Name of Supervisor____________________________ Title_____________________________ Rating Summary of Performance: (Check the one category that best describes the staff member’s overall Good performance) Evaluation Criteria Outstanding Good Very Poor Fair 1. well with other staff members Outstanding: Exceeds established 2. Works well with public and patients goals/expectations for the position 3. Works well within team/ promotes and is clearly outstanding overall. teamwork Very Good: Meets and frequently 4. Comes to work on time and is exceeds all established dependable goals/expectations for the position. 5. Completes work within deadlines Good: Adequately meets established 6. Follows directions of supervisor goals/expectations for the position. 7. Works well without supervisory Fair: Meets some, but not all direction established goals/expectations for 8. Quality of technical skills the position and improvement in 9. Follows policies and procedures specific areas is required. 10. Readiness for more responsibility Poor: Unacceptable for the position and significant improvement is required General comments on overall performance (if Outstanding or Poor rating full explanation, including specific achievements/incidents must be cited):
Name of Supervisor____________________________ Title_____________________________ Evaluation Criteria Rating Summary of Performance: (Check the one category that best describes the staff member’s overall performance) Outstanding: Exceeds established goals/expectations for the position and is clearly outstanding overall. Very Good: Meets and frequently exceeds all established goals/expectations for the position. Good: Adequately meets established goals/expectations for the position. Fair: Meets some, but not all established goals/expectations for the position and improvement in specific areas is required. Poor: Unacceptable for the position and significant improvement is required Outstanding Very Good Good Fair Poor 1. well with other staff members 2. Works well with public and patients 3. Works well within team/ promotes teamwork 4. Comes to work on time and is dependable 5. Completes work within deadlines 6. Follows directions of supervisor 7. Works well without supervisory direction 8. Quality of technical skills 9. Follows policies and procedures 10. Readiness for more responsibility General comments on overall performance (if Outstanding or Poor rating full explanation, including specific achievements/incidents must be cited):
DMSS%20Supervision%20Manual%20FINAL%2030AUG09.docx