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Phs-838 FORM PHS 838

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Department of Health and Human Services
Commissioned Corps of the U.S. Public Health Service
Commissioned Officers’ Effectiveness Report
Officer’s SERNO
SECTION 1. ADMINISTRATIVE DATA: Required.
PART I. OFFICER ADMINISTRATIVE INFORMATION.
a. Name and Rank of Rated Officer (Last, First, MI, Rank): b. Period Covered by Report (MM/DD/YY):
From ______________________ To ______________________
c. Type of Report (Check only one):
Annual
Officer Transfer Supervisor Transfer Interim Other ______________________
d. HHS Division or Non-HHS Organization for Report Period: e. Position/Billet Title for Report Period:
f. Position/Billet Grade for Report Period (check highest):
O - 1
O - 2 O - 3 O - 4 O - 5 O - 6 O - 7 O - 8
g. In current billet since (MM/DD/YY):
__________________________
PART II. RATER’S COMMENTS AND SIGNATURE.
a. Name and Job Title of Rater (Last, First, MI, Title): b. Phone Number: c. Time supervising this officer
______ Years
______ Months
d. Please rate the officer’s overall performance of job duties during the report period. Satisfactory
Marginal Unsatisfactory
e. Strengths: List the areas in which the officer displays strong qualities and superior skills. (3 lines = 240 Courier New 10 pt. characters)
f. Areas for Improvement: List the areas needed for continued growth and development. (3 lines = 240 Courier New 10 pt. characters)
g. Signature / Date _____________________________________________________________________ ___________________
PART III. RATED OFFICER’S SIGNATURE and CONCURRENCE / NON-CONCURRENCE.
a. Select one option.
I concur with this evaluation.
I disagree with this evaluation. Comments may be submitted through your Commissioned Corps Liaison.
b. Signature / Date
I have read this review and have had the opportunity to discuss it.
_____________________________________________________________________ ___________________
PART IV. REVIEWING OFFICIAL’S COMMENTS, SIGNATURE AND CONCURRENCE / NON-CONCURRENCE.
a. Name and Job Title of Reviewing Official (Last, First, MI, Title): b. Phone Number:
c. Select one option.
I concur with this evaluation.
Although this evaluation is reasonable, this rater is somewhat more demanding than average.
Although this evaluation is reasonable, this rater is somewhat less demanding than average.
I disagree with this evaluation.
d. Reviewing Official’s Comments.
e. Signature / Date __________________________________________________________________ _________________
f. Agency Liaison / Date __________________________________________________________________ _________________
PHS-838 (Rev. 08/2015) Page 1 of 4
Department of Health and Human Services
Commissioned Corps of the U.S. Public Health Service
Commissioned Officers’ Effectiveness Report (cont)
Officer’s SERNO
SECTION 2: OFFICER ’S COMMENTS:
To Be Completed by Officer.
OFFICER INSTRUCTIONS: Describe your duties, goals and accomplishments during the performance period. Use the space provided.
Additional pages will be discarded.
Description. Describe the main duties and responsibilities in your job during the performance period. (5 lines = 400 Courier New 10 pt. characters)
Goals. List your work-related goals for the next performance period and long term career goals. (5 lines = 400 Courier New 10 pt. characters)
Accomplishments. List your accomplishments related to the elements you will be rated on in section 3. (21 lines = 1680 Courier New 10 pt.
characters)
PHS-838 (Rev. 08/2015) Page 2 of 4
Department of Health and Human Services
Commissioned Corps of the U.S. Public Health Service
Commissioned Officers’ Effectiveness Report (cont)
Officer’s SERNO
SECTION 3: PERFORMANCE EVALUATION
: To Be Completed by the Rater. Optional if period of supervision is less than 6 months.
RATER INSTRUCTIONS: Rate the officer in relation to the needs of the position as follows: 1 = Unsatisfactory range; 2 to 3 = Marginal range; 4 to
7 = Satisfactory range. Fill in only one circle per element. To assist you, guidance for marginal, satisfactory and exceptional performance is presented.
Number ratings without narrative guidance are to be used when an Officer is performing either above or below the level specified by numbered comments,
as judged by the Rater. Comments are required. Describe the action(s) upon which you based your rating. Be specific so that there is a clear connection
between the Officer’s actions and your rating. Use the space provided at the end to comment.
1. Leadership - Demonstrates and communicates vision and sense of purpose; nurtures an environment conducive to accomplishing the organization’s
mission.
- Demonstrates behavior that
maintains the status quo, often
seeking direction in accomplishing
the team’s goals.
- Has minimal influence on others.
- Demonstrates behavior that facilitates
collaboration, fairness, and inclusiveness.
- Influences others through actions,
accomplishments, and team work.
- Consistently demonstrates behavior that
contributes to the organization’s success by
fostering effective relationships, inspiring the
trust of others, and nurturing group
effectiveness and cohesion.
- Influences others by exhibiting vision,
innovation, resilience, inclusiveness, and by
teaching and coaching others.
2. Initiative and Growth - Recognizes and acts on programmatic and personal developmental needs, resulting in advancement of programmatic goals
and growth in professional skills.
- Needs assistance in identifying
opportunities to improve work
performance.
- Work performance improves with
regular supervisory input and
detailed instructions about
assignments.
- Needs guidance to understand how
personal decisions and actions
contribute to mistakes or impedes
success of individual and group
projects.
- Recognizes opportunities for growth and
seeks experiences to improve work
performance.
- Willingly incorporates new approaches
and responsibilities to advance program
goals. Requires minimal supervision and
seeks guidance with solutions only for
unexpected barriers.
- Accepts responsibility for personal
decisions or mistakes and learns from
errors.
- Independently seeks out and completes
challenging opportunities that broaden
expertise, maximize job performance, and
enhance value to the program.
- Anticipates program needs including
potential barriers. Proactively and decisively
implements innovative solutions to improve
work processes with impact beyond scope
of assigned responsibilities.
- Actively identifies personal role in a
problem and contributes to the solution,
enhancing the successful outcome of
individual and group projects.
3. Communication Skills - Conveys clear and succinct written and verbal messages that are appropriate to the audience. Listens to and understands
information from others.
- Needs assistance in expressing
main thoughts clearly, both orally
and in writing, and clarifying the
meaning and intent of others'
communication.
- Uses correct spelling, grammar,
and punctuation to create simple
documents.
- Tailors communication (verbal and
written) to the level and experience of the
audience, ensuring that messages are
organized, useful and accurate.
- Utilizes strong listening skills to formulate
direct, responsive answers to questions.
- Organizes and expresses complex ideas,
both orally and in writing, to successfully
inform and influence individual and
managerial decisions that advance the
organization’s mission.
- Is a confident and effective speaker, asks
open-ended questions, and recognizes and
accommodates a vast diversity of ideas and
traditions.
4. Interpersonal Skills - Facilitates relationships in a manner that motivates others to maximize their abilities, skills, and knowledge to affect the desired
outcomes.
- Prefers work activities that can be
completed independently and does
not require sustained interaction with
individuals of differing viewpoints or
opinions.
- Minimally contributes to the
resolution of conflicts or
disagreements.
- Participates in group activities,
demonstrates respect for others, and
receives and offers constructive feedback,
which contributes to the achievement of
organizational goals.
- Contributes to the resolution of conflicts.
- Promotes collaboration by demonstrating
respect, friendliness, appreciation, humor,
empathy, and a positive attitude. Serves as
a mentor to others.
- Is cognizant of the needs of others and
works to ensure equal treatment of all within
the work environment. Serves as mediator in
resolving conflicts.
PHS-838 (Rev. 08/2015) Page 3 of 4
Department of Health and Human Services
Commissioned Corps of the U.S. Public Health Service
Commissioned Officers’ Effectiveness Report (cont)
Officer’s SERNO
5. Planning and Organization - Balances workload to ensure timely completion of projects, accommodating multiple and changing priorities.
- In collaboration with supervisor, sets
and acts on priorities for work activities
which usually results in meeting
predetermined deadlines.
- Seeks assistance in managing
multiple work assignments and in
identifying priority assignments.
- Determines individual work priorities
based on organizational needs and
acts on those priorities with minimal
supervisory guidance; completes
assignments on time.
- Sets realistic deadlines, based on
sound criteria; keeps supervisor and
others informed of progress of
activities.
- Met written performance goals for
last year as agreed upon with
supervisor.
- Optimizes time and resources efficiently, and
anticipates unexpected situations in order to
attain the highest quality work.
- Clearly and independently recognizes how the
work of the individual relates to work of others
within and outside the organization; understands
the purpose of the work; and establishes
realistic priorities and deadlines.
- Develops project or work plans that set clear,
well-defined desired outcomes and establishes
methods of measuring progress, resulting in the
advancement of the organization’s mission.
6. Professional Competencies - Demonstrates knowledge, skills, and abilities to function successfully in the position.
- Basic knowledge of subject matter
required for assigned duties;
demonstrates average ability to learn
and apply specialized knowledge.
- Seeks assistance in understanding
issues, concepts, and situations which
affect job performance.
- Needs supervisory assistance to
ensure quality work products.
- Demonstrates in depth knowledge
of subjects required by assigned
duties; is viewed as a competent and
credible authority on specialty or
operational issues.
- Clear understanding of issues,
concepts and situations and applies
lessons learned to improve individual
productivity.
- Quality of work is commensurate
with Officer’s rank.
- Exhibits great depth and breadth of knowledge
of multiple subjects; is viewed by others within
and outside immediate office as a subject
matter expert.
- Excellent grasp of complex issues, concepts
and situations, and applies lessons learned to
improve individual and organizational
productivity.
- Consistently produces work of exceptional
quality.
7. Analysis, Judgment and Decision-Making - Identifies and considers information in order to reach sound conclusions and take appropriate actions.
- Needs guidance in analyzing facts,
alternatives, and impact before making
decisions.
- Majority of judgments are relevant and
correct.
- Employs sound judgment, logical
reasoning, and uses resources
wisely; makes timely and accurate
decisions.
- Opinions sought by others.
- Keen analytical insight and understanding of
key issues and relevant information to make
appropriate decisions; is sought after to resolve
complex problems.
- Consistent, superior judgment inspires the
confidence of others.
8. Overall Effectiveness - Synthesis of Officer’s performance, and impact on program in current position.
- An adequately performing Officer with
some potential to accept increased
responsibilities and for professional
growth.
- A very competent Officer making
significant contributions that enhance
the assigned position, respected by
peers; good potential for continued
growth and development.
- A distinguished Officer, recognized for
expertise with impact extending beyond
assigned position; serves as a role model for
others in the program.
Rater’s Comments. Describe the action(s) upon which you based your ratings. Explain the impact of the action and why it was important. (10 lines = 800
Courier New 10pt. characters)
PHS-838 (Rev. 08/2015 Page 4 of 4
INSTRUCTIONS FOR COMPLETING PHS-838 (Rev. 08/15)
COMMISSIONED OFFICERS’ EFFECTIVENESS REPORT (COER)
Privacy Provisions
Personnel records are subject to the provisions of the Privacy Act of 1974. The applicable system of record is 09-40-0001,
“PHS Commissioned Corps General Personnel Records,” HHS/PSC/HRS.
General Instructions
For additional information see Commissioned Corps Instruction 351.01 (CC25.1.1) of the Commissioned Corps Issuance
System (CCIS), located on the Commissioned Corps Management Information System (CCMIS) web page: http://dcp.psc.gov.
For up-to-date deadlines and announcements consult the CCMIS and the Personnel Operations Memorandum (POM)
(located on the CCMIS web page).
Raters and Reviewing Officials: Officers are responsible for ensuring that the Rater and Reviewing Official have all of the
information needed to complete the COER by deadlines specified in the POM.
For assistance, contact your agency's Commissioned Corps Liaison Officer (A listing of agency Liaison Officers is located
on the CCMIS web page). You may also contact the COER Information inbox
(phscoers@hhs.gov
):
Division of Commissioned Corps Personnel and Readiness (DCCPR)
ATTN: COER Administrator,
1101 Wootton Parkway, PL - 100,
Rockville MD 20852
e-mail:
phscoers@hhs.gov
Put your PHS Serial Number (SERNO) in the space provided at the top, right of each page.
Use only the space available; additional pages will be discarded. The line and character limit for the text is included in
each comment box. Note: spaces count as characters; returns count as lines.
Specific Instructions for Officer
a. Section 1, Part I.g, include all time in billet including time before any modifications to billet grade or description.
1. Complete Section 1, Part I: Officer Administrative Information. All information is required.
a. All comments are optional, but strongly recommended.
b. In the spaces provided, describe your duties, goals and accomplishments during the period covered by the rating
period (Section 1, Part I.b). Provide a concise listing of your accomplishments in relation to performance elements
that you will be rated on in Section 3. Describe in specific terms what you did and why it was important to your job
duties, career goals or both.
2. Complete Section 2: Officer's Comments.
i. If you need assistance identifying a Rater, consult policy references above or contact your Commissioned
Corps Liaison Officer.
a. Your Rater MUST have your Officer Administrative Information and Officer Comments to complete the evaluation.
3. Provide this form, including your completed sections, to your Rater by the deadline given in the POM.
a. Any changes must be presented to the Rater for consideration.
b. The Rater may change his/her evaluation during this phase as well but must present the revised evaluation to
you prior to your concurrence/non-concurrence.
c. Please consult policy references for additional details.
4. After your Rater shares his/her evaluation with you, you may make changes to Section 2: Officers Comments.
Additional instructions on next page
PHS-838 (Rev. 08/2015) Instruction Page 1
Specific Instructions for Officer (cont)
a. Indicate if you concur or non-concur with the evaluation.
b. Sign and date the form in the space provided.
5. Complete Section 1, Part III.
6. Provide the completed form to your Reviewing Official. If you need assistance, contact your Rater or your
Commissioned Corps Liaison.
Specific Instructions for Rater
1. Review Section 1, Part I: Officer Administrative Data. Please contact the Officer to correct any inaccuracies.
2. Review Section 2: Officer's Comments.
3. Complete Section 3: Performance Evaluation. Optional if period of supervision is less than 6 months.
a. 1 Unsatisfactory range
b. 2 - 3 Marginal range
c. 4 - 7 Satisfactory range,
4. Rate the Officer in relation to the needs of the position as follows:
a. Numbered ratings without narrative guidance are to be used when the officer is performing above or below ratings
2, 4 or 6.
i. For example, a score of 5 is appropriate when an officer performs above a level 4 description, but not as
high as a level 6 description.
5. Fill in only one circle per element. To assist you, guidance for marginal, satisfactory and exceptional performance is
provided under ratings 2, 4 and 6.
b. Be specific so that there is a clear connection between the officer's actions and your rating. Use the space
provided at the end of the section to comment.
a. Describe the action(s) upon which you base your ratings.
6. Rater's Comments are required unless period of supervision is less than 6 months.
a. Provide your name and job title.
b. Provide your phone number and the Area Code. Outside of the U.S., include the Country Code.
c. Enter time supervising the Officer in years and months.
d. Rate the Officer's overall job performance during the Rating period. This rating should align with the scoring in
Section 3.
e. List Strengths (Optional, but strongly encouraged).
f. List Areas for Improvement (Optional, but strongly encouraged).
7. Complete Section 1, Part II: Rater's Comments and Signature. Completion of all boxes is required unless otherwise
indicated.
8. Share your evaluation with the Officer and discuss performance. You may change the performance evaluation if you
judge it necessary following your discussion with the Officer.
9. Once the evaluation is in final form, sign and date it in the space provided in Section 1, Part II.g.
10. Provide the completed form to the Officer.
Additional instructions on next page
PHS-838 (Rev. 08/2015) Instruction Page 2
Specific Instructions for Reviewing Official
1. The Officer forwards the signed evaluation to you, the Reviewing Official.
a. Provide your name and job title.
b. Provide your phone number including the Area Code. Outside of the U.S., include the Country Code.
c. Review all sections for fairness and clarity.
2. The Reviewing Official completes Part IV, Reviewing Official's Comments, Signature, and Concurrence/Non-
Concurrence.
a. Are the ratings in Section 3 clearly supported by written comments on performance elements, strengths and/or
areas for improvement?
b. Are the assigned scores for each competency supported by the Officer's comments?
c. Does the average of the assigned scores align with the Overall Performance in Part II?
d. Do the Rater's comments give an accurate description of the Officer and clearly support the assigned score?
e. Was the Rater sensitive to the Officer's grade and to any unique and significant differences in the assignment?
3. Consider the following when reviewing the evaluation:
a. If you agree with the evaluation you may indicate it on the form and sign, or provide comments (Optional, but
strongly encouraged).
b. If you disagree with the evaluation, enter comments, otherwise optional.
c. Sign and date the evaluation.
4. Note: If you are not satisfied that the ratings are well-justified, you may inform your agency Commissioned Corps
Liaison Officer of your concerns.
PHS-838 (Rev. 08/2015) Instruction Page 3
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Completed 27 February 2020

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