Use this step by step explanation to craft a good employee performance feedback review for a community health worker. Find the right words with quality phrases.

A community health worker is responsible for educating community members on the various health issues both current and future and the available relevant health programs. He/she will promote a better understanding of the health issues affecting the community as a whole by responding to various general and specific needs and issues.

In addition to that, he/she will also get to perform the following roles; keeping accurate data and information on the health programs, collaborating with other professionals to promote health related issues, coordinating health programs, planning and budgeting for community health activities, conducting health related trainings and assessing and evaluating of the health conditions within the community.

Employee Performance Review Sample

Employee's Name: Title:
Review Period: __/__/__ to __/__/__ Employee SSN:
Work Location: Supervisor's Name:

Instructions

  1. Rating: Rate the employee against the core skills based on how well he/she demonstrates each skill. Give scores 1, 2, or 3 for each rating depending on the employee's performance.
  2. Comments: Use this area to give examples of employee's performance phrases. The phrases should describe how well an employee has performed on previously set goals based on the given core skill.
  3. Summary: Use this section to give a summary of the employee's strengths and areas for improvement or development. Recommend a step increase for an employee who has met the expectations and performance improvement plans for one who doesn't meet expectations.
  4. Human Resources Review: Human resources manager must examine and indicate whether he/she concurs with the evaluation and comments. If the manager agrees, then he/she must sign the evaluation form. If he/she doesn't concur, then he/she must provide reasons explaining why this is so.
  5. Signatures: Sign the evaluation form and give it to the employee to go through and answer the Self Evaluation Questions. Ask him/her to sign and date the evaluation form before giving it back to the human resources for filing.

Rating Meaning

The employee fails to perform the most important aspects of the job satisfactorily. Requires close guidance to carry out routine jobs. He/she needs significant improvement in all areas. Meetings should be held between the employee and the supervisor to discuss performance deficiencies.

1

Employee routinely meets and exceeds expectations in all areas of responsibility. Produces high-quality work that at times exceeds expectations. Consistently meets the most critical annual goals. Occasionally produces timely and accurate results.

2

The employee consistently and significantly exceeds the communicated expectations by producing exceptionally high-quality work. He/she demonstrates exceptional knowledge of his/her duties and is highly recognized by others as an authority in his/her area of work.

3

Supervisor's Feedback

Skill

Comments

Rating

TEAMWORK SKILLS: Teamwork is the process of collaboratively working with a group of people with an aim to achieve a set goal within a business ensuring that the staff and management cooperate using their skills and provide constructive feedback.

Has a good way of solving team conflicts and ensures that peace and harmony are upheld.

Encourages other team members to continue to improve themselves and to do well at all time.

2

MULTI-TASKING: Multi-Tasking allows one to juggle and perform more than one task at a time without losing track of what you are working on or dropping the ball.

Takes breaks when one needs them in order to balance rushes and refresh one's mind for tasks that require intense focus

Posts one's to-do list in a prominent place spot in order to remind oneself what really needs to get done

2

SAFETY AT WORK: Safety is being protected from hurt or other non-desirable outcomes that may tend to overrule a situation and cause damages of different kinds.

Requires all employees to wear protective gear necessary to do their jobs safely in order to prevent exposure to hazardous materials

Goes beyond the regulations; addresses all safety hazards, whether they are covered by laws or not

2

EMPATHY: Empathy is the understanding of another person's condition from their perspective by placing yourself in their shoes and feeling what they are feeling.

Provides mentoring, coaching and stretching assignments that help colleagues and team members to develop to their full potential

Sets oneself the challenge of having a conversation with a stranger every week in order to understand life in another person's perspective

2

ATTENTION TO DETAIL: Attention to Detail is the capacity to achieve a thoroughness and accuracy when accomplishing a task.

Has a proactive attitude that focuses on creating ideas for handling daily tasks or correcting issues

Maintains a schedule; sets aside a certain amount of time and to devote to specific tasks and projects

3

COMMITMENT TO THE JOB: Commitment to the Job is the feeling of responsibility that a person has towards a mission and goals of an organization.

Sets an example for employees who don't have the experience or confidence to go through the challenging times and hold out for the rewards of success

Trains and takes online courses in order to improve one's own skills in a way that best serves the company

2

PERSONAL ACCOUNTABILITY: Personal Accountability is the feeling that you are entirely responsible for your actions and consequences taking ownership without blaming others.

Holds oneself and others accountable for making principled decisions and addresses unethical and unsatisfactory behavior head on

Generates enthusiasm among the team members for accomplishing common goals that elevates the team and ensures the company success

2

PERSONAL DRIVE: Personal Drive is a combination of desire and energy in its simplest form directed at achieving a goal in whatever you have set your heart to accomplish.

Operates as an effective representative of the company in both internal and external forums

Is able to continue moving forward and sustain effort even after a setback or negative feedback

2

PERSUADING OTHERS: Persuading others is making sure your best ideas get a fair hearing without manipulating others or using trickery.

Speaks in the affirmative in order to maintain directness and keep one's own intentions clear

Plans what one intends to say before one does so and then delivers it with conviction and confidence

2

USING COMMON SENSE: Using Common Sense is the ability to see what is missing in a situation or a project and supplying it without necessarily being assigned or asked to do it.

Slows down when one is upset or stressed; refrains from making hasty decisions in order to avoid hurting others

Gets constant feedback from other employees in order to know own strengths and areas that need improvement

2

Self Evaluation

Self Evaluation Question

Employee Comments

TEAMWORK SKILLS:

Do you always take credit for what others have done or you appreciate their efforts?

Do you show leadership skills while you are in a team and how will you rate your leadership skills?

[employee comments]
MULTI-TASKING:

How do you prioritize your tasks to make sure that all are attended to and that they meet deadlines?

What are some of the ways and techniques that you have found to make handling of multiple tasks easier and more effective?

[employee comments]
SAFETY AT WORK:

How do you set your company's safety rules? How do you make sure that every employee follows these rules?

Is there a time when you have had to deal with an employee who repeatedly ignored the company's safety instructions? What did you do?

[employee comments]
EMPATHY:

How can you tell that a colleague needs help? What steps would you go through to provide comfort?

Can you think of a time someone interpreted something you said negatively, even though you didn't intend for it to be negative?

[employee comments]
ATTENTION TO DETAIL:

What techniques do you use to make sure you have the right information about a certain project?

Are there times you have had difficult experiences working with details at work? How did you go about that?

[employee comments]
COMMITMENT TO THE JOB:

Can you describe a situation when you demonstrated initiative and took action without waiting for directions? Were you happy with the outcome?

Can you describe a situation where you had to be very persistent or dedicated in order to achieve goals?

[employee comments]
PERSONAL ACCOUNTABILITY:

Can you describe a day when your supervisor was absent, and you had to make tough decisions? What are some of the decisions you made?

Would you rather design procedures and plans or implement/manage them? Why?

[employee comments]
PERSONAL DRIVE:

What personal and career goals have you set for yourself? What are you doing to make sure that these goals are accomplished?

What behaviors, workplace events or actions limit or destroy your personal drive? What do you do to get back on track?

[employee comments]
PERSUADING OTHERS:

Describe a time when you have used persuasion to convince someone to see things your way. What tips did you use?

Describe the most difficult persuasion exercise you have conducted. What made it difficult and how did you go about it?

[employee comments]
USING COMMON SENSE:

What have you done to improve your ability to use common sense at work?

Your workspace is messy. You can take one hour to clean it, or you can take three hours to shift to a new workspace. What should you do and why?

[employee comments]

Summary

Sections 1-4: To be completed by the supervisor

Section 5: To be completed by the employee

1. Exceeds Job Related Expectations

2. Areas to improve

3. Goals completed since last performance feedback

4. Goals for next period

5. Employee comments

Signatures

I acknowledge that I discussed this performance feedback with my supervisor. My signature does not mean that I agree or disagree with this appraisal.
Employee: Date:
Supervisor: Date:
Human Resources: Date:
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