Positions
Revised December 2017
1. Professional Competence and Expertise – Demonstrates a high level of professional knowledge and
proficiency related to the responsibilities of his/her position (reflected via related contributions and
accomplishments during the rating period).
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
2 Interpersonal Skills – Interacts with people–employees and customers in a constructive way (produces
good results through interaction with others; open and considerate of needs and views of others; recognizes
“people” or “service aspects of issues,” sensitive and responsive to customers; cooperative.)
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
3. Written Communications – Expresses thoughts and ideas clearly and thoroughly in writing (memoranda,
letters, proposals, reports, etc.).
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
Performance Feedback Form Page 3 of 7
Supervisor/Management Positions
Revised December 2017
4. Problem Solving/Decisiveness – Defines problems/issues systematically, makes objective decisions based
on the facts, makes requests or executes decisions effectively.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
5. Flexibility/Adaptability – Adapts and modifies behavior to perform effectively under varying
circumstances, changing organizational requirements, or unclear conditions.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
6. Leadership – Provides effective advice, direction, guidance, and training to others (work unit or City wide)
to enhance work products; including, timely objective performance feedback and development.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
Performance Feedback Form Page 4 of 7
Supervisor/Management Positions
Revised December 2017
7. Conflict Management – Manages conflict and collaborates effectively with other organizational elements,
e.g., customers, other managers, work units, and departments.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
8. Finance – Develops and manages resources and services within approved budgetary guidelines.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
9. Teamwork – Fosters teamwork and cooperation with other team members and operating units in pursuit of
the City’s goals by proactively assisting and involving others, sharing relevant information, and providing
constructive feedback.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
Performance Feedback Form Page 5 of 7
Supervisor/Management Positions
Revised December 2017
10. Ethics – Models and communicates high ethical standards.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
11. Initiative – Identifies immediate action needed; addresses current and imminent issues and opportunities,
and seizes opportunities to enhance organizational performance and advance organizational goals.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
12. Planning – Forecasts the future needs of the organization and develops a Plan of Action, with goals,
strategies and milestones.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
Performance Feedback Form Page 6 of 7
Supervisor/Management Positions
Revised December 2017
13. Quality of Work - Work processes and results are accurate, efficient and meet established standards; takes
early corrective action to avoid problems/errors; incorporates values and standards (internal and external) in
preparing products and in providing service.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
14. Dependability - Achieves work assignment and project deadlines; consider absences and tardiness as well as
attentiveness to work assignments.
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
15. Additional Criteria –
(Specify any additional criteria relevant to the employee’s position.)
FACTOR FEEDBACK
N/A
1 - Seldom
2- Sometimes
3- Usually
4- Fully
Points
Examples of Work Performance:
Developmental Needs:
Performance Feedback Form Page 7 of 7
Supervisor/Management Positions
Revised December 2017
SUMMARY FEEDBACK
The employee’s summary feedback rating should be based on as much fact and first-hand observation of
performance as possible. Inflating a rating for the purpose of avoiding negative feedback or achieving a
potentially higher reward for the employee is neither desirable nor acceptable. The summary feedback rating
is the average of the applicable factors listed above (total points/number of applicable factors).
Seldom
1
Sometimes
2
Usually
3
Fully
4
Total
Points
1 1.5 2 2.5 3 3.5 4
.
I have read this appraisal and have discussed the results with my supervisor. My signature does not imply
agreement, only that the discussion took place and feedback was provided.
Employee’s Signature ID Number
Date
Immediate Supervisor’s Signature
Date
Department Director’s Signature
Date
City Manager’s Signature
(Only required for mid-manager positions & above)
Date
Employee Comments:
Supervisor Comments:
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Performance Feedback Supervisory Management Fillable PERFORMANCE FEEDBACK

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Completed 21 March 2020

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