CareStat, LLC
CareStat, LLC
Home Health Services
90 Day Performance Review
___________________________ was hired on ________________ in the current position of _______________________.
As you know, we follow a policy that specifically states that all employees will have a performance evaluation after 90 days of employment. Please complete this form indicating your opinions based on performance during this period. If you have any question, please contact HR.
Outstanding Above Average Below Totally
Average Average Unsatisfactory
Job knowledge_________________________________________________________________
Effectiveness___________________________________________________________________
Quality of Work________________________________________________________________
Dependability__________________________________________________________________
Initiative______________________________________________________________________
Judgement_____________________________________________________________________
Cooperation____________________________________________________________________
Potential______________________________________________________________________
Additional Comments:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Has this employee been promoted? Yes or No? If the answer to this question is yes, please list the former position and the new position.
__________________________________promoted to ______________________________this promotion began or will begin on _________________________________.
_____________________________________ _____________________
Employee Signature Date
_____________________________________ _____________________
Supervisors Signature Date
Revised 8-9-08
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