Personnel Appraisal

Competency Evaluation

1 – Poor Performance: Does not deliver acceptable results, significant improvements are necessary.

2 – Needs Improvement: Does not deliver acceptable results consistently, improvements are needed.

3 – Meets Expectations: Consistently delivers acceptable results, development opportunities exist.

4 – Exceeds Expectations: Consistently delivers very good results, some opportunity for improvement.

5 – Outstanding: Consistently delivers outstanding results.

📋 Employee & Supervisor Information

Employee Job Title (Position) *

Employee Name *

Date *

District / Base *

Supervisor Title

Supervisor Name

2nd Level Title

2nd Level Name

🔧 Specific Job Functions

Select a position above to load its specific job functions.

⭐ Behaviors and Attributes

1. Identifies, Utilizes, Follows, and Reviews Work Safe Procedures, JSAs, and Permits-to-Work in accordance with scope of work tasks

2. Awareness of own competency level – Authority to Operate / Approved Competent Operator / training and coaching

3. Seeks guidance and demonstrates desire to learn and develop skills

4. Communication

5. Job-Knowledge/Skills and Problem Solving

6. Initiative (Self-Starter)

7. Leadership (provides a good example and motivates others)

8. Teamwork

9. Follows instructions and adheres to PIC on any given task and/or supervisor

10. Planning and Organizing

11. Turnover with Alternate

🎯 Overall Evaluation

Circle the Overall Evaluation

💬 Comments & Development

Supervisor Comments and Actions/Recommendations for Employee Development

Employee Comments and Self-Appointed Actions/Recommendations for Development

✍️ Acknowledgement & Sign-Off

Employee acknowledges the final evaluation result

Supervisor Signature (type name)

2nd Level Supervisor Signature (type name)

📸 Photos (0/6)

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