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Section I:\nEmployee InformationCheck\nOne☐ Full-Time\n☐ Part-TimeCheck\nOne☐ Probationary Review\n☐ Annual Review
Employee\nNameDepartmentProbationary\n90-180 Day\nReview☐ 90 ☐ 180\n☐ Other: ______
Employee\nID #Job TitleEvaluation\nPeriod
Section II: Employee Self-Assessment (To be completed by employee before meeting with supervisor)
Please complete the Employee Self-Assessment to evaluate your performance, accomplishments, and goals for the specified period by filling out the sections below.
1. How would you assess your effectiveness in leading your team or meeting departmental objectives? Provide examples of significant decisions you made and their outcomes.
2. Evaluate your communication skills and ability to foster collaboration within your team and across departments. What strategies have you used to improve teamwork and resolve conflicts?
3. What steps have you taken to enhance your skills and professional development? Are there specific areas where you feel additional training or resources would benefit your role?
4. What topics would you like to discuss with your supervisor during your evaluation?
5. Identify areas where you believe you could improve your performance or contribute more effectively. What support or resources would help you address these areas?
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"html_text": "Check\nOne", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 499.52, 680.576, 591.84, 727.44 ], "text": "☐ Probationary Review ☐ Annual Review", "html_text": "☐ Probationary Review\n☐ Annual Review", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": true, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 1, "location": [ 37.92, 633.712, 591.84, 680.576 ], "cells": [ { "location": [ 37.92, 633.712, 130.24, 680.576 ], "text": "Employee Name", "html_text": "Employee\nName", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 130.24, 633.712, 222.56, 680.576 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 222.56, 633.712, 314.88, 680.576 ], "text": "Department", "html_text": "Department", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 314.88, 633.712, 407.2, 680.576 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 407.2, 633.712, 499.52, 680.576 ], "text": "Probationary 90-180 Day Review", "html_text": "Probationary\n90-180 Day\nReview", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 499.52, 633.712, 591.84, 680.576 ], "text": "☐ 90 ☐ 180 ☐ Other: ______", "html_text": "☐ 90 ☐ 180\n☐ Other: ______", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 2, "location": [ 37.92, 586.848, 591.84, 633.712 ], "cells": [ { "location": [ 37.92, 586.848, 130.24, 633.712 ], "text": "Employee ID #", "html_text": "Employee\nID #", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 130.24, 586.848, 222.56, 633.712 ], "text": "", "html_text": "", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 222.56, 586.848, 314.88, 633.712 ], "text": "Job Title", "html_text": "Job Title", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 314.88, 586.848, 407.2, 633.712 ], "text": "", "html_text": "", "links": [], "cell_header_index": 3, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 407.2, 586.848, 499.52, 633.712 ], "text": "Evaluation Period", "html_text": "Evaluation\nPeriod", "links": [], "cell_header_index": 4, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" }, { "location": [ 499.52, 586.848, 591.84, 633.712 ], "text": "", "html_text": "", "links": [], "cell_header_index": 5, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 3, "location": [ 37.92, 539.984, 591.84, 586.848 ], "cells": [ { "location": [ 37.92, 539.984, 591.84, 586.848 ], "text": "Section II: Employee Self-Assessment (To be completed by employee before meeting with supervisor)", "html_text": "Section II: Employee Self-Assessment (To be completed by employee before meeting with supervisor)", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 4, "location": [ 37.92, 493.12, 591.84, 539.984 ], "cells": [ { "location": [ 37.92, 493.12, 591.84, 539.984 ], "text": "Please complete the Employee Self-Assessment to evaluate your performance, accomplishments, and goals for the specified period by filling out the sections below.", "html_text": "Please complete the Employee Self-Assessment to evaluate your performance, accomplishments, and goals for the specified period by filling out the sections below.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 5, "location": [ 37.92, 446.256, 591.84, 493.12 ], "cells": [ { "location": [ 37.92, 446.256, 591.84, 493.12 ], "text": "1. How would you assess your effectiveness in leading your team or meeting departmental objectives? Provide examples of significant decisions you made and their outcomes.", "html_text": "1. How would you assess your effectiveness in leading your team or meeting departmental objectives? Provide examples of significant decisions you made and their outcomes.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 6, "location": [ 37.92, 399.392, 591.84, 446.256 ], "cells": [ { "location": [ 37.92, 399.392, 591.84, 446.256 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 7, "location": [ 37.92, 352.528, 591.84, 399.392 ], "cells": [ { "location": [ 37.92, 352.528, 591.84, 399.392 ], "text": "2. Evaluate your communication skills and ability to foster collaboration within your team and across departments. What strategies have you used to improve teamwork and resolve conflicts?", "html_text": "2. Evaluate your communication skills and ability to foster collaboration within your team and across departments. What strategies have you used to improve teamwork and resolve conflicts?", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 8, "location": [ 37.92, 305.664, 591.84, 352.528 ], "cells": [ { "location": [ 37.92, 305.664, 591.84, 352.528 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 9, "location": [ 37.92, 258.8, 591.84, 305.664 ], "cells": [ { "location": [ 37.92, 258.8, 591.84, 305.664 ], "text": "3. What steps have you taken to enhance your skills and professional development? Are there specific areas where you feel additional training or resources would benefit your role?", "html_text": "3. What steps have you taken to enhance your skills and professional development? Are there specific areas where you feel additional training or resources would benefit your role?", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 10, "location": [ 37.92, 211.936, 591.84, 258.8 ], "cells": [ { "location": [ 37.92, 211.936, 591.84, 258.8 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 11, "location": [ 37.92, 165.072, 591.84, 211.936 ], "cells": [ { "location": [ 37.92, 165.072, 591.84, 211.936 ], "text": "4. What topics would you like to discuss with your supervisor during your evaluation?", "html_text": "4. What topics would you like to discuss with your supervisor during your evaluation?", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 12, "location": [ 37.92, 118.208, 591.84, 165.072 ], "cells": [ { "location": [ 37.92, 118.208, 591.84, 165.072 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 13, "location": [ 37.92, 71.344, 591.84, 118.208 ], "cells": [ { "location": [ 37.92, 71.344, 591.84, 118.208 ], "text": "5. Identify areas where you believe you could improve your performance or contribute more effectively. What support or resources would help you address these areas?", "html_text": "5. Identify areas where you believe you could improve your performance or contribute more effectively. What support or resources would help you address these areas?", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" }, { "row_index": 14, "location": [ 37.92, 24.48, 591.84, 71.344 ], "cells": [ { "location": [ 37.92, 24.48, 591.84, 71.344 ], "text": "", "html_text": "", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 6, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/0" } ], "ref": "#/tables/0" } ], "n_rows": 15, "n_cols": 6, "ref": "#/tables/0", "reading_order": 1 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 293.04, "t": 717.72, "r": 302.52, "b": 709.2 }, "text": "Full-Time", "field_kind": "checkbox", "label": "Full-Time", "pdf_field_name": "FullTime", "pdf_field_type": "CheckBox", "reading_order": 2 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 468.24, "t": 716.88, "r": 479.28, "b": 709.56 }, "text": "Probationary Review", "field_kind": "checkbox", "label": "Probationary Review", "pdf_field_name": "Probationary Review", "pdf_field_type": "CheckBox", "reading_order": 3 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 293.04, "t": 703.08, "r": 302.52, "b": 694.56 }, "text": "Part-Time", "field_kind": "checkbox", "label": "Part-Time", "pdf_field_name": "PartTime", "pdf_field_type": "CheckBox", "reading_order": 4 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 468.24, "t": 702.6, "r": 479.28, "b": 695.28 }, "text": "Annual Review", "field_kind": "checkbox", "label": "Annual Review", "pdf_field_name": "Annual Review", "pdf_field_type": "CheckBox", "reading_order": 5 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 287.16, "t": 687.48, "r": 395.64, "b": 657.6 }, "text": "Full-Time Part-Time_Department", "field_kind": "text", "label": "Full-Time Part-Time_Department", "pdf_field_name": "FullTime PartTimeDepartment", "pdf_field_type": "Text", "reading_order": 6 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 107.16, "t": 685.32, "r": 226.44, "b": 656.52 }, "text": "Employee Name", "field_kind": "text", "label": "Employee Name", "pdf_field_name": "Employee Name", "pdf_field_type": "Text", "reading_order": 7 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 499.2, "t": 684.48, "r": 508.68, "b": 675.96 }, "text": "180", "field_kind": "checkbox", "label": "180", "pdf_field_name": "180", "pdf_field_type": "CheckBox", "reading_order": 8 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 468.6, "t": 683.28, "r": 479.64, "b": 675.96 }, "text": "90", "field_kind": "checkbox", "label": "90", "pdf_field_name": "90", "pdf_field_type": "CheckBox", "reading_order": 9 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 513, "t": 673.8, "r": 551.52, "b": 660.36 }, "text": "undefined", "field_kind": "text", "label": "undefined", "pdf_field_name": "undefined", "pdf_field_type": "Text", "reading_order": 10 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 468.36, "t": 668.88, "r": 479.4, "b": 661.56 }, "text": "Other", "field_kind": "checkbox", "label": "Other", "pdf_field_name": "Other", "pdf_field_type": "CheckBox", "reading_order": 11 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 287.16, "t": 653.28, "r": 395.64, "b": 623.16 }, "text": "Full-Time Part-Time_Job Title", "field_kind": "text", "label": "Full-Time Part-Time_Job Title", "pdf_field_name": "FullTime PartTimeJob Title", "pdf_field_type": "Text", "reading_order": 12 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 463.8, "t": 653.28, "r": 590.88, "b": 623.16 }, "text": "90 180 Other:_Evaluation Period", "field_kind": "text", "label": "90 180 Other:_Evaluation Period", "pdf_field_name": "90 180 OtherEvaluation Period", "pdf_field_type": "Text", "reading_order": 13 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 107.16, "t": 650.64, "r": 226.44, "b": 621.84 }, "text": "Employee ID #", "field_kind": "text", "label": "Employee ID #", "pdf_field_name": "Employee ID", "pdf_field_type": "Text", "reading_order": 14 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 42, "t": 543.36, "r": 590.64, "b": 472.68 }, "text": "1. How would you assess your effectiveness in leading your team or meeting departmental objectives? Provide examples of significant decisions you made and their outcomes._Row_1", "field_kind": "text", "label": "1. How would you assess your effectiveness in leading your team or meeting departmental objectives? Provide examples of significant decisions you made and their outcomes._Row_1", "pdf_field_name": "1 How would you assess your effectiveness in leading your team or meeting departmental objectives Provide examples of significant decisions you made and their outcomesRow1", "pdf_field_type": "Text", "reading_order": 15 }, { "page": 1, "type": "FORM_FIELD", "location": { "l": 42, "t": 444.24, "r": 590.64, "b": 374.4 }, "text": "2. Evaluate your communication skills and ability to foster collaboration within your team and across departments. What strategies have you used to improve teamwork and resolve conflicts?_Row_1", "field_kind": "text", "label": "2. 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Identify areas where you believe you could improve your performance or contribute more effectively. What support or resources would help you address these areas?_Row_1", "field_kind": "text", "label": "5. Identify areas where you believe you could improve your performance or contribute more effectively. 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Successful:Employee consistently performed job duties; work and behavior expectations consistently met; met performance goals and supervisor's expectations; completed and verified own work in a timely, accurate and thorough manner. Needs Improvement:Employee did not consistently and/or accurately perform job duties; work and/or behavior expectations were not met; did not meet performance goals and/or supervisor's expectations; not consistently reliable in handling daily duties; requires more supervision than expected.", "reading_order": 6 }, { "page": 2, "type": "TITLE", "location": { "l": 39.84, "t": 530.64, "r": 164.16, "b": 518.88 }, "text": "CORE EXPECTATIONS", "reading_order": 7, "level": 3 }, { "page": 2, "type": "TEXT", "location": { "l": 39.12, "t": 518.4, "r": 571.44, "b": 492.48 }, "text": "The evaluating supervisor will assess the employee according to their meeting the core expectations listed below. The evaluating supervisor must rate according to the evaluation rating provided above and provide comments where required.", "reading_order": 8 }, { "page": 2, "type": "TABLE", "location": { "l": 41.04, "t": 492.48, "r": 592.32, "b": 42.96 }, "text": "
CORE EXPECTATIONSRATINGEVALUATING SUPERVISOR'S COMMENTS
Leadership and Decision-Making:\nDemonstrates strong leadership by setting clear goals, making informed decisions, and fostering a positive and productive work environment. Leads by example and inspires accountability within their teams.☐ Excellent\n☐ Successful\n☐ Needs Improvement
Strategic Planning and Execution:\nDevelops, implements, and evaluates strategies and processes that align with the KSU's mission and objectives. Effectively manages resources to meet deadlines and deliver results.☐ Excellent\n☐ Successful\n☐ Needs Improvement
Communication and Collaboration:\nExhibits excellent communication skills, ensuring clear, professional, and timely interactions with university faculty, staff, students, and community members. Encourages collaboration and works effectively across departments to achieve KSU goals.☐ Excellent\n☐ Successful\n☐ Needs Improvement
Ethical and Professional Conduct:\nUpholds the highest standards of integrity, confidentiality, and professionalism. Ensures compliance with institutional policies and regulations while fostering an inclusive and respectful workplace.☐ Excellent\n☐ Successful\n☐ Needs Improvement
Adaptability and Flexibility:\nResponds positively to changing circumstances, priorities, and needs within the university environment.☐ Excellent\n☐ Successful\n☐ Needs Improvement
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Leads by example and inspires accountability within their teams.", "html_text": "Leadership and Decision-Making:\nDemonstrates strong leadership by setting clear goals, making informed decisions, and fostering a positive and productive work environment. Leads by example and inspires accountability within their teams.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" }, { "location": [ 224.8, 342.64, 408.56, 417.56 ], "text": "☐ Excellent\n☐ Successful\n☐ Needs Improvement", "html_text": "☐ Excellent\n☐ Successful\n☐ Needs Improvement", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" }, { "location": [ 408.56, 342.64, 592.32, 417.56 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" } ], "ref": "#/tables/2" }, { "row_index": 2, "location": [ 41.04, 267.72, 592.32, 342.64 ], "cells": [ { "location": [ 41.04, 267.72, 224.8, 342.64 ], "text": "Strategic Planning and Execution:\nDevelops, implements, and evaluates strategies and processes that align with the KSU's mission and objectives. Effectively manages resources to meet deadlines and deliver results.", "html_text": "Strategic Planning and Execution:\nDevelops, implements, and evaluates strategies and processes that align with the KSU's mission and objectives. Effectively manages resources to meet deadlines and deliver results.", "links": [], "cell_header_index": 0, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" }, { "location": [ 224.8, 267.72, 408.56, 342.64 ], "text": "☐ Excellent\n☐ Successful\n☐ Needs Improvement", "html_text": "☐ Excellent\n☐ Successful\n☐ Needs Improvement", "links": [], "cell_header_index": 1, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" }, { "location": [ 408.56, 267.72, 592.32, 342.64 ], "text": "", "html_text": "", "links": [], "cell_header_index": 2, "rowspan": 1, "colspan": 1, "column_header": false, "row_header": false, "placeholder": false, "ref": "#/tables/2" } ], "ref": "#/tables/2" }, { "row_index": 3, "location": [ 41.04, 192.8, 592.32, 267.72 ], "cells": [ { "location": [ 41.04, 192.8, 224.8, 267.72 ], "text": "Communication and Collaboration:\nExhibits excellent communication skills, ensuring clear, professional, and timely interactions with university faculty, staff, students, and community members. 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Overall Evaluation Rating
☐ Excellent☐ Successful☐ Needs Improvement
PERFORMANCE EVALUATION SUMMARY\nThe evaluating supervisor will determine an overall evaluation rating and provide a brief narrative that summarizes the employee's work performance, accomplishments or areas needing improvement during this evaluation period. If a rating of excellent or needs improvement is chosen, the evaluating supervisor must provide justification for the rating.
Overall Evaluation Signatures
OVERALL EVALUATION SIGNATURES\nThe evaluating supervisor should review the evaluation with the employee and discuss the evaluation ratings. Any ratings of needs improvement, the supervisor will provide the employee an improvement plan.
Print NameSignatureDate
Employee
Evaluating Supervisor
Office of Human Resources
If the employee chooses not to sign the performance evaluation, they should use the employee's comments section or attach additional documentation to explain the reason they do not wish to sign the evaluation.
EMPLOYEE COMMENTS\nThe employee will use the comment section below to make any comments specific professional about their evaluation and supervisor. This area can also be used to explain if the employee does not wish to sign the evaluation.
GOALS\nThe following goals have been agreed to by the employee and supervisor for the next performance evaluation period.\nThere must be at least three goals listed.
1.
2.
3.
4.
5.
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