Performance Evaluation Form Non-Exempt Staff (Page 3 of 3) in pdf

Instructions for Performance Evaluation Form for Non-Exempt Employees

This form is used for annual or performance improvement plan evaluations for non-exempt (hourly) employees. If you have any

question about whether this is the correct for use, please contact the Human Resources Department.

The form has areas to be completed by the evaluator to identify the employee being evaluated, the evaluator and the dates of the

evaluation period. This information is to be entered at the top of both pages of the evaluation form in the spaces provided.

The evaluation itself it contained in five sections identified with Roman numerals I through V.

I. Job Description Review – The evaluator reviews the job description of the employee being evaluated and confirms its accuracy or

notes any proposed changes. For unique job descriptions (that is, when there is only one incumbent with that title), changes may be

appropriate if duties, responsibilities, supervision details or qualifications change. It is less likely that changes will be appropriate in job

descriptions in which there are multiple incumbents with the same title. Typically, not all employees with the same job title routinely

perform all the duties or responsibilities appropriate for the group as a whole. Changes in job descriptions for positions with multiple

incumbents should only be recommended if the job description as a whole no longer applies to the employee being evaluated or if the

change is applicable to all of the incumbents. Please note any proposed changes and alert the Department of Human Resources which

must approve all changes. Both the evaluating supervisor and the employee should initial that they have review the job description and

enter the date on which this review was conducted. In the case of a change in the job description that is approved by Human

Resources, the supervisor should meet again with the employee, confirm the change and provide the employee with a copy of the

revised job description.

II. Performance Evaluation – The evaluator rates the employee’s performance in each of the performance factors listed and puts a

check mark or X in the column best describing the performance.

Unsatisfactory – Performance regularly falls substantially below the requirements of the job. The evaluator must include comments

describing the unsatisfactory performance and establish measurable goals and timetable for improvement in Section III.

Needs Improvement – Performance regularly falls below or occasionally falls substantially below the requirements of the job. The

evaluator must include comments describing the unsatisfactory performance and establish measurable goals and timetable for

improvement in Section III.

Meets Expectations – Performance regularly meets the requirements of the job, with few cases of performance that is unsatisfactory or

that needs improvement. Performance may occasionally exceed the requirements of the job.

Exceeds Expectations -- Performance regularly exceeds the requirements of the job. The evaluator must include comments describing

the performance in measurable terms.

Unplanned absences and lateness should be entered on the form and discussed with the employee. Unplanned absences exceeding

the maximum acceptable limit described in BAMSI’s Attendance Policy should be addressed as described in the policy.

Finally, the evaluator uses a check mark or X to evaluate the employee’s overall performance, based on and consistent with the

individual performance factor evaluations and supported by the evaluator’s comments and entries in Section III. Supervisors must

create a Performance Improvement Plan with measurable performance goals and timetables for employees with an overall evaluation

of Unsatisfactory or Needs Improvement. Employees with an overall evaluation of Unsatisfactory must be evaluated again in three (3)

months and may be subject to dismissal if there is not measurably significant and sustained improvement and progress at that time.

Employees who are evaluated as Needs Improvement for two (2) consecutive evaluation periods must be evaluated again in three (3)

months and may be subject to dismissal if there is not measurably significant and sustained improvement and progress at that time.

Documented monthly progress meetings between the employee and the evaluator must be held in all cases for employees on

Performance Improvement Plans.

III. Performance Narrative and Comments by Immediate Supervisor -- The evaluator must provide a rationale for the employee’s

overall performance evaluation as well as the status of performance objectives, strengths and developmental needs and measurable

objectives for next evaluation period. Detail must support evaluations of Unsatisfactory, Needs Improvement or Exceeds Expectations.

IV. Comments by Next Level Supervisor – The supervisor of the evaluator completes, signs and dates this portion of the evaluation

BEFORE it is reviewed with the employees. This demonstrates the next level supervisor has reviewed the evaluation and agrees with

the comments and conclusions.

V. Comments by Employee – The employee signs and dates the evaluation to acknowledge that it has been discussed with the

employee, that the employee has been provided a copy of the evaluation and that the employee and the evaluator have reviewed the

employee’s job description. The employee’s signature and date are required and do not necessarily signify that the employee

agrees with the evaluation. Employees may provide their own comments on the evaluation form, or submit additional comments

within three (3) days of the evaluation, or on their next day of scheduled work if it not within the three-day period. Employee comments

will be attached to the evaluation and maintained with it in the employee’s personnel file.

Performance Evaluation Form Non-Exempt Staff Page 3

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