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Route this form to: This form is for departmental use.

U Wide Form UM 941 Rev: 06/08

Performance Appraisal

Use this form two, three or four times per year to clarify performance expectations, set challenging goals, rate how well the employee performed, and develop an action plan for job or career development. At the end of the year, use the Administrative Summary (UM !"# to convert the two to four performance ratings into an average rating for the year. $hat average rating may be used for salary actions or other administrative purposes. See additional instructions on the pages % and &.

*** Complete all pages before signing the front of this form. ***
Employee Name (Last, First, MI) Dept ID Jo Code $ro ationary Appraisal $er!orman"e Appraisal

Entity Classi!i"ation #itle Dates Covered From%

College/ Administrative Unit

#o%

#&e rater s&o'ld !or(ard t&is per!orman"e appraisal to t&e dean, dire"tor or department &ead !or revie( and signat're e!ore dis"'ssing t&e rating (it& t&e employee) Appraisals are not !inal 'ntil all signat'res &ave een o tained) *ater+s Comments%

*ater+s ,ignat're *ater+s Name (printed) #itle Camp's Address

Date $&one

#&e dean, dire"tor or department &ead s&o'ld ta-e t&is opport'nity to identi!y and resolve pro lems, s'"& as per!orman"e standards or ratings t&at may e too lenient or too stri"t) #&ese ratings (ill "ontri 'te to t&e employee+s ann'al rating (Form UM ./0)) Dean, Dire"tor or Department 1ead+s Comments%

Dean, Dire"tor or Department 1ead+s ,ignat're Dean, Dire"tor or Department 1ead+s Name (printed) #itle Camp's Address

Date $&one

#&e employee+s signat're means only t&at t&e employee &as &ad an opport'nity to revie( and "omment on t&is appraisal) Employee+s Comments%

Employee+s ,ignat're

Date

The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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SECTION I: Performance Standards (Beginning of e!ie" Period# 2) *esponsi ility Monitor y E6pe"tation 7 $er!orman"e is "ompletely a""epta le (&en8) 4 o! 5o

E6"ellen"e 7 $er!orman"e is e6"ellent (&en8

0) *esponsi ility Monitor y E6pe"tation 7 $er!orman"e is "ompletely a""epta le (&en8)

4 o! 5o

E6"ellen"e 7 $er!orman"e is e6"ellent (&en8

9) *esponsi ility Monitor y E6pe"tation 7 $er!orman"e is "ompletely a""epta le (&en8)

4 o! 5o

E6"ellen"e 7 $er!orman"e is e6"ellent (&en8

/) *esponsi ility Monitor y E6pe"tation 7 $er!orman"e is "ompletely a""epta le (&en8)

4 o! 5o

E6"ellen"e 7 $er!orman"e is e6"ellent (&en8

:) *esponsi ility Monitor y E6pe"tation 7 $er!orman"e is "ompletely a""epta le (&en8)

4 o! 5o

E6"ellen"e 7 $er!orman"e is e6"ellent (&en8

The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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SECTION II: ating Performance (End of e!ie" Period# 2) *esponsi ility


Not ,atis!a"tory Marginal A"&ieved E6pe"tations More t&an E6pe"ted M'"& more t&an e6pe"ted A"&ieved E6"ellen"e E6"eptional A"&vmnt)

4 o! 5o

0) *esponsi ility

4 o! 5o

Not ,atis!a"tory

Marginal

A"&ieved E6pe"tations

More t&an E6pe"ted

M'"& more t&an e6pe"ted

A"&ieved E6"ellen"e

E6"eptional A"&vmnt)

9) *esponsi ility

4 o! 5o

Not ,atis!a"tory

Marginal

A"&ieved E6pe"tations

More t&an E6pe"ted

M'"& more t&an e6pe"ted

A"&ieved E6"ellen"e

E6"eptional A"&vmnt)

/) *esponsi ility

4 o! 5o

Not ,atis!a"tory

Marginal

A"&ieved E6pe"tations

More t&an E6pe"ted

M'"& more t&an e6pe"ted

A"&ieved E6"ellen"e

E6"eptional A"&vmnt)

:) *esponsi ility

4 o! 5o

Not ,atis!a"tory

Marginal

A"&ieved E6pe"tations

More t&an E6pe"ted

M'"& more t&an e6pe"ted

A"&ieved E6"ellen"e

E6"eptional A"&vmnt)

The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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SECTION III: $eneral Beha!iors (optional# Problem Sol!ing: Des"ri e positive and/or pro lem e&aviors (e)g), "onsiders e!!e"ts o! de"ision; s'ggests (ays to in"rease e!!i"ien"y; identi!ies pro lems and pra"ti"al sol'tions; does not disting'is& et(een important and 'nimportant pro lems)) Initiati!e: Des"ri e positive and/or pro lem e&aviors (e)g), ma-es appropriate de"isions a o't (&en to a"t independently and (&en to "ons'lt (it& ot&ers; !ollo(s t&ro'g& on tas-s (it&o't reminders; re!ers everyt&ing to s'pervisor (&et&er or not its ne"essary; ma-es 'na't&ori<ed de"isions)) Planning%Organi&ational S'ills: Des"ri e positive and/or pro lem e&aviors (e)g), s"&ed'les (or- e!!e"tively; ma-es appropriate 'se o! availa le reso'r"es; does not "ope (it& interr'ptions e!!e"tively)) Interpersonal S'ills (Clients%Co"or'ers#: Des"ri e positive and/or pro lem e&aviors (e)g), o tains/provides appropriate in!ormation; adapts to "&anging demands !rom ot&ers; o!!ers to &elp "o(or-ers (&en o(n (or-load permits; "omplains a o't pro"ed'res and poli"ies (it&o't o!!ering s'ggestions !or improvements; e6&i its 'n"ooperative or r'de e&aviors)) (ttendance%P)nct)alit*: Des"ri e positive and/or pro lem e&aviors (e)g), meets s'pervisor+s re='irements; arrives late 't leaves on time; does not noti!y s'pervisor o! a sen"e in advan"e)) Orderliness: Des"ri e positive and/or pro lem e&aviors (e)g), e='ipment and s'pplies are stored appropriately at t&e end o! t&e day; (or- area is appropriately presenta le to t&e p' li"; (or- area is messy and dirty)) CO+P,ETE (-+INIST (TI.E STEPS BE/O E INTE .IE0 (see instr)ctions# -isc)ss the ratings in ,e"tion II and ,e"tion III (i! appropriate) (ction Plans For a"&ieving e6pe"tations ("onsider timeta les, (or-s&ops, setting interim goals, et"))

For a"&ieving e6"ellen"e (optional)

For "areer development (optional)

e!ie"%re!ise performance standards !or t&e ne6t appraisal period (see ,e"tion I)) #&is page (ill not e pla"ed in t&e employee+s "entral !ile)
The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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INST 1CTIONS SECTION I: Performance Standards Use at t&e BE$INNIN$ o! a revie( period to list t&e per!orman"e standards !or ea"& 5o +s responsi ilities) esponsibilit*% >rite t&e name o! t&e responsi ility eginning (it& an a"tion ver (e)g), ?$rovide s'pplies@)) 2o" +onitored% Indi"ate &o( yo' intend to monitor per!orman"e (o servation, s'rveys, a report, et"))) Percent of 3ob% Indi"ate t&e responsi ility+s importan"e as a per"ent o! t&e 5o ) (I! yo' &ave a ?mis"ellaneo's@ "ategory, or i! a responsi ility &as distin"t parts, yo' may split t&e per"entage among t&e parts)) Standards% Des"ri e t&e level o! ='antity, ='ality, and timeliness yo' e6pe"t and t&e level yo' "onsider e6"ellent per!orman"e) Use t&e de!initions elo( as a g'ide) (I! yo' need more room, atta"& a list to ,e"tion I)) Expectation% $er!orman"e (o'ld e "ompletely a""epta le i! t&is level o! ='ality, ='antity, and timeliness (ere a"&ieved, and no more. Excellence% A m'"& &ig&er level o! per!orman"e, (&i"& most employees (o'ld !ind di!!i"'lt 't possi le to a"&ieve)

SECTION II: ating Performance Use at t&e EN- o! a revie( period to rate &o( (ell t&e employee per!ormed "ompared to t&e standards in ,e"tion I) Collect Information: For e6ample, Employee Inp't Form (AA ./9), s'rveys, re"ords, et") ead Performance Standards: #&is reminds yo' (&at aspe"ts o! per!orman"e yo' intend to rate) -escribe Performance: Des"ri e t&e ='ality, ='antity, and timeliness o! t&e (or- t&e employee prod'"ed) Note 'ne6pe"ted pro lems t&at (ere eyond t&e employee+s "ontrol and &o( t&ese (ere &andled) Consider revie(ing t&e des"ription (it& t&e employee e!ore ma-ing a rating) Use ALACB INB or #C$E) Choose a ating: Compare yo'r des"ription o! t&e employee+s per!orman"e to t&e standards in ,e"tion I) C&oose t&e rating t&at est s'mmari<es &o( (ell t&ose standards (ere a"&ieved) ?Achieved Expectation@ means t&e employee did all t&at (as des"ri ed in t&e E6pe"tations standard) ?More than Expected@ means per!orman"e (as more li-e t&e E6pe"tations standard t&an t&e standard !or E6"ellen"e) ?Much More than Expected means per!orman"e (as more li-e t&e standard !or E6"ellen"e) ?Achieved Excellence@ means t&e employee did all t&at (as des"ri ed in t&e standard !or E6"ellen"e in addition to (&at (as e6pe"ted) ?Exceptional Achievement@ means per!orman"e (as innovative, e6tremely di!!i"'lt to a"&ieve, or ot&er(ise etter t&an des"ri ed in t&e standard !or E6"ellen"e) Enter Percent of 3ob. >rite t&e responsi ility+s importan"e as a per"ent o! t&e 5o 'nder t&e rating yo' pi"-ed) 2) #ype *eports (DE 4 o! 5o )
Not ,atis!a"tory Marginal A"&ieved E6pe"tation More t&an E6pe"ted M'"& more t&an e6pe"ted A"&ieved E6"ellen"e E6"eptional A"&vmnt)

(In t&is e6ample, t&e des"ription o! per!orman"e mat"&es t&e E6pe"tation ,tandard)

DE 4

F DE4 o! 5o

I! yo' &ave a ?mis"ellaneo's@ "ategory, or i! yo' split t&e responsi ility+s per"ent importan"e among its parts, rate ea"& part separately) #&e ratings !or t&e parts may !all in t&e same or di!!erent rating "ategories) For e6ample, 0) Mis"ellaneo's ,"&ed'le meetings (0E4 o! 5o ) ,end Mailings (2E4 o! 5o ) (9E 4 o! 5o )
Not ,atis!a"tory Marginal A"&ieved E6pe"tation More t&an E6pe"ted M'"& more t&an e6pe"ted A"&ieved E6"ellen"e E6"eptional A"&vmnt)

0E 4

2E 4

F 9E4 o! 5o

S)mmari&e the ratings. Add 'p t&e per"entages listed 'nder ea"& rating "ategory and (rite totals in t&e s'mmary rating o6) #&is s&o(s t&e total per"entage o! t&e 5o t&at (as per!ormed at ea"& level) For e6ample,
Not ,atis!a"tory Marginal A"&ieved E6pe"tation More t&an E6pe"ted M'"& more t&an e6pe"ted A"&ieved E6"ellen"e E6"eptional A"&vmnt)

,UMMA*C

.E 4

2E 4

F 2EE4 o! 5o

The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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SECTION III: $eneral Beha!iors (Optional# Use t&is se"tion !or t&ree p'rposes% To identif* general beha!iors that sho)ld be capitali&ed )pon "hen planning for career de!elopment. Consider (ays to ta-e etter advantage o! t&e employee+s strengt&s in t&e "'rrent 5o , and !o"'s on t&ese strengt&s (&en designing an a"tion plan !or "areer development) To identif* general beha!iors that ma* be an obstacle to career de!elopment. Consider (ays to &elp t&e employee o tain t&e ne"essary training or e6perien"e to over"ome t&ese o sta"les) To identif* general beha!iors that are creating diffic)lties in the c)rrent 4ob. *evise t&e per!orman"e standards in ,e"tion I to s'mmari<e yo'r e6pe"tations) For e6ample, i! t&e employee &as not een &elping "oG(or-ers (&en time permitted, and t&is is "reating a pro lem, revise t&e E6pe"tation ,tandards !or t&e appropriate responsi ilities to indi"ate (&en and &o( t&e employee is e6pe"ted to &elp "oG(or-ers)

(dministrati!e Steps Before Inter!ie" Sign t&e !ront o! t&e per!orman"e appraisal !orm) /or"ard to t&e dean, dire"tor, or department &ead !or revie( and signat're AEFH*E dis"'ssing t&e ratings (it& t&e employee) #&is allo(s !or t&e possi ility t&at some revision may e ne"essary e!ore t&e revie()

SECTION I.: Inter!ie" and (ction Plan -isc)ss the ratings and s)mmar* in ,e"tion II (it& t&e employee) Also dis"'ss ,e"tion III, i! appropriate) -e!elop action plans y dis"'ssing (ays to &elp t&e employee improve per!orman"e, develop on t&e 5o , and/or plan !or "areer development) ,'mmari<e t&e res'lting a"tion plans (i! any) in t&e spa"es provided) Set performance standards for the ne5t appraisal period y revie(ing t&e standards in ,e"tion I and revising t&em as ne"essary; yo' may also revise ea"& responsi ility+s importan"e as a per"entage o! t&e 5o ) I! yo' ma-e "&anges, p&oto"opy ,e"tion I o! t&is !orm , (rite yo'r minor revisions on t&e "opy, and atta"& it to ,e"tion I o! t&e !orm yo' (ill 'se ne6t time) I! yo' ma-e s' stantial "&anges, yo' may (is& to start over on a ne( !orm)

(dministrati!e Steps (fter Inter!ie" Emplo*ee signs on t&e !ront o! t&e per!orman"e appraisal !orm) #&e employee+s signat're only means t&at t&e employee &ad an opport'nity to revie( and "omment on t&e ratings) $i!e the emplo*ee a cop*. #&is (ill ena le an employee to re!er a"- to t&e ratings and a"tion plans) Place in department file for no". Co' (ill need ,e"tion II o! t&e !orm again at t&e end o! t&e year to "omplete t&e Administrative ,'mmary)

E/E ENCE +(TE I(,S: $er!orman"e Appraisal Form (AA ./2) Administrative ,'mmary Form (AA ./0) Employee Inp't Form (AA ./9) Ieneral Inp't Form (AA .//) I'idelines !or >riting a Jo Des"ription I'idelines !or >riting $er!orman"e ,tandards I'idelines !or *ating $er!orman"e

The University of Minnesota is an equal opportunity educator & employer. 2001 by the Regents of the University of Minnesota.

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