Eval Form

Page 1

CITY OF LOS ANGELES EMPLOYEE EVALUATION REPORT Employee Copy Personnel Copy

PDAS-28E (Rev. 03/09)

Page 1

LAST NAME

FIRST NAME

EMPLOYEE NO.

DEPARTMENT

DIVISION/SECTION

CLASS CODE

REASON FOR RATING

PROBATIONARY

ANNUAL

OTHER (Please specify):

RATING PERIOD

SUPERVISOR NAME

This evaluation is based on my observation and knowledge of the employee's performance during the stated rating period, and represents my best judgment of his/her performance.

Unsatisfactory

Improvement Needed

Meets Standard

Terminate

Continue Probation

Complete Probation

Exceeds Standard

Outstanding

OVERALL EVALUATION

PROBATION RECOMMENDATION

DATE

RATER

(mm/dd/yyyy)

I have reviewed this evaluation and concur with it. DATE

REVIEWER

(mm/dd/yyyy)

This report has been discussed with me and I have received a copy of this evaluation. My signature does not indicate agreement with the rating.

EMPLOYEE'S SIGNATURE

DATE

(mm/dd/yyyy)

For additional Detail of Assignment go to Page 3.

DETAIL OF ASSIGNMENT (Basis for Evaluation): Please detail the tasks and duties assigned to the employee being evaluated.

RATING SCALE Based on observation during the rating period, the employee is being rated using the below scale: Outstanding

- Performance factor was consistently demonstrated at an exceptionally high level.

Exceeds Standards

- Performance factor was consistently demonstrated at a high level.

Meets Standards

- Performance factor was consistently demonstrated at a satisfactory level.

Need Improvement

- Performance factor was demonstrated at less than a satisfactory level.

Unsatisfactory

- Performance factor was demonstrated at an unsatisfactory level.


PDAS-28E (Rev. 03/09)

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RATE EACH FACTOR: Unsatisfactory

Improvement Needed

Meets Standard

Exceeds Standard

Outstanding

1. QUANTITY OF WORK Completes a large amount of work in a timely manner.

2. QUALITY OF WORK Completes work in an accurate and thorough manner.

3. ORAL COMMUNICATION Communicates orally in a clear, concise, and effective manner.

4. WRITTEN COMMUNICATION Communicates in writing in a clear, concise and effective manner.

5. WORK HABITS Consistently complies with assigned work schedule; maintains productivity during scheduled work hours; follows safety rules and other instructions; plans and performs work in a well-organized manner that maximizes use of time and materials.

6. PERSONAL RELATIONS Interacts effectively and appropriately with co-workers, supervisors, other City employees, members of the public.

7. ADAPTABILITY Performs usual work with minimal instruction, and performs effectively in new and/or emergency situations.

8. OTHER (Specify)

For additional Comments or Suggestions go to Page 3.

COMMENTS: Specific comments are to be provided regarding the employee's performance during the rating period.

SUGGESTIONS FOR EMPLOYEE DEVELOPMENT: Indicate suggestions for the employee's development prior to the next rating period.


PDAS-28E (Rev. 03/09)

DETAIL OF ASSIGNMENT (Basis for Evaluation):

Page 3

Please detail the tasks and duties assigned to the employee being evaluated.

COMMENTS: Specific comments are to be provided regarding the employee's performance during the rating period.

SUGGESTIONS FOR EMPLOYEE DEVELOPMENT: Indicate suggestions for the employee's development prior to the next rating period.


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