EMPLOYEE PERFORMANCE APPRAISAL FORM

EMPLOYEES NAME:

JOB TITLE:

DEPARTMENT:

SUPERVISOR:

DATE OF HIRE:

REVIEW DATE:

DATE DUE TO PERSONNEL:

Check One:

Self-Review

Supervisors Review

Final Review

SECTION I: CORE VALUES AND OBJECTIVES

The performance criteria in Section I apply to all City of Somerville non-represented employees.

1. Attendance:
U

Definition: Reports for work regularly with a minimum number of absences and
tardiness. Gives notice when absence or tardiness is unavoidable. Receives
authorization when time off is needed. Observes appropriate lunch and break
schedules. Submits justification for absences as required and/or requested.
Standard: Be ready to work at the beginning of the workday or start time.
Standard: Submit request for leave or vacation in writing at least 10 (ten)
business days prior to time off being requested, for requests for time off longer
than one day.
Standard: Have no unexcused or unauthorized absences.
U

MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

COMMENTS AND EXAMPLES:

2. Productivity and Use of Time:

U

Definition: Manages own time and uses appropriate work methods, techniques,
and equipment to achieve the most effective and efficient result in the time
available. Is mutually respectful of time and schedule of others. Balances
multiple priorities and focused on desired outcome(s).
Standard: Prioritize work assignments based on established guidelines.
Standard: Complete all work assignments within designated deadline; notify
appropriate staff in advance of inability to complete assignment within
designated timeline.
Standard: Use available technology to accomplish work expeditiously.
Standard: Be considerate of meeting start times and other peoples time.
Whenever possible, contact meeting organizer when you will be late or absent.
Standard: When hosting meetings, have specific, identifiable outcomes. When
coordinate meetings, inform participants of the beginning and ending time. Keep
to schedule unless all participants agree to extend time. Develop and follow
meeting agendas. Reserve meeting rooms in advance.
COMMENTS AND EXAMPLES:
U

EXCEEDS EXPECTATIONS

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

3. Teamwork and Collaboration:

U

Definition: Makes and sustains effective and productive relationships with other
members of the workplace and the public. Is respectful of differing viewpoints.
Meets commitments to co-workers and employees in other departments.
Standard: Treat co-workers with respect and professionalism at all time. Allow
for differing points of view.
Standard: Contribute to the upkeep of shared department spaces.
Standard: Meet commitments to coworkers and other employees at all time.
Willingly contribute to time-sensitive group efforts as they arise.
Standard: Know when to work collaboratively to ensure that workload for the
work unit is completed and know when to work independently.
COMMENTS AND EXAMPLES:

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

4. Customer Service and Communication:

U

Definition: Responds effectively and in a timely manner to the needs of a

diverse set of internal and external customers such that customer service is
accurate, courteous, and effective. Provides oral and written information and
services in a clear, concise, thorough, accurate, and timely fashion.
Standard: Utilize telephone and email in accordance with Telecommunications
Policy. Barring technical difficulties, do not allow your voicemail box or email
inbox to become full.
Standard: Provide rapid response to all community contacts. Generally, provide
written response within seven (7) business days of correspondence and respond
to messages within two (2) business days of receipt. When making referrals,
ensure that community members are placed in direct contact with appropriate
staff.
Standard: If you are out of the office for more than one day, place an automatic
out-of-office message on your voicemail and email that designates an alternate
contact to which inquiries can be directed.
Standard: Maintain a positive attitude when responding to constituent requests.
COMMENTS AND EXAMPLES:
U

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

5. Quality and Accountability:

U

Definition: Follows through on assigned tasks to ensure high quality work

products that match the City and Department objectives. Makes responsible
use of City resources (time and money). Follows City policies.
Standard: Work products are completed on time with little or no errors and in
accordance with relevant policies. Require minimal supervision.
Standard: If applicable: Keep projects within proposed budget at all times. Be
resourceful with expenditures of City funds (do more with less).
Standard: Demonstrate an understanding and support for established goals of
the City and Department. Align and prioritize work products toward these goals.
Standard: Accept and understand constructive criticism. Take appropriate
action to correct and improve performance.
COMMENTS AND EXAMPLES:

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

6. Adaptability, Initiative and Problem-Solving

Definition: Adapts to organizational changes (e.g., technology, resources, and
personnel). Takes initiative in identifying any problems and takes appropriate
steps to resolve them.
Standard: Create solutions to problems by identifying issues, working
collaboratively to develop strategies and implementing innovative solutions.
Standard: Advise supervisor first and appropriate staff in a timely fashion about
impending problems or issues related to work responsibilities.
COMMENTS AND EXAMPLES:

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

7. Performance Management and Leadership

U

(for supervisory/managerial/Dept. Head positions only)

Definition: Sets clear expectations and communicates regularly with employees

on performance issues. Communicates City goals and policies with staff.
Provides appropriate coaching and feedback. Completes performance
appraisals on time and consistent with the Citys policy. Follows through on staff
improvement action plans to enhance overall employee performance. Utilizes
data in management and decision-making.
Standard: Complete all Performance Appraisals within established timelines.
Include all relevant information to support ratings.
Standard: Maintain performance documentation on all staff members
(accomplishments, areas for improvement, etc.) throughout the year.
Standard: Take appropriate steps to ensure that all staff under your supervision
is performing at Meets Expectations or higher level through regular feedback,
coaching, and training.
Standard: Host regular staff meetings to ensure all staff are aware of goals,
policies, and major initiatives. Encourage employee input in improving
departmental operations.
Standard: Understand and utilize current and relevant data from available
resources (including, but not limited to SomerStat) to improve service delivery
and to inform management of staff and initiatives.
Standard: Plan, organize, and delegate appropriately to achieve goals within
scheduled time and fiscal limits.
COMMENTS AND EXAMPLES:
U

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE
NOT APPLICABLE

SECTION II: POSITION-SPECIFIC PERFORMANCE CRITERIA

Performance criteria are to be filled in based on any primary tasks outlined in the employees job description that have not
been addressed in Section I.

1. Criterion #1: Job Knowledge

Definition: Demonstrates competency in required job knowledge and skills of
[FILL IN].

EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS

Standard: [FILL IN]

IMPROVEMENT NEEDED

Standard: [FILL IN]

UNACCEPTABLE
COMMENTS AND EXAMPLES:

SECTION III: REVIEW OF GOALS SET DURING PREVIOUS REVIEW PERIOD

Status of Goal
Review Goal #1:

Completed
In Progress
Tabled

Review Goal #2:

Completed
In Progress
Tabled

Review Goal #3:

Completed
In Progress
Tabled

Explanation of Status

SECTION IV: OVERALL EVALUATION

Overall Comments, Commendations, and Recommendations
Comments:

Overall Rating
EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
IMPROVEMENT NEEDED
UNACCEPTABLE

SECTION V: SETTING NEW GOALS WITH AN ACTION PLAN

You may wish to use an additional sheet of paper if more space is needed.

Goals

Action Steps

Time Required

Resources
Needed

How does this goal

support the
Dept.s/Mayors goals?

Goal #1:

Goal #2:

Goal #3:

SECTION VI: EMPLOYEE COMMENTS (OPTIONAL)

The employee may choose to provide additional comments about his/her performance.

SECTION VII: SIGNATURES

The signature of the employee signifies the employee has had a review meeting with his/her supervisor and
has read and received a copy of his/her appraisal. It does not necessarily signify agreement.

EMPLOYEE SIGNATURE:

DATE:

1ST REVIEWER SIGNATURE (I.e., Direct Supervisor):

DATE:

2ND REVIEWER SIGNATURE:

DATE:

INSTRUCTIONS FOR COMPLETING THE PERFORMANCE APPRAISAL FORM

Overall Instructions: At this time, only employees who are not represented by a collective bargaining
unit are subject to the Performance Appraisal Process. This form is to be completed by the supervisor
upon meeting with his/her subordinate employee. The reviewing structure should follow the reporting
structure of the Departments Organizational Chart, unless otherwise discussed with the Personnel Dept.
In other words, supervisors will be in charge of reviewing their direct subordinates (1 st Reviewer), with all
appraisals in that Dept. read and signed by the Dept. Head (2 nd Reviewer). Dept. Heads will be reviewed
by the Mayor or Mayors Executive Office Designee (1st Reviewer), with all Dept. Heads appraisals read
and signed by the Mayor (2nd Reviewer). These signatures are required in Section VII.
Section I: The performance criteria in Section I apply to all City of Somerville non-bargaining-unitrepresented employees, including Department Heads and other managers. Certain criteria, namely #7
Performance Management and Leadership or which are otherwise noted, may only apply to Dept. Heads
and other managers. For each criterion, the reviewing supervisor should provide a rating as well as
evidence by way of Comments and Examples that support that rating. Comments and Examples are an
important and required part of completing the form.
Section II: Section II performance criteria are to be filled in based on any primary tasks outlined in the
employees job description that have not been addressed in Section I. Based on the job description, the
supervisor, in conjunction with the employee must determine what the appropriate criteria, definitions, and
standards are prior to completing the appraisal. As in Section I, a rating and supportive Comments and
Examples need to be supplied for each criterion. Whereas Section I criteria apply to all City employees,
Section II criteria are specific to the job description for the position being reviewed.
Section III: Section III provides an opportunity to review progress in meeting goals set during the
previous review. For each goal, note the status of the goal as either Completed, In Progress, or
Tabled. In addition, provide an explanation for the progress status for each goal. If significant progress
is still needed toward a particular goal, it is recommended that this goal be included in Section V.
Section IV: Based on the performance ratings and evidence provided in Sections I and II, and with
consideration of progress made toward goals as described in Section III, an overall performance
evaluation will be provided in Section IV to summarize the employees performance. A rating and
supportive comments are required.
Section V: Section V is to be used to set new goals for the upcoming review period. For each goal, the
following information needs to be provided: Action Steps (what the employee needs to do to reach the
goal); Time Required (approximately how long it should take to reach the goal); Resources Needed (e.g.,
training or other resources recommended); and Link to Dept/Mayors Goals (how the employees goals
supports the Dept. or Mayors goals). These goals will be formally reviewed at the next review period (in
Section III). This goal-setting section should be referenced regularly throughout the year and treated as a
fluid, living document.
Section VI: The Employee may provide any additional performance-related comments that s/he wishes to
become part of her/his permanent record. This section is optional.
Section VII: Appropriate signatures are required in this section.

RATINGS KEY
Exceeds Expectations
The performance of an employee at this level consistently exceeds all of the job standards and performance
expectations. The employee is performing at a level well beyond what is normally expected of the majority
of employees with similar duties.
Meets Expectations
An employee at this level consistently meets the established job standards and performance expectations.
The results consistently achieved are those the City would expect of employees in this position level.
Improvement Needed
Performance does not consistently meet the essential job standards and performance expectations of the
position, or is marginally acceptable. Development, coaching, or training is needed to reach full
effectiveness.
Unacceptable
Performance demonstrates an inability or unwillingness to meet job standards and performance
expectations of the position. Immediate and sustained improvement is required.