Use this sample and step by step explanation to craft a meaningful 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.

Does not listen to what other team members have to say and always interrupts when they are talking.

Takes credit for work done by others and does not appreciate what others have done.

1

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.

Does not create time to inspect the facility for areas that need repair or improvement

Does not seek employees input on how to maintain a higher level of safety awareness in the company

1

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.

Does not care about own words and actions and the perception they create in others

Does not take time to imagine what is going on in another person's life or allow time to walk in their shoes

1

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

Employs trusted colleagues to look over one's work and offers them the same courtesy

Reviews work carefully for completeness, accuracy, and mistakes before sending it out

2

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

Anticipates company's needs and possible problems, and comes up with suggestions to address those needs

2

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

Does not create own processes and timelines for getting things done thus keeps on missing deadlines

Does not observe punctuality; always gets to work late and misses important meetings and appointments with team members and clients

1

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 interest in learning new things or attending courses that enhance one's professional and personal development

Is unable to control one's emotions and is always picking fights with fellow colleagues and customers

1

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

Tries too hard to persuade, which puts off people faster or makes them lose interest in what one has to say

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

Tells others what to do instead of helping them learn how to differentiate the right from wrong or pointing them in the right direction

1

Self Evaluation

Self Evaluation Question

Employee Comments

TEAMWORK SKILLS:

Give an instance you contributed actively to a group problem and what was the result?

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

[employee comments]
MULTI-TASKING:

What system do you use to keep track of multiple projects? How has this helped you 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 often do you organize safety training programs for your employees? How has this helped the employees and the company at large?

If you were chosen to conduct a company's safety audit, how would you go about it?

[employee comments]
EMPATHY:

Can you think of a time when you had to deliver less than ideal news? How did you go about it?

Why is it important for employees to show empathy towards each other as well as towards their customers?

[employee comments]
ATTENTION TO DETAIL:

Is there a time you identified an error that had been overlooked by a colleague? What did you do to fix it?

Can you describe a time when you were able to produce quality work when under pressure? How did you go about ensuring the quality of your work?

[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?

Have you ever been overloaded with work? How do you manage your work so that it gets done on time?

[employee comments]
PERSONAL ACCOUNTABILITY:

Give an example of a time when despite carefully planning, things did not turn out as expected or went out of hand. What did you do?

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

[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:

Is there a time when you have had to persuade a group of managers to accept your proposal or idea? How did you go about it?

In your opinion, which is the best time to persuade others? Explain your answer

[employee comments]
USING COMMON SENSE:

When is the last time you failed in a project because you did not use common sense? How did you rise up?

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

[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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