Non-Exem pt PERFORMANCE APPRAISAL A Employee Name RSMM 1013 Title Department Period Covered By Review To 5 Ii Hire Date {j if" Type of Review ?Annual CI Requested CI Follow Up (Check One) The Employee Performance Appraisal is designed to provide feedback to employees on their performance and to provide a dialogue between the employee and hisiher supervisor. Employees have the opportunity to be active participants in the performance review process. PREPARA TION l) The Non?Exempt Performance Appraisal Packet consists of two parts: a) The employee Self-Appraisal, which is completed by the employee b) The Performance Appraisal, which is completed by the supervisor 2) Upon receiving the Review Packet the supervisor should: a) Schedule the appraisal meeting with the employee at a mutually convenient time b) Ask the employee to complete the Self-Appraisal and to bring it to the appraisal meeting c) Con?rm employee has attended Anniversary Training. If the employee has not attended this training heishe needs to be scheduled. A review will not be performed until this takes place. c) Con?rm that employee has received annual mantoux test. 3) Prior to the appraisal meeting the supervisor should complete the Performance Appraisal as follows: a) Complete the Performance Review Criteria, Safety Review Check and the Performance Appraisal Summary sections b) Complete the Overall Evaluation Section of the appraisal c) Have employee sign job description d) Return the completed Performance Appraisal to Human Resources for approval and increased pay rate (if applicable) e) Once Performance Appraisal is signed and approved by Human Resources, it will be returned to the supervisor to present to the employee. CONDUCTING THE APPRAISAL l) The supervisor should ?rst discuss the contents of the Employee Self Appraisal form with the employee. The supervisor and employee should then discuss the Performance Review Criteria ratings, the Safety Review Check and Performance Appraisal Summary and the Overall Evaluation. 2) The supervisor should provide an Opportunity for the employee to respond to the appraisal and offer the employee to comment in the space provided. 3) The supervisor and employee should sign and date the appraisal where indicated to acknowledge that the review discussion took place. 4) The supervisor will make a copy of the entire Performance Appraisal and give it to the employee. 5) The supervisor will return the original copy ofthe Performance Appraisal with the ESC form attached to the Human Resources Department. PERFORMANCE REVIEW Check the appropriate performance level for each Performance Review Criteria listed below, as it most accurately describes the employee?s performance during the time period covered by the review. Any criteria rated at ?Exceeds Job Requirements?, ?Needs Improvement?, or ?Unsatisfactory? requires supporting comments where indicated. PERFORMANCE RE VIE Comments lualueAOlduII speeN suopmoodxa spew suctimoodxg spoaoxa etqeonddv 10N Job KnowledgefSkill Quality of Work, Accuracy, Tho roughness Quantity of Work Initiative Ability to Work Effectively with Co- Workers Personal Appearance Attendancer'Punctuality Attitude toward position Appropriate interaction with residents, clients or families (if applicable to position) Responsiveness to supervision and work direction Participation in scheduled in services Understands and adheres to universal precautions Additional Review Factor SAFETY REVIEW CHECK Employee has attended Anniversary Training YesE No Employee has received his/her annual Mantoux Yes No Employee has signed annual job description Yes?q No PAY INCREASE RECOMMENDED . Yes No APPROVED RATE INCREASE: . NON-EXEMPT Please complete both sides EMPLOYEE Employee Name: - - Performance Appraisal Date: 5) I -- [0 The Performance Appraisal Program at Walker is designed to provide feedback to you on your work performance and to provide a dialogue between you and your supervisor. You have to opportunity to be an active participant in the performance review process. Please note that to be eligible for your annual pay increase, you must have completed Anniversary Training for that year. Failure to do so will delay your review and you will not be eligible for back pay. Please complete the questions on the Self-Appraisal form prior to your Performance Appraisal meeting with your supervisor. These questions are intended to help identify speci?c areas you may wish to discuss with your supervisor at the time of your review. 1. What are the parts of your job that you like the best? (duties, conditions, supplies, policies, etc.) if - .- LILLQIZ Games P?j?i?p?f aft/Leg]. Fir (-9 (la-If you-?Ls (seguesin (1.1/2.4 Lyn/v +0 at; My (595+ 327? marry ?atbedAre there any activities or procedures within your department or unit that you would like to see changed? ?21: plcare gig/J li/?Why? 02C Skin bra-emits Wat/2 fesc?demis gig?? gums? Ammo 0mg?? ?ajls. {~kc0se9 nails; ?ow Cuff-j. uft?f ?1,692.70 +0 hardware? +ch lie?ole?n Skin P'Psl?cl?mlgs I How could they be done differently? [aw (ix/?7 8 hack t.