State of Alaska
|EMPLOYEE NAME |EMPLOYEE ID NUMBER |DEPARTMENT / DIVISION |REPORTING COVERAGE |
| | | |FROM: TO: |
|PCN |JOB CLASS TITLE |REASON FOR EVALUATION REPORT |
| | | INTERIM | RESIGNATION / SEPARATION |
| | |ANNUAL/PAY INCREMENT |OTHER: |
|POSITION DESCRIPTION REVIEWED BY RATER FOR ACCURACY Yes No If No, explain: | | |
|INTRODUCTION is used to briefly describe the responsibilities of the position and reason for the evaluation report. |
|Comments/Narrative: |
|PRIOR GOALS is used to describe the goals set during the prior rating period. |
|Comments/Narrative: |
|PERFORMANCE is demonstrated by: quantity, quality, accuracy, and completeness of work; knowledge of job fundamentals; judgment shown on the job; willingness and ability to carry out new assignments; independence |
|of performance; commitment towards job. |
|UNACCEPTABLE |LOW ACCEPTABLE |MID ACCEPTABLE |HIGH ACCEPTABLE |OUTSTANDING |
|Comments/Narrative: |
|WORK HABITS are demonstrated by: attendance; punctuality, appearance and grooming; safety. |
|UNACCEPTABLE |LOW ACCEPTABLE |MID ACCEPTABLE |HIGH ACCEPTABLE |OUTSTANDING |
|Comments/Narrative: |
|INTERPERSONAL RELATIONSHIPS are demonstrated by: consideration of public and co-workers; teamworking; acceptance of supervision and coaching. |
|UNACCEPTABLE |LOW ACCEPTABLE |MID ACCEPTABLE |HIGH ACCEPTABLE |OUTSTANDING |
|Comments/Narrative: |
|SUPERVISORY (For Supervisory Employees Only) skills are shown by: training, coaching and directing reporting employees; evaluating reporting employees; planning and organizing work, including delegation; problem |
|solving and decision-making ability; affirmative action achievement; cost effectiveness; and labor contract administration. |
|UNACCEPTABLE |LOW ACCEPTABLE |MID ACCEPTABLE |HIGH ACCEPTABLE |OUTSTANDING |
|Comments/Narrative: |
|OVERALL RATING: overall effectiveness must be explained. Other performance considerations, such as strong points and areas requiring improvement should be included. |
|UNACCEPTABLE |LOW ACCEPTABLE |MID ACCEPTABLE |HIGH ACCEPTABLE |OUTSTANDING |
|Comments/Narrative: |
|Rater’s Recommended Action: |
|NEW GOALS is used to describe the goals set for the next rating period. |
|Comments/Narrative: |
|Rating was discussed with employee: Yes No If No, explain: |
|Signature: Date: |
|Employee’s Name: Title: |
|Employee: Concur with Rating Disagree with Rating (Employee Comments Attached: Yes No) |
|Signature: Date: |
|Rater’s Name: Title: |
|Employee ID: |
| |
|Reviewed and Approved by: |
|Division Approver |
|Signature: Date: |
|Name: Title: |
|Department HR Approver |
|Signature: Date: |
|Approver Name: Title: |
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