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

A Community Health Outreach Worker is responsible for providing the medically underserved people with information about health and disease prevention as well as assisting them to adopt a healthy lifestyle. He/she is tasked with making connections and building sustainable relationships with the targeted population and traveling to homes, community agencies, and religious organizations.

Besides that major role, he/she will be tasked with performing other responsibilities like; facilitate and coordinate community health events within the community, conduct health presentations to the community members during outreach programs, attending health-related meetings, organizing and participating in community health training, monitoring and reporting the progress of health programs and keeping health related data.

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

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.

Is afraid to report any suspicious or unusual behavior, with an employee, that could become a safety hazard

Does not post safety signs thus employees keep on forgetting about the everyday risks inherent in their jobs

1

DEPENDABILITY: Dependability is the characteristic of being able to be counted on and relied upon by providing services that be trusted within a period.

When given a choice always opts for the reputable one ensuring discipline is highly maintained

Builds an environment of dependability and trust around the workplace

2

ASSERTIVENESS: Assertiveness is the inclination to stand up for your rights or other people's rights in a calm and concrete way without being aggressive or accepting a wrong.

Finds it hard to initiate and maintain comfortable relationships with colleagues at work

Lacks good listening skills. Responds quickly without listening carefully to what the other person has to say, thus missing important details

1

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

Frequently forgets one's task and projects and loses track of details on how and when everything needs to come together

Has difficulty sticking to own schedule and always keeps on altering it in order to follow a specific rhythm

1

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.

Shows eagerness to promote the company's products and services to customers in order to make the customers feel part of the company's long-term success

Takes initiative to complete tasks and does not need to be reminded what is next on the agenda

2

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

Takes ownership of personal or team performance and helps team members to achieve their goals or improve their performance

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.

Does not show respect and courtesy to team members, customers, and external agencies

Wastes plenty of time doing things that are not important to the company and fails to work on what is important

1

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

Makes assumptions about the person one is persuading and therefore is not able to reassess when new evidence emerges

Gets angry or upset when the person one is persuading refuses to buy one's idea or solution to a problem

1

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.

Is not able to stand for own values in the face of criticism; often does what other people want but not what one thinks is right

Bases own opinions on what others think instead of doing own research and looking at both sides of the story

1

QUALITY OF WORK: The quality of Work is the value of work or products produced by the employees as well as the work environment they are provided with.

Sets unrealistic goals for employees, which kills their energy and motivation to work on the goals

Does not check own work, to make sure that one meets the set quality standards, before submission

1

Self Evaluation

Self Evaluation Question

Employee Comments

SAFETY AT WORK:

Give an example of a time when an employee caused an accident due to neglecting safety procedures. How did you deal with him/her?

How would you deal with an employee who does not use the protective equipment?

[employee comments]
DEPENDABILITY:

Are you trustworthy to handle the tasks given without passing them on to others?

Are you a loyal person that your coworkers and management can rely on?

[employee comments]
ASSERTIVENESS:

Can you describe a situation where you were able to strengthen a relation with a colleague by using effective communication?

How good are your listening skills? Do you have instances when you made mistakes because you did not listen well to what someone had to say?

[employee comments]
ATTENTION TO DETAIL:

Describe a time when you were confused by a client's request. What process did you use to clarify things?

What tools/techniques do you use to check your work? Why do you use these tools/techniques?

[employee comments]
COMMITMENT TO THE JOB:

Are there times you have come in early or stayed late in order to meet a deadline?

Have you ever been in a situation where you had to lead a group of colleagues? How did you handle it?

[employee comments]
PERSONAL ACCOUNTABILITY:

Can you describe a time when you were asked to handle a tough problem which challenged your personal accountability? What was the outcome?

Describe a time you reacted to pressure situations or short deadlines. How did you do it?

[employee comments]
PERSONAL DRIVE:

Look back to when you were about seven years old. Is where you are now where you wanted to be?

How do you ensure that your personal drive level is high on a daily basis?

[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?

How do you avoid making the most common mistakes at work like being late or missing deadlines?

[employee comments]
QUALITY OF WORK:

Describe the most challenging task you have handled. What made it challenging and what was the quality of work produced?

How have you made sure that your projects meet the agreed quality standards? What tools or methods have you used?

[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: