Center for Discovery and Adolescent Change

Counselor Performance Review

Employee Name:______Date of Review: ______Hire Date: ______

Job Title:______Supervisor/Reviewer:______

Assign a score for each category, 1 through 4, tally all scores and enter in the space at the bottom of the evaluation. There are a total of 100 possible.

1. Goals and knowledge Score: ____/ 16

  1. _____Possesses a comprehensive knowledge of Center for Discovery’s programs, services and schedules
  1. _____Knows and complies with the treatment program’s and division’s expectations, visions and values
  1. _____Has developed a knowledge of treatment program, and has become knowledgeable relative to adolescent mental health
  1. _____Has developed understanding of the program schedule, the various groups and interventions therein and is able to assume leadership of any group listed in the daily program schedule.

2. Performance and development Score: ____/ 44

  1. _____Counselor is able to present didactic/psycho-educational groups and workshops in a clear and knowledgeable manner.
  1. _____Counselor provide milieu leadership and supervision in an effective and open approach that invited clients to join and participate.
  1. _____Possesses understanding and is able to communicate knowledgably relative to diagnosis as well as being able to document and describe observations clearly.
  1. _____Exercises initiative in creating new opportunities and tools to support the program and its clients.
  1. _____Has identified specific area/s for overall improvement.
  1. _____Counselor finds appropriate coverage for shifts and informs the supervisor if unable to complete a shift.
  1. ____Is aware of safety and security issues and supports improvement.
  1. _____Counselor consistently demonstrates superior judgment when dealing with clients.

Employee Name:______

  1. _____ Employee utilizes credit cards, petty cash, and company expenses in an efficient and responsible manner, provides receipts and obtains approval for unusual cash expenditures
  1. _____Counselor is prompt for all shifts, meetings, in-services, and trainings.
  1. _____ Counselor assists when requested with conducting tours, visits, etc

3. Communication and reporting Score: ____/ 16

  1. _____Counselor works well within the treatment team structure.
  1. _____Counselor receives supervision and director openly and is able to implement suggestions.
  1. _____Communicates needs, concerns, asks questions and seeks guidance from supervisor when uncertain
  1. _____ Counselor addresses staff and professionals in an appropriate and timely manner, speaking respectfully and listening closely

4. Interaction and work habits Score: ____/ 24

  1. _____Responds to supervisor, team, staff and professionals in a constructive, non-defensive, mature and professional manner
  1. _____Responds promptly to feedback from supervisor and shows dedication and motivation to improve
  1. _____ Is willing to serve and goes above and beyond what is expected in most situations
  1. _____ Counselor is appropriately dressed for a professional setting, and in compliance with the employee dress code.
  1. _____ Counselor works effectively within the team setting, demonstrating willingness to be flexible with fellow team members when indicated and avoids needless conflict.
  1. _____ Counselor follows rules, protocol requirements and guidelines set forth for all employees at the Center for Discovery

Employee Name:______

Overall Performance Summary:Score: ______Pay Increase______%

______

Things I need from you in the coming year:

1.______2.______

3.______

Things you need from me in the coming year:

1.______

2.______

3.______

Employee Comments: ______

______

______

Employee SignatureDate

______

Supervisor SignatureDate

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Revised 7/3/06

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