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Performance Review Summary Sheet

The Performance Review Summary Sheet is to be completed by the employee’s manager at the end of the annual review
process. The employee may also choose to complete it prior to the performance discussion. Additional documentation may
be attached as necessary. Include the employee’s name, social security number and date on all additional
documents.
Employee Last Name First MI Employee #

Position Review Period


From to

Performance Evaluation
Use the scale below to evaluate the employee’s performance on each factor A, B & C.
Far Exceeds: Clearly and consistently demonstrates extraordinary and exceptional
accomplishments in all major areas of responsibility. Far Exceeds
Exceeds: Accomplishments are well beyond reasonable, but demanding standards of
performance, especially in the key areas of responsibility. These individuals
consistently demonstrate truly outstanding achievements in terms of quality and Exceeds
quantity of output.
Met: Performance clearly meets all major requirements of the position in terms of
quality and quantity of output. Individuals of this level consistently perform in an
effective and professional manner.
Met
Met some not all: Performance does not fully meet job requirements in all areas of
major responsibility. The need for improvement is clearly evident. Met Some Not All
Does not meet: This Rating is not acceptable for more than 6 months. If an employee
does not meet minimum job requirements, they should receive an action plan with Does Not Meet
definitive action plans to improve performance.

A. Job Performance: Applies professional/technical skills, solves problems quickly and effectively, completes and
follows through on assignments. See specific performance measured on page 2.

B. Annual Goals: Reaches established goals and expectations. See specific goals on page 2.

August 2003
C. Core Values Leadership;

Resident Satisfaction: Focuses on Resident needs, ensures the resident is satisfied, works to retain the residents
business, focuses on solutions.

Integrity in Relationships: Fosters open communication, listens to others, strives to get along with teammates,
residents, vendors, clients, and employees.

Teamwork and Trust: Builds relationships, gets along with people who are different from themselves, addresses and
resolves conflict positively, influences others, openly shares information.

Fiscal Responsibility: “Good Judgment”-“Doing the right thing”, decisive, involves others, learns quickly and
adapts well to change. Ensures we are prudent in delivering products and/or service.

Innovative services & products: Shares ideas to “new ways” of providing better service, whether it is a new product
or new process.

Individual Initiative, expression & creativity: Provides direction, motivates others, leads by example, provides
feedback, coaches and develops others.

Job Performance:
Specific performance measured.
Rating

Established goals and expectations:


Specific goals set at the beginning of the year and rate.
Rating

Core Values – Behaviors:


List expected Core Values “behaviors” and / or demonstrated behavior and rate.

August 2003
Rating

Overall Rating:
Consider ratings on job performance; set goals and Core Values leadership behaviors with its various components.
Consider how this employee has performed overall for the review period.
Overall Rating

Employee Comments:
Record below any comments desired as a result of the Performance Review discussion.

Development Plan/Goals:
Identify opportunities for employee development and action plans to enhance performance. Begin by asking the
employee for their thoughts and ideas. In the Performance Review discussion, agree on the Development Plan and
document below.
Development Opportunity Action Plan Target Date

Future Development
Employee:
August 2003
In what areas would you like to gain more experience?

What specific positions/career opportunities interest you?

What are your long-term career interests?

Manager:
What career options do you see for this employee?

What are potential development activities to help this employee achieve their career goals?

Employee and manager have discussed performance goals and results.


Employee Signature Date Manager Signature Date

Department Department

August 2003

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