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Feedback for Staff Review and Development

Instructions

You may use this optional form to solicit feedback about your performance or your team or employee’s performance. This feedback can then be used as input for the annual Staff Review and Development Plan.
To use this form:

·  Complete the information in the two boxes in this document.

·  Distribute the form to each appropriate individual who has had an opportunity to observe your performance or your team or employee’s performance at work.

Employee Job Title
College/Dept Review Period
Person Providing Feedback Job Title

Performance Factors

Instructions for the Person Providing Feedback

Please complete and return this form to provide feedback that should be used as input to the employee’s annual Staff Review and Development Plan.
The following performance factors reflect Penn State values and priorities. Please consider these factors when providing input about any employee’s performance during the review period.

Job Knowledge: Demonstrates the appropriate specialized knowledge required to perform the job; effectively performs duties and responsibilities; keeps current with new developments in areas of responsibility

Judgment and Problem Solving: Anticipates and identifies problems; gathers facts and analyzes causes; evaluates alternative solutions; takes or recommends actions; follows up, to ensure problem resolution

Self-Management: Produces services/output efficiently; effectively uses time and meets deadlines; is punctual and reliable; works effectively with directions given; takes initiative; provides acceptable volume of work

Teamwork: Shares information and resources with others; gives timely responses to requests made by others; interacts well with all individuals; establishes and maintains effective working relationships; promotes teamwork and values the group’s success

Quality: Effectively produces a caliber of work consistent with established departmental standards; completes work thoroughly and accurately; pays attention to detail; contributes to the improvement of the quality of services provided by the University

Support of Diversity: Demonstrates a respect for the value of individuals regardless of their background or culture; contributes to processes that create and support a diverse environment; participates in diversity programming and activities

Customer Service: Effectively represents the University to students, parents, faculty, staff, patients, alumni, and other customers of the University; understands and constructively responds to customer needs

Communication: Effectively conveys ideas, information, and/or instructions to others; listens attentively and clarifies information when necessary; participates in meetings effectively; contributes to establishing a favorable communication environment; understands instruction

Supervision (if applicable): Effectively directs and oversees the performance of others; clearly communicates goals; appropriately manages staff relations and development; effectively solicits, encourages, and manages process improvements in unit.

Optional Unit-Specific Factors (if applicable)

The employee’s work unit has defined the following factor(s) as additional performance criteria that are vital to the individual’s position. Please consider these factors when providing input about the employee’s performance.
Factor
Factor
Performance Feedback and Suggestions for Development

Objective, constructive feedback is essential to the continuing development of employee as well as team productivity and performance. Considering all relevant performance factors and standards, please discuss employee strengths and needs that you have had the opportunity to observe. Be sure to emphasize suggestions for further development of both strengths and opportunities. When describing the employee’s (or team’s) level of performance, the following words may be helpful: significantly exceeds expectations; exceeds expectations; meets expectations; partially meets expectations and does not meet expectations.

Strengths and accomplishments; opportunities for growth and development:

Optional Overall Evaluation

[You may leave the Overall Evaluation blank if you prefer to do so.] Considering all of the behaviors that you have observed, indicate the definition that best describes this employee’s overall contribution during the review period.

______Significantly exceeds expectations

Exceeds expectations

Meets expectations

Partially meets expectations

Does not meet expectations

Signature of Person Providing Feedback Date

Please return your written feedback before ______to the following person:
Name
Address

To support the employee’s continuing professional development, please consider discussing your feedback directly with the employee. Thank you for your time and cooperation.