Employee Appraisal Checklist - Google Forms

8/12/2014 EMPLOYEE APPRAISAL CHECKLIST - Google Forms
https://docs.google.com/a/dsims.net/forms/d/1WeNDHC9MFFlZ8J2883w93bZqoJSBrsK9KRjy5T8NFWs/edit 1/4
PERFORMANCE APPRAISAL CHECKLIST
Appraisal of Performance on Relevant Factors
Rating Scale: 1=lowest 5=highest
* Required
1. NAME OF THE APPRAISEE: *
2. DESIGNATION: *
3. NAME OF THE APPRAISER: *
4. DEPARTMENT: *
5. LOCATION: *
6. Adaptability *
Mark only one oval per row.
1 2 3 4 5
Manages competing demands
Adapts to changes in the work
environment
Accepts instruction
Changes approach or method to
best fit the situation
7. Communications *
Mark only one oval per row.
1 2 3 4 5
Expresses ideas and thoughts
well verbally
Expresses ideas and thoughts
well in written form
Exhibits good listening and
comprehension
Keeps others adequately informed
Selects and uses appropriate
communication methods
8/12/2014 EMPLOYEE APPRAISAL CHECKLIST - Google Forms
https://docs.google.com/a/dsims.net/forms/d/1WeNDHC9MFFlZ8J2883w93bZqoJSBrsK9KRjy5T8NFWs/edit 2/4
8. Cooperation *
Mark only one oval per row.
1 2 3 4 5
Establishes and maintains
effective relations
Displays positive outlook and
pleasant manner
Offers assistance and support to
co-workers
Works cooperatively in group
situations
Works actively to resolve conflicts
9. Dependability *
Mark only one oval per row.
1 2 3 4 5
Responds to requests for service
and assistance
Follows instructions, responds to
management direction
Takes responsibility for own
actions
Commits to doing the best job
possible
Keeps commitments
10. Initiative *
Mark only one oval per row.
1 2 3 4 5
Volunteers readily
Undertakes self-development
activities
Seeks increased responsibilities
Takes independent actions and
calculated risks
Looks for and takes advantage of
opportunities
Asks for help when needed
11. Job Knowledge *
Mark only one oval per row.
1 2 3 4 5
Competent in required job skills
and knowledge
Exhibits ability to learn and apply
new skills
Requires minimal supervision
Displays understanding of how job
relates to others
Uses resources effectively
8/12/2014 EMPLOYEE APPRAISAL CHECKLIST - Google Forms
https://docs.google.com/a/dsims.net/forms/d/1WeNDHC9MFFlZ8J2883w93bZqoJSBrsK9KRjy5T8NFWs/edit 3/4
12. Organization Support *
Mark only one oval per row.
1 2 3 4 5
Follows policies and procedures
Completes administrative tasks
correctly and on time
Supports organization’s goals and
values
Supports and respects diversity
13. Planning and Organization *
Mark only one oval per row.
1 2 3 4 5
Prioritizes and plans work
activities
Uses time effectively
Plans for additional resources
Integrates changes smoothly
Sets goals and objectives
Works in an organized manner
14. Problem Solving Rating: *
Mark only one oval per row.
1 2 3 4 5
Identifies problems in a timely
manner
Gathers and analyzes information
skillfully
Develops alternative solutions
Resolves problems in early stages
Works well in group problem
solving situations
15. Productivity *
Mark only one oval per row.
1 2 3 4 5
Consistently handles assigned
workload
Establishes and manages
priorities effectively
Works efficiently and uses time
effectively
Establishes processes and
procedures for getting work done
8/12/2014 EMPLOYEE APPRAISAL CHECKLIST - Google Forms
https://docs.google.com/a/dsims.net/forms/d/1WeNDHC9MFFlZ8J2883w93bZqoJSBrsK9KRjy5T8NFWs/edit 4/4
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16. Quality Rating
Mark only one oval per row.
1 2 3 4 5
Demonstrates accuracy and
thoroughness
Displays commitment to
excellence
Looks for ways to improve and
promote quality
Applies feedback to improve
performance
Monitors own work to ensure
quality
17. Core Values *
Mark only one oval per row.
1 2 3 4 5
Demonstrates student
centeredness
Demonstrates professional
development and scholarship
Demonstrates integrity and ethics
Demonstrates respect, diversity
and pluralism
Demonstrates innovation and
flexibility
Demonstrates teamwork and
collaboration
18. Additional Recommendations or Feedback(if any)