Texas Department of Criminal Justice



PART I - ADMINISTRATIVE DATA ADVANCE \l501. DATE: FORMTEXT ?????ADVANCE \l5 02. PERIOD OF REPORT:FROM: FORMTEXT ?????TO: FORMTEXT ?????ADVANCE \l5 03. REASON: FORMCHECKBOX INTERIM FORMCHECKBOX ANNUALEMPLOYEEADVANCE \l5 04. NAME: (Last, First, MI) FORMTEXT ?????ADVANCE \l5 05. JOB TITLE:CORRECTIONAL OFFICER IV - FORMTEXT ????? 06. PAYEE ID: FORMTEXT ?????ADVANCE \l5 ADVANCE \l5 07. UNIT/DEPARTMENT: FORMTEXT ?????RATINGSUPERVISORADVANCE \l5 08. NAME: (First Line Supervisor) FORMTEXT ?????ADVANCE \l5 09. JOB TITLE: FORMTEXT ?????ADVANCE \l5 10. SIGNATURE: ADVANCE \l5 11. DATE:SENIORRATERADVANCE \l5 12. NAME: (Second Line Supervisor) FORMTEXT ?????ADVANCE \l5 13. JOB TITLE: FORMTEXT ?????ADVANCE \l5 14. SIGNATURE: ADVANCE \l5 15. DATE:REVIEWER(If Applicable)ADVANCE \l5 16. NAME: (Warden/Facility Administrator/Department Head/Designee) FORMTEXT ?????ADVANCE \l5 17. JOB TITLE: FORMTEXT ?????ADVANCE \l5 18. SIGNATURE: ADVANCE \l5 19. DATE:PART II - PERFORMANCE ASSESSMENTSA. Essential Functions: The rating supervisor has reviewed the essential functions and determined that all essential functions are aligned with the duties performed by the position: YES FORMCHECKBOX NO FORMCHECKBOX If no, follow the procedures in PD-52, “Performance Evaluations,” Section IV.B, “Part II.A – Essential Functions.”1. Assumes a high level of responsibility for the care and custody of assigned inmates through knowledge of and adherence to laws, rules, regulations, and standard operating procedures governing the Texas Department of Criminal Justice (TDCJ). FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDS2. Searches for contraband and provides security; counts, feeds, and supervises inmates in housing, work, and other areas accessed by stairs; and maintains security of assigned areas involving long periods of sitting and standing, climbing stairs and ladders to reach assigned areas, and working at heights. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDS3. Provides custody and security of inmates including observing actions of inmates, squatting and bending to conduct “pat” and “strip” searches of inmates, restraining and securing sometimes assaultive inmates, and transferring and transporting inmates by walking or riding in various vehicles such as trailers, vans, buses, and other forms of transportation. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDS4. Supervises and provides security of inmates performing technical skills such as construction, maintenance, laundry, food service, and in varied industrial and agricultural operations which involve climbing stairs and ladders and climbing around the inside or outside of buildings; works outdoors and indoors without air conditioning; works around motorized or moving equipment and machinery; and is subject to all types of weather. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDS5. Ability to work protracted, irregular, and overtime hours as required; be willing to travel and work at other facilities as needed; responds to emergencies, including climbing stairs and ladders while searching for escaped inmates, hearing calls for and calling for help, giving first aid at the emergency site, carrying an injured or unconscious inmate or employee various distances to safety up or down stairs and ladders; and uses force and deadly force, including the use of chemical agents or firearms, to control inmates. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDS6. Reads, reviews, and properly applies information found in inmate records which is related to the inmate’s health and safety and to the security of the facility; provides leadership and technical guidance to other staff; complies with policies, procedures, rules, and regulations; enforces inmate disciplinary rules; and prepares and maintains records, forms, and reports. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDSB. Standards of Conduct: Employee has adhered to expected standards of conduct, including the rules of conduct described in the Listing of Employee General Rules of Conduct and Disciplinary Violations identified in PD-22: FORMCHECKBOX YES FORMCHECKBOX NO If no, identify the specific rule violation and disciplinary action imposed. Attach additional page if MENTS: FORMTEXT ????? C. TDCJ Safety Policy: Employee has adhered to TDCJ Safety Policy FORMCHECKBOX YES FORMCHECKBOX NO If no, identify specific safety policy deficiency and corrective action that has been taken. Attach additional page if necessary.RATING SUPERVISOR COMMENTS: FORMTEXT ?????Employee Name: REF NAME \* Upper \* MERGEFORMAT Payee ID: REF PAYEEID \* MERGEFORMAT D. Fraud Risk Assessment (applies only to Salary Group B22 or C5 and above):ADVANCE \u2ADVANCE \l5 Proactively addresses the potential of fraud in the discharge of assigned duties. If no, identify deficiency and corrective action that has been taken. FORMCHECKBOX YES FORMCHECKBOX NO FORMTEXT ?????852170698500E. Supervisory Functions, if applicable:ADVANCE \u2ADVANCE \l5 1. Schedules employee’s work and off duty time. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDSADVANCE \u2ADVANCE \l5 2. Provides training and instruction to subordinate employees. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDSADVANCE \u2ADVANCE \l5 3. Evaluates and counsels subordinate employees. FORMCHECKBOX NEEDS MUCH IMPROVEMENT FORMCHECKBOX NEEDS SOME IMPROVEMENT FORMCHECKBOX MEETS STANDARDS FORMCHECKBOX SOMEWHAT EXCEEDS STANDARDS FORMCHECKBOX EXCEEDS STANDARDSADVANCE \u2ADVANCE \l5 4. EEO Support: Adheres to TDCJ EEO Policy. If no, identify deficiency and corrective action that has been taken.86423512065000 FORMCHECKBOX YES FORMCHECKBOX NO FORMTEXT ?????PART III - PERFORMANCE DESCRIPTIONNeeds much improvement - Does not meet standard requirements. All aspects of performance are poor. Corrective action is needed.Needs some improvement - Inconsistently meets standard requirements, performance still needs improvement.Meets standards - Meets standard requirements. Performance has been as expected of employees in same or related positions.Somewhat exceeds standards - Always meets standard requirements. Performance exceeds that normally expected of employees in same or related positions.Exceeds standards - Consistently meets and exceeds standard requirements. Performance is outstanding on a regular basis.Written Justification Required for Ratings of “Needs Much Improvement,” “Needs Some Improvement,” and “Exceeds Standards”: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Employee may attach comments or provide comments within three workdays of performance evaluation review:EMPLOYEE SIGNATURE (for Performance Evaluation):DATE:The employee’s signature acknowledges receipt of this Employee Performance Evaluation form and does not indicate concurrence or non-concurrence with the performance assessments.Note to Employee: With few exceptions, you are entitled upon request: (1) to be informed about the information the TDCJ collects about you; and (2) under Texas Government Code §§?552.021 and 552.023, to receive and review the collected information. Under Texas Government Code §?559.004, you are also entitled to request, in accordance with TDCJ procedures, that incorrect information the TDCJ has collected about you be corrected.CONFIDENTIAL INFORMATION AGREEMENTI understand that information concerning any person, system or asset of the Texas Department of Criminal Justice that is obtained while performing my duties is to be held in strictest confidence and may not be disclosed except as required by job duties or law. I understand that computer system passwords I receive or devise are confidential. I will NOT disclose any passwords or post them where they may be viewed by others; this includes a co-worker, manager, supervisor, friend, partner, administrative assistant, or others. The only exception to this rule is in the event an information technology specialist requires the password to resolve an access problem. Once the problem has been corrected, I will immediately change my password. Use of a password not issued specifically to me or to a group of which I am a member is expressly prohibited. I am responsible for any computer transaction performed as a result of access authorized by use of my password. I agree to abide by all written conditions and restrictions imposed by the Information Security Manual. I agree further NOT to attempt to circumvent the computer security system by using or attempting to use, any transaction, hardware, software, files, or resources I am not authorized to use. I understand that any copyrighted material, including commercial software, which may be made available, is protected by copyright laws and is not to be copied for any reason without permission from the copyright owner. I understand that the violation of copyright laws, including those applicable to computer software, may result in fines and other legal action. I also understand that unauthorized access or use of the computer system of the Texas Department of Criminal Justice constitutes a “Breach of Computer Security” as defined under Chapter 33 of the Texas Penal Code and may be a criminal offense under Texas Penal Code §?33.02.EMPLOYEE SIGNATURE:DATE: ................
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