Youth Advocate Programs, Inc

Youth Advocate Programs, Inc.

Program Director Performance Evaluation Form

☐90 Day Performance Evaluation☐ Annual Performance Evaluation

Employee Name (Print):

Program Number:

Ultipro # (5 digits):

Review Period Start Date:

Review Period End Date:

Instructions: Evaluate each employee according to the following scale. Written comments should explain the factual basis of the rating in each category, including the overall appraisal.

ExceptionalEmployee far exceeds requirements and expectations.

OutstandingEmployee regularly exceeds the requirements of the job.

GoodEmployee meets all job requirements and may exceed them at times.

Needs improvementEmployee needs improvement to meetjob requirements.

InadequateEmployee has consistently been unable to do the job.

Supervision:

Provides weekly supervision to staff.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Provides timely performance evaluations to staff (i.e. 90 day and annually).

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Provides staff with short term and long term goals and objectives.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Program and Fiscal Management:

Meets the CEO expectations of percentage (%) of service hours and the number (#) of kids and families served.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Is familiar with all contracts associated to the program (i.e. over/under utilization, rates of services, and compliant with all requirements).

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Manages overall program cost (i.e. overtime and write offs).

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Outcomes:

Entry and Post discharges are completed in a timely manner.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Program meets performance target as determined by the PQI standards.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Quarterly/annual reports and analysis of forensic review are being performed.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

The Support Center:

Understand the roles/function of each TSC department.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Works in a cooperative manner with all departments.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Provides timely response to TSC requests.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Documentation:

Completes YAP and state mandated paperwork in a timely manner (i.e. new hire paperwork, exit interview)

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Completes monitoring and audits as directed by YAP and RA contract terms.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Special Incidents Reports are completed and submitted according to YAP and RA standards.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Community Connections and System Change:

Demonstrates strong community collaboration (i.e. community events, RA relationships, school engagement).

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Promotes “VOICE” activities.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Develop and maintains strong advisory boards.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Individualized Service Planning:

Ensure that ISP goals are developed and implemented in partnership with child and family team.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Utilizes strength based tools for safety planning and effective advocate matching.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Develop community resources for support work and the “go to” people.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Marketing:

Pursues program growth and development.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Performs presentations in the community routinely.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Expands program through strategic planning for saturation.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Advocates and Staffing Activities:

Continues ongoing recruitment/ hiring of staff and finding support work sites.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☒ / Inadequate
☐
Comments:

Maintains a cultural competent environment.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☒ / Inadequate
☐
Comments:

Ensures that staff are doing the required hours (i.e. individual/group time or billable and nonbillable)

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Training:

Ensures that all staff arecompliant with all mandated training requirements (i.e. BAT, YAP/Wrap, IC or other specified trainings).

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Provides opportunities for staff development and training.

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Overall Job Performance Rating:

Exceptional
☐ / Outstanding
☐ / Good
☐ / Needs Improvement
☐ / Inadequate
☐
Comments:

Future Goals:

1.

2.

3.

______

Employee SignatureDate

______

Supervisor SignatureDate

Created April 2014