Senior Community Service Employment Program Supervisor'S Evaluation Form
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2SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
Supervisor’s Evaluation
To be completed every APRIL & OCTOBER by Training Site Supervisor and reviewed with Enrollee and
OWS (if in area).
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APRIL
OCTOBER
TERMINATION
HOST AGENCY
PHONE
:___________________________________
:______________________________
SUPERVISOR
ENROLLEE
:_____________________________________
:____________________________
TRAINING START DATE:___________ END DATE:_________ TOTAL TIME:______________
Employment goal(s):
________________________________________________________
Target Date for Employment
: _________________________________________________
Tasks that trainee is learning and practicing to prepare for employment.
Can Perform
Can Perform
Needs
Independently
with Support
Instruction
Notes for Reference
and Guidance
Not Done
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A. ___________________________
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B. ___________________________
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C. ___________________________
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D. ___________________________
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E. ___________________________
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F. ___________________________
In reviewing the position description, are current duties in keeping with those listed above?
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Yes
No
Explain differences:
_____________________________________________________________________
______________________________________________________________________________________________________
_____________________________________________________________________________________________________
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If no, has a new position description been provided? Yes
In what ways could the trainee’s job be upgraded, especially where trainee is performing tasks at or above market
level:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Trainee Name:
Page 2
__________________
F:\Website\employ\SupervisorEvaluation.doc
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