PERFORMANCE EVALUATION FORM P530A- 3/03


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PART I: EMPLOYEE INFORMATION

Employee Name: ...............

Classification: ...................

Bargaining Unit: ...............

Evaluator: .........................

Department: ......................

Evaluation Period: From (mm/yy):

/

To (mm/yy):

/

Employee Status:

Permanent

Probationary, Ending
(mm/dd/yy)

/

/

Temporary, Ending (mm/dd/yy)

/

/

Evaluation Type:

Annual

3rd Month

6th Month

11th Month

Other


PART II: PERFORMANCE REVIEW
IMPORTANT NOTE: When entering data in the large boxes include a whenever you would like a paragraph marker.

List the employee's major responsibilities:

Review the seven (7) dimensions of performance. Under each category,
comment on the employee's accomplishments and challenges during the evaluation
period. Indicate level of performance achieved using the following scale:

5 = Superior 4 = Above Satisfactory
3 = Satisfactory 2 = Needs Improvement
1 = Unsatisfactory

1) Knowledge of policies, procedures, and programs: Scale=

Demonstrates organizational awareness; knows administrative
policies and procedures; has knowledge of business practices; provides accurate
information on policies and procedures; makes information easily accessible
to all members of the campus community.

2) Skills and abilities:
Select a minimum of four which are applicable to the work
assignments. Evaluators may identify other relevant criteria if desired.

a) ANALYTICAL AND DATA ANALYSIS: Recognizes what information
is critical; plans and conducts research and analyses in a deliberate and
comprehensive manner, presents results in clear and concise manner.

b) COMMUNICATION: Writes clearly; edits work for spelling
and grammar; presents numerical data effectively; expresses thoughts
clearly, verbally and in writing; seeks out and develops productive
work relationships; listens with empathy, responds diplomatically; responds
accurately and promptly to questions; listens and gets clarification.

c) LEADING OTHERS: Prioritizes and plans work activities
of others to meet unit, department and college priorities and timelines; motivates
others towards common goals, integrates changes, demonstrates ability to
coach, mentor, train and develop others.

d) INFORMATION TECHNOLOGY: Demonstrates ability to create,
edit, format letters, tables and other documents; demonstrates ability to
create newsletters or brochures; demonstrates ability to create, edit and
format effective slide presentations incorporating video, audio and graphics;
demonstrates ability to create and publish a web page using HTML or an easy-to-use
authoring application; demonstrates ability to create spreadsheets, use calculations,
generate charts and graphs.

e) JUDGEMENT; PROBLEM SOLVING; AND DECISION MAKING: Gathers
relevant data; evaluates information based on appropriate standards; synthesizes
facts, concepts and principles; alerts appropriate persons to emerging problems;
is willing to make and take responsibility for decisions; consults with appropriate
people; supports and explains reasoning for decisions; makes timely decisions.

f) TEAM WORK: Balances individual and unit responsibilities;
gives and welcomes feedback; contributes to building a "user-friendly" environment,
ensures cooperation and cohesion, facilitates groups in decision making process.

g) PROJECT COORDINATION: Develops plans; coordinates projects;
communicates changes and progress; completes projects on time and within existing
resources.

h) WORK PRACTICES: (Includes attendance, punctuality,
safety, organization of work area): Schedules time off in advance unless
an emergency dictates otherwise; follows department procedures for requesting
and reporting use of leave; ensures work responsibilities are covered
when absent or apprises supervisor of pending responsibilities or upcoming
deadlines; arrives at appointments and meetings on time. Utilizes appropriate
safety measures, maintains a professional and orderly work environment.

i) SELF-DEVELOPMENT/CAREER PLANNING: Seeks opportunities
for professional development; identifies opportunities to contribute to organizational
goals; is willing to learn new skills.

j) CONTRIBUTIONS TO CAMPUS, CSU, COMMUNITY, IF APPLICABLE:
Contributions toward achievement of strategic planning, college, department
and unit goals.

Describe and assess a minimum of four skills and abilities below:

Scale=

Scale=

Scale=

Scale=

3) Quality: Scale=

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.

4) User Friendly Interactions: Scale=

Acts/behaves in a manner that reflects respect, courtesy
and civility, appreciation, empathy, trust, inclusion and consultation. .
Establishes and maintains effective work relationships; offers assistance
and support to co-workers. Understands lines of reporting, responsibility,
and accountability. Provides accurate information; makes information easily
accessible to all members of the campus community.

5) Quantity: Scale=

Completes work in a timely manner; strives to increase
productivity.

6) Planning and Results: Scale=

Prioritizes and plans work activities to meet unit, department
and college priorities and timelines; identifies needed resources; plans
and utilizes existing and new resources efficiently; accommodates multiple
demands for commitment of time energy and resources; adapts to changing priorities,
situations and demands; integrates changes.

7) Creativity and Innovation: Scale=

Engages in creative problem solving; thinks "globally";
knows how to re-engineer processes; is open and receptive to new ideas.

8) Overall Rating: Scale=

Add the ratings and divide by the number of dimensions
rated. Describe the employee's overall performance.


PART III: PERFORMANCE PLAN
List the development objectives the employee has achieved during the evaluation
period. Next, list your developmental objectives, the activities through
which you propose the employee should achieve them and the projected timelines:


PART IV: EVALUATOR'S SIGNATURE

Evaluator's Name Evaluator's Signature:
Title: _________________________
Date

PART V: EMPLOYEE'S SIGNATURE & ACKNOWLEDGEMENT OF EVALUATION

____ I have had an opportunity to read and discuss this
performance review with the evaluator.

____ I am attaching my comments regarding this evaluation.

____ I would like to discuss this evaluation with an
Appropriate Administrator.

____ I decline to sign.

____ I will submit my rebuttal.

Employee's Signature _______________________________________
Date


PART VI: APPROPRIATE ADMINISTRATOR'S REVIEW

For probationary employee only, recommend:

___ Grant Permanent
Status

___ Reject During
Probation (Forward Recommendation)

Comments (Include date and participants. Be sure to copy
evaluator and employee. This is important):

_____________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Administrator's Name
______________________Administrator's Signature _____________________________

Title
_________________________________________________________
Date
______________________