The 2015 performance evaluation period is upon us. This review is for calendar year 2015. Please review the instructions below carefully to successfully complete the evaluation process:

Evaluation Form. All evaluations must be completed using the form below.

·  The form can be completed and electronically signed OR printed and signed.

·  The self-evaluation is voluntary, though recommended.

Due Date. All evaluation forms must be submitted via email is March 4, 2016.

·  The employee should keep a copy of the performance evaluation and self-evaluation forms.

·  The supervisor should email the originals to for inclusion in the employee’s personnel file. Use email subject “2015 Performance Evaluation”.

·  For employees who have been with Dornsife less than ninety (90) days, a performance evaluation is not required, but may be completed and submitted for the employee’s personnel file.

Ratings. Each box on the form should have a rating of 1 or greater. Use rating “0” only if the competency is not applicable. To calculate overall rating:

·  For employees who are non-supervisor, add the total score of sections 1-9 then divide by the number of boxes rated 1 or greater.

·  For employees who are supervisor (including those who supervise students), add the total score of sections 1-10 then divide by the number of boxes rated 1 or greater.

·  Examples: The total score is 30. (a) Only 7 boxes are rated 1 or greater and 2 boxes are rated 0 (not applicable). Your overall score would be 30/7 = 4.29. (b) All 9 boxes are rated 1 or greater, then the overall rating would be 30/9 = 3.33.

Employee-Supervisor Meeting. Once the evaluation form has been completed, the supervisor and employee should meet to discuss the self-evaluation and supervisor’s evaluation. A discussion of goals and objectives for the upcoming year should take place at this meeting. Add the work objectives discussed to the end of the evaluation form.

·  The employee is strongly encouraged to self-evaluate by filling out the same form before the meeting. This will provide discussion points for employee and supervisor.

·  The supervisor and employee should sign the performance evaluation form.

·  If the employee refuses to sign the evaluation, a note indicating the refusal and date should be written on the signature line.

Date / Evaluation Year / 2015
Employee / Supervisor
Job Title / Supervisor Title
Employee # / Completed by / £ Employee £ Supervisor

1.  WORK OBJECTIVES FROM PREVIOUS YEAR (if applicable)

2.  PERFORMANCE RATING

Rating Definitions 0 – Not Applicable 2 – Meets Some Expectations 4 – Exceeds Some Expectations

1 – Below Expectations 3 – Meets Expectations 5 – Exceeds Expectations

An OVERALL rating below 2.5 or above 4.75 MUST include written justification in the COMMENTS/OBSERVATION section.

0 / 1 / 2 / 3 / 4 / 5
1. Quality of Work/Productivity
Produces results and/or provides services consistent with defined University standards for position. Takes initiative and produces work that is consistent with defined productivity standards for the position. / £ / £ / £ / £ / £ / £
2. Reliability/Accountability
Demonstrates reliability, dependability and accountability in all aspects of the defined role. / £ / £ / £ / £ / £ / £
3. Integrity/Ethics
Operates in accordance with USC policies and applicable laws and exhibits conduct consistent with USC’s Code of Ethics. / £ / £ / £ / £ / £ / £
4. Communication
Is effective in interpersonal interactions as well as communicating both verbally and in writing. / £ / £ / £ / £ / £ / £
5. Customer Service/Customer Focus
Effectively applies knowledge of departmental service or product to best satisfy the customer’s needs and expectations. / £ / £ / £ / £ / £ / £
6. Problem Solving/Decision Making
Builds a logical approach to address problems and/or manage the situation at hand by drawing on one's knowledge and experience, calling on other references and resources as necessary. / £ / £ / £ / £ / £ / £
7. Creativity/Innovation
Thinks and operates creatively. Seeks out new responsibilities; acts on opportunities. Has significant impact in creating breakthrough products or services that fulfill an institutional need. / £ / £ / £ / £ / £ / £
8. Teamwork/Collaboration
Behaviors include: collegiality, productive team interactions, and contributions to accomplishing unit /departmental goals. / £ / £ / £ / £ / £ / £
9. Legal and Regulatory Compliance
Awareness of applicable laws and regulations, adherence to standards and requirements, holds self and others accountable for compliance, cooperates with investigations and audits. / £ / £ / £ / £ / £ / £
OVERALL RATING
Add the rating of sections 1-9 and divide by the number of boxes rated 1 or greater = / For non-supervisors

3.  PERFORMANCE RATING FOR SUPERVISORS

Complete this section if you are evaluating staff with supervisor responsibilities. / 0 / 1 / 2 / 3 / 4 / 5
10. Leadership
Establishes vision, strategic direction, maintains high-performance culture, supports continuous learning, Thinks and operates creatively. Seeks out new responsibilities; acts on opportunities. Has significant impact in creating breakthrough products or services that fulfill an institutional need. Effectively applies knowledge of departmental service or product to best satisfy the customer’s needs and expectations. / £ / £ / £ / £ / £ / £
OVERALL RATING
Add the rating of sections 1-11 and divide by the number of boxes rated 1 or greater / For supervisors

4.  COMMENTS/OBSERVATIONS AND RECOMMENDATIONS for work objectives, projects, or performance improvement.

5.  WORK OBJECTIVES / STAFF DEVELOPMENT & PLANNING

List below three work objectives for the coming year.

The list may include objectives from the previous year’s evaluation carried forward.

Included in Last Year’s Evaluation?
£ Yes
£ Yes
£ Yes

6.  I acknowledge that I have been provided a copy of my performance evaluation. (Optional: Attach staff feedback.)

Employee Signature / Date
Supervisor Signature / Date